Fertility issues in women

Infertility may be caused by a variety of factors. One in four couples cannot identify a reason.


Infertility is defined as the inability to conceive after at least a year of regular, unprotected sexual activity.

Approximately one-third of the time, infertility is caused by female causes and one-third of the time by both female and male factors. In the other instances, the etiology is either unknown or a mix of male and female variables.

Female infertility reasons might be difficult to diagnose. Various therapies exist, depending on the reason of infertility. Many infertile couples will eventually get pregnant without therapy.


Inability to conceive is the primary manifestation of infertility. A lack of ovulation may be indicated by a menstrual cycle that is too long (35 days or more), too short (less than 21 days), irregular, or missing. There may be no other symptoms.

Ovulation difficulties are a frequent cause of infertility (the monthly release of an egg from the ovaries).

Some difficulties prohibit an egg from being released at all, while others prevent it just during certain cycles.

Ovulation issues may be caused by:

polycystic ovary syndrome (PCOS)

Thyroid issues – both hyperactive and hypoactive thyroid glands might impede ovulation

In premature ovarian failure, the ovaries cease functioning before the age of 40.

Surgery causes scarring.

The fallopian tubes, which connect the ovaries to the uterus, may be damaged or scarred by pelvic surgery.

Occasionally, cervical surgery may also cause scarring or shorten the womb’s neck (the cervix).

Cervical mucus issues

Mucus in the cervix grows thinner during ovulation, allowing sperm to swim through it more readily. If there is an issue with the mucus, it might be more difficult to conceive.


In or around the womb, noncancerous growths called fibroids may impair fertility. In certain instances, they may prevent a fertilized egg from implanting in the uterus, or they may obstruct a fallopian tube.


Endometriosis is a disorder in which fragments of the uterine lining (the endometrium) begin to develop in other organs, such as the ovaries.

This may harm the ovaries or fallopian tubes, resulting in infertility.

Pelvic inflammatory condition

PID is an infection of the upper female genital tract, which consists of the uterus, fallopian tubes, and ovaries.

It is often the result of a sexually transmitted illness (STI). PID may cause scarring and damage to the fallopian tubes, making it almost hard for an egg to reach the uterus.


If they do not want to have any more children, some women opt to get sterilised.

Sterilisation involves restricting the fallopian tubes to prevent an egg from reaching the uterus.

Rarely is sterilisation reversible, and even if it is, you may not be able to conceive a child.

Medications and pharmaceuticals

Some medication and drug side effects might have an influence on fertility. These consist of:

non-steroidal anti-inflammatory drugs (NSAIDs) – the long-term use or high dosage of NSAIDs, such as ibuprofen or aspirin, can make it more difficult to conceive chemotherapy – medicines used for chemotherapy can occasionally cause ovarian failure, which means your ovaries will no longer function properly

Neuroleptic drugs – antipsychotic drugs that are often used to treat psychosis – may sometimes induce missing periods or infertility.

spironolactone is a medication used to treat fluid retention (oedema); fertility should return around two months after discontinuing spironolactone.

Illegal substances, such as marijuana and cocaine, may have a negative impact on fertility and make ovulation more challenging.


What is infertility among women?

Infertility is a disorder in which the capacity to get pregnant and give birth is hampered or restricted. For heterosexual couples (male and female), this condition is often discovered after one year of attempting to conceive (but may be diagnosed sooner depending on other factors). One-third of the causes of infertility in heterosexual couples are male-related, one-third are female-related, and one-third are due to a mix of factors or are unknown. When the female spouse is determined to be the cause of infertility, it is referred to as female infertility or “female factor” infertility.

How frequent is infertility among women?

Infertility is a prevalent illness. At least 10% of women experience infertility in some form. The probability of infertility rises as a woman aged.


What causes infertility in women?

There are a multitude of potential reasons of infertility. However, pinpointing the specific reason may be challenging, and some couples experience “unexplained” or “multifactorial” infertility (multiple causes, often both male and female factors). Among the potential reasons of female factor infertility are:

Included in this category are polyps, fibroids, septum, and adhesions inside the uterine cavity. Other abnormalities (such as a septum) are evident at birth but polyps and fibroids may develop spontaneously at any moment. Adhesions may occur after procedures such as dilation and curettage (D&C).

Concerns about the fallopian tubes: Pelvic inflammatory illness, often caused by chlamydia and gonorrhea, is the most prevalent cause of “tubal factor” infertility.

There are several reasons why a woman may not ovulate (release an egg) on a regular basis. Hormonal imbalances, a history of food disorders, alcohol misuse, thyroid disorders, extreme stress, and pituitary tumors are all examples of factors that might interfere with ovulation.

Problems with quantity and quality of eggs: Before menopause, a woman’s egg supply may “run out” prematurely, despite the fact that she is born with an unlimited number of eggs. In addition, some eggs will have an incorrect amount of chromosomes, preventing them from being fertilized or developing into a healthy child. Some of these chromosomal anomalies (such as “balanced translocation”) may harm every egg. Others are random, but increase in frequency as a woman ages.

Who is at risk for infertility in women?

