According to WomensHealth.gov, approximately one-third of infertile couples have problems with female infertility. Female infertility can stem from a number of causes. These range from age-related hormonal changes to a history of sexually transmitted infections (STIs).
Many women with fertility problems eventually get pregnant. However, they may need medical help. In some cases, treatment isn’t necessary—many once infertile couples go on to conceive successfully.
One of the biggest risk factors for infertility is age. Once a woman is in her mid-thirties, it’s much harder to get pregnant. This is because egg quality declines significantly after the age of 32. Women over the age of 40 also have an increased risk of having babies with chromosomal abnormalities, such as Down syndrome.
Other risk factors for female infertility include:
- history of STIs
- being significantly overweight
- being significantly underweight
- heavy alcohol use
- high caffeine intake–more than six cups of coffee a day
Lack of ovulation is the primary cause of infertility in women. This is also called anovulation. The Mayo Clinic states that up to 25 percent of female infertility is caused by problems with ovulation.
Without ovulation, no egg is available for fertilization. Pregnancy cannot occur. There are a number of reasons women may have problems with ovulation.
Abnormal Hormone Levels
Hormonal problems can interfere with ovulation in several ways. Eggs may not mature properly. They also may not be released from the ovary.
A combination of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) is responsible for ovulation. If these hormones aren’t at optimal levels, ovulation may be irregular. Things that might affect your hormones include:
- severe stress
- weight loss
- weight gain
- certain health problems
Polycystic Ovarian Syndrome
Polycystic ovary syndrome (PCOS) causes an overproduction of androgens. Androgens are male hormones, such as testosterone. PCOS causes symptoms such as:
- menstrual problems
- weight gain
- excessive hair growth
PCOS is also a common cause of female infertility.
Primary Ovarian Insufficiency (POI)
Primary ovarian insufficiency is when a woman’s ovaries stop working before the age of 40. The ovaries stop producing normal amounts of hormones. They may also stop ovulating altogether. This is also known as premature ovarian failure. It can be caused by:
- chromosomal problems
- exposure to toxins, such as chemotherapy or radiation
- autoimmune disease
Luteal Phase Defect
With this condition, your body does not produce enough progesterone after ovulation. Progesterone is important in preparing the uterine lining for a fertilized egg.
Other factors can also cause infertility. These include damage to the fallopian tubes and structural problems with the uterus or cervix.
Damaged Fallopian Tubes
Tubal infertility is caused by damaged fallopian tubes. Scar tissue in the tubes keeps sperm from reaching the egg. It can also keep a fertilized egg from implanting in the uterus. Reasons a woman may have damaged fallopian tubes include:
- previous surgery
- prior ectopic pregnancy (a pregnancy in which a fertilized egg implants in the fallopian tube)
- scarring caused by an STI
Pelvic inflammatory disease (PID) is a major cause of tubal infertility. PID occurs after a STI, such as gonorrhea, ascends into the uterus and fallopian tubes. It can cause major scarring as well as abnormal bleeding.
Endometriosis is an abnormal growth of the uterine lining in which cells from the uterus become implanted in other parts of the body and grow in these inappropriate sites. This condition can lead to pain, uterine scarring, and fertility issues. Substances produced by the excess endometrial tissue may also affect conception.
Other Uterine Problems
Other uterine problems can also prevent fertilized eggs from implanting. These include:
- fibroids (benign uterine tumors)
- other growths and tumors
- irregular uterine shape
- previous dilation and curettage (D&C)
Dilation and curettage is a procedure used to remove the uterine lining. It can be used to treat several health conditions.
Cervical stenosis is a condition where the opening to the uterus becomes narrowed or blocked. This can be caused by genetic problems or damage to the cervix. It can make it difficult for the sperm to reach the egg.
Many women who have trouble conceiving will never learn why. Some research suggests that the likelihood of an eventual pregnancy might be higher for women whose infertility is unexplained than for women with identified issues.