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Causes For Female Infertility

Causes of infertility in women

There are many causes for infertility in women. Some can be treated with medicines and some with modified lifestyle changes and some require surgery. When the cause is untreatable, the only options can be with the help of donor eggs or surrogacy.
The success rate of treatment in female diagnosed with infertility is about 50%.  In some women, the cause for infertility cannot be found. This is called unexplained infertility (idiopathic infertility).

Problems with the menstrual cycle (ovulation problems)

1 in every 5 women who have problems conceiving naturally has issues with ovulation like

Hormonal issues like the inability to produce mature eggs due to malfunctioning of the hypothalamus or the pituitary gland

Polycystic ovaries (PCOS)

Hyperprolactinemia – The condition of raised levels of prolactin (a pituitary hormone).

Scarred ovaries due to radiation exposure or extensive surgeries
unruptured follicle syndrome

Premature menopause (condition in which ovaries stop producing eggs).

Problems with fallopian tubes

Fallopian tubes can get affected due to the below factors

Infections like STD (sexually transmitted diseases) and tuberculosis (TB)

Abdominal diseases like colitis and appendicitis, which can lead to blockage and scarring of the fallopian tubes.

Ectopic pregnancy that takes place in the fallopian tube is a life threatening condition. Sometimes this kind of pregnancy leads to tubal damage that cannot be reversed.

Surgery of the abdominal or pelvic organs can lead to adhesions that change the tubes in such a way that it is difficult for the eggs to pass through them.

Hydrosalpinx is a kind of blockage of the fallopian tubes in which the tube gets obstructed near its fimbrial end. In such case, fallopian tube is filled with clear watery fluid.

Pyosalpinx is a case in which the blocked tube is acutely inflamed and it is filled up with pus. It can be treated sometimes with the help of antibiotics. If not, then it may rupture and form an abscess in the pelvis in which condition surgery may be needed to remove the tubes.


Endometriosis is a condition in which there is an excessive growth of uterus lining or endometrium. This may occur in the uterus, pelvic peritoneum, abdomen, ovaries, or fallopian tubes. The symptoms of endometriosis may include heavy and painful menstrual periods, premenstrual spotting, urge to urinate, and rectal bleeding. It can be diagnosed with the help of a laparoscopy.

The normal cysts can be removed with the help of hormonal treatment or surgery but in severe cases of endometriosis it can be difficult to treat. In this case, an option can be to undergo an IUI or IVF treatment to have a child.

Heavy bleeding/unusual long periods/early menopause/early miscarriage

Abnormal vaginal bleeding that is different from normal menstrual bleeding with heavy bleeding for long periods (called menorrhagia) and bleeding between periods. In women who are approaching menopause, hormone imbalance problems cause menorrhagia along with irregular cycles (also called dysfunctional uterine bleeding DUB). The other causes include uterine polyps and fibroids.
In women generally the menopause starts in the late forties but in some women the periods may stop in their thirties (that is called early menopause). The symptoms may include night sweats, hot flushes, insomnia, painful intercourse, vaginal drying, loss of libido, urinary infections, skin thinning, nails splitting, pains and aches, incontinence, mood changes, irritation, anxiety, poor memory and concentration.

If it suspects premature menopause, a woman may be referred for a laparoscopy, the ovaries are examined by a laparoscope which allows the doctor to see if there are ovaries that contain follicles with eggs. Women with premature menopause can still become pregnant but through assisted conception only.

Many women conceive after a miscarriage without any problems but it is suggested to wait for 1-3 menstrual cycles after miscarriage to conceive again even when you are ready to conceive physically, as you may not be ready emotionally.

Pelvic Inflammatory Disease (PID)

Infection that causes inflammation in the uterus, Fallopian tubes and ovaries is called pelvic inflammatory disease (PID).  The bacteria that cause Chlamydia and gonorrhea are said to be the primary causes for Pelvic Inflammatory Disease. This infection occurs as a consequence of sexually transmitted Chlamydia, miscarriage, termination, childbirth, or the IUD fitting.

In some women this shows no symptoms other than the difficulty to become pregnant. This is sometimes misdiagnosed of either endometriosis or appendicitis, as the symptoms are similar for both. The symptoms may include abdominal pain across the lower abdomen, high temperature, and very heavy painful periods. This can also cause pain during sex due to a scar.  PID is diagnosed with a laparoscopy and through internal examination. PID is treated with antibiotics and in severe cases the antibiotics are given intravenously in a hospital.

The other factors may include

Fertility in women drops drastically after the age of 35

Life style factors like smoking, drinking, stress, and overweight.
Thyroid problems.
Diabetes and epilepsy.

Abnormal uterus.

Congenital abnormalities such as septate uterus which may lead to miscarriage.

Abnormal cervical mucus because of hormonal imbalance can also leads to infertility.

Sometimes, the exact cause may not be identified even after many tests. Everything seems normal but the reason remains a mystery. In this case of unexplained infertility, fertility therapy that includes drugs with ART (assisted reproductive technology) is opted.

Articles you may be interested in:

Causes for male infertility

Treatments for male infertility

Fertility treatment options for female

Possible complications of infertility treatments

Sperm banking

Surgical Treatment For Female Infertility

Fertility Drugs/medicines

IUI (intrauterine Insemination)

In Vitro Fertilization (ivf)

Third Party Assistance (donors Sper, Donors Egg, Surrogacy)