Numerous variables might raise a woman’s risk of infertility. Female infertility may be caused by general health issues, genetic (inherited) characteristics, lifestyle choices, and age. Specific variables may include:

  • Age.
  • An problem with hormones that hinders ovulation.
  • Abnormal menstrual cycle.
  • Obesity.
  • Being underweight.
  • Having a low body-fat percentage due to rigorous exercise.
  • Endometriosis.
  • Structural difficulties (problems with the fallopian tubes, uterus or ovaries).
  • Uterine fibroids.
  • Cysts.
  • Tumors.
  • Autoimmune problems (lupus, rheumatoid arthritis, Hashimoto’s disease, and thyroid gland abnormalities).
  • Sexually transmitted diseases (STIs) (STIs).
  • Polycystic Ovary Disorder (PCOS).
  • Initial Ovary Deficiency (POI).
  • Excessive substance usage (heavy drinking).
  • Smoking.

DES syndrome (DES is a drug given to women to reduce pregnancy issues such as preterm delivery and miscarriage. However, this medicine has caused infertility in certain offspring of DES-using women.

A previous ectopic (tubal) pregnancy.

What effect does aging have on female infertility?

The likelihood of a woman getting pregnant diminishes with age. Age is becoming a more prevalent issue in female infertility, as more couples wait until their 30s or 40s to have children. Women over the age of 35 are more likely to have fertility troubles. Among the causes for this are:

There are less eggs in total.

A greater proportion of eggs contain an aberrant number of chromosomes.

An increased likelihood of contracting further health issues.


What questions will my physician ask to identify female infertility?

Your healthcare professional will need to be aware of your menstrual cycles, previous pregnancies, miscarriages, pelvic discomfort, irregular vaginal bleeding, and vaginal discharge. Additionally, you may be questioned about any previous pelvic infections or sexually transmitted diseases (STIs). Some questions may include:

  • Have you already experienced pregnancy or miscarriage?
  • Is your menstrual cycle regular and painless, or is it painful and irregular?
  • Do you experience excessive or abnormal bleeding?
  • Have you had pelvic pain?
  • Have you ever had abdominal surgery?
  • What tests will my doctor do to detect female infertility?

Some tests may be performed in the office of your healthcare provider as part of a physical exam. These tests may consist of:

  • A general physical examination.
  • A Pap smear.
  • A pelvic exam.
  • An abdominal ultrasound.
  • A breast examination to detect abnormal milk output.

Other testing may need laboratory procedures. These tests may consist of:

  1. The blood tests your doctor orders will depend on your medical history and the potential diagnosis he or she is examining. Examples of laboratory tests include thyroid, prolactin, ovarian reserve, and progesterone tests (a hormone produced during the menstrual cycle that signals ovulation).
  2. X-ray hysterosalpingogram (HSG): A dye is injected into the cervix, and the caregiver uses an X-ray to see how the dye flows through the fallopian tube. This test looks for obstructions.
  3. In laparoscopy, a laparoscope, a tiny monitoring equipment, is put into the belly to examine the organs.
  4. Contrary to an abdominal ultrasound, in which the probe is positioned across the abdomen, this test involves inserting an ultrasound probe into the vagina. It gives the physician a clearer view of organs such as the uterus and ovaries.
  5. Saline sonohysterogram (SIS): This test examines the uterine lining to detect polyps, fibroids, and other structural abnormalities. During a transvaginal ultrasound, the uterus is filled with saline (water) to provide a better view of the uterine cavity for the healthcare professional.
  6. During hysteroscopy, a flexible, camera-equipped instrument called a hysteroscope is introduced into the vagina and into the cervix. The healthcare practitioner inserts it into the uterus to examine the organ’s inside.

Administration and treatment

How is infertility in women treated?

After your healthcare professional has identified female infertility and determined the underlying reason, a number of treatment options are available. The form of therapy is determined on the cause of infertility. Surgical procedures may be performed to correct structural disorders, while hormonal drugs may be used for other diseases (ovulation issues, thyroid conditions).

Many patients will need artificial insemination or in vitro conception (fertilizing eggs with sperm in the lab to make embryos, then transferring the embryo into the uterus).

Adoption and gestational surrogacy may also be available to infertile women who want to establish a family.


Can infertility in women be prevented?

The majority of types of female infertility cannot be foreseen or avoided. However, in certain instances, the risk factors that may lead to infertility may be managed to avoid this illness. Changes in lifestyle, such as limiting alcohol use and stopping smoking, may be advantageous to fertility, as can keeping a healthy weight and engaging in regular physical activity. It is essential to contact your healthcare physician periodically and address any additional concerns you may have for female infertility.


What is the prognosis for infertility in women?

The outlook for female infertility is highly dependent on the person and the underlying cause of the condition. In instances when medicine may cure an ovulatory disorder or a simple surgical operation can fix a structural problem (polyps or single fibroids), the prognosis is typically favorable. Learn more about your prognosis by discussing your family history, risk factors, and underlying medical conditions with your doctor.


When should I see my physician about female infertility?

If you are a woman in a heterosexual relationship with regular intercourse and monthly periods and you have been attempting to conceive (get pregnant) without birth control for 12 months, you should see your doctor (six months if you are over the age of 35). In addition, it is essential to consult your healthcare physician often if you become sexually active.