The Causes of Female Infertility  

Medical Director

Dr Mireia Galian

IVI London

Trying to conceive is an exciting time for many couples. However, if pregnancy tests keep displaying negative results and months pass by, it can become a nerve-racking and stressful time as couples realise they may be struggling with infertility.  

As a woman, finding out you are infertile can be heart-breaking. It can make you feel hopeless and like less of a woman because your body isn’t doing what you think it should be able to do naturally. Although infertility in women is a common problem, there are fertility treatments available to help you have the family you’ve always wanted.  

What is infertility?

Infertility is defined by the World Health Organisation (WHO) as the failure to achieve a pregnancy after 12 months of regular unprotected sex. Regular intercourse is typically defined as 2 – 3 times per week. If a woman is over 35, it’s recommended to seek specialist help after six months of trying. Furthermore, women who can get pregnant but are unable to stay pregnant may also have problems with infertility.  

Infertility does not just affect women. Both men and women can struggle with infertility problems. So, you’re not alone.   

What the causes of female infertility?

In terms of the causes of infertility, females can encounter a number of problems. The most common causes of female infertility include:  

• Problems with ovulation  
• Damage to the fallopian tubes or uterus
• Problems with the cervix  

Age can also contribute to a woman’s fertility because female fertility steadily decreases as a woman ages. This means the chances of conceiving gradually fall with age. There are also further causes of female infertility that may affect a woman’s ability to conceive naturally. These include:  

• Smoking  
• Excess alcohol use  
• Stress
• Being overweight or underweight
• Sexually transmitted infections  

Ovulation Disorders

It is common for ovulation disorders to affect a woman’s ability to conceive naturally. Ovulation disorders mean a woman ovulates infrequently or not at all. This is the cause of infertility in about 1 in 4 infertile couples. Without successful ovulation, there are no eggs to be fertilised.  

Polycystic Ovaries (PCO) or Polycystic Ovarian Syndrome (PCOS)

Ovulation problems are often caused by Polycystic Ovarian Syndrome (PCOS). This is the most common cause of infertility in women. It is associated with insulin resistance, abnormal hair growth on the face or body, obesity, and acne. PCOS can have a significant impact on a woman’s ability to get pregnant.  

Damage or injury to the fallopian tubes

A woman’s fallopian tubes can become damaged for various reasons, from surgery to contracting sexually transmitted infections (STIs). Damage to a woman’s fallopian tubes can either keep the sperm from getting to the egg or block the passage of the fertilised egg into the uterus.  

Premature ovarian failure, or early menopause

This disorder is also referred to as primary ovulation insufficiency and is characterised by an autoimmune response or by the premature loss of eggs from your ovaries. This can be caused by family genetics or chemotherapy. If a woman has premature ovarian failure, her ovaries no longer produce any eggs.  

Endometriosis

Endometriosis can affect a woman’s ability to conceive naturally. Endometriosis occurs when tissue that usually grows inside the uterus implants itself in other locations around the body. Endometriosis can also affect the lining of the uterus, disrupting the implantation of the fertilised