What causes female infertility?

There are many possible causes of infertility. However, it can be difficult to pinpoint the exact cause, and some couples have “unexplained” infertility or “multifactorial” infertility (multiple causes, often both male and female factors).

Some possible causes of female factor infertility can include:

• Problems with the uterus: This includes polyps, fibroids, septum or adhesions inside the cavity of the uterus. Polyps and fibroids can form on their own at any time, whereas other abnormalities (like a septum) are present at birth. Adhesions can form after a surgery like a dilation and curettage (D&C).
• Problems with the fallopian tubes: The most common cause of “tubal factor” infertility is pelvic inflammatory disease, usually caused by chlamydia and gonorrhea.
• Problems with ovulation: There are many reasons why a woman may not ovulate (release an egg) regularly. Hormonal imbalances, a past eating disorder, substance abuse, thyroid conditions, severe stress and pituitary tumors are all examples of things that can affect ovulation.
• Problems with egg number and quality: Women are born with all the eggs they will ever have, and this supply can “run out” early before menopause. In addition, some eggs will have the wrong number of chromosomes and cannot fertilize or grow into a healthy fetus. Some of these chromosomal issues (such as “balanced translocation”) may affect all of the eggs. Others are random but become more common as a woman gets older.

Who is at risk for female infertility?

Many factors can increase a woman’s risk of female infertility. General health conditions, genetic (inherited) traits, lifestyle choices and age can all contribute to female infertility. Specific factors can include:

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• Hormone issue that prevents ovulation.
• Abnormal menstrual cycle.
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• Being underweight.
• Having a low body-fat content from extreme exercise.
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• Structural problems (problems with the fallopian tubes, uterus or ovaries).
• Uterine fibroids.
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• Autoimmune disorders (lupus, rheumatoid arthritis, Hashimoto’s disease, thyroid gland conditions).
• Sexually transmitted infections (STIs).
• Polycystic Ovary Syndrome (PCOS).
• Primary Ovary Insufficiency (POI).
• Excessive substance use (heavy drinking).
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• A past ectopic (tubal) pregnancy.

In today’s world, postponement of marriage & pregnancy has led to age related infertility due to decrease ovarian reserve in females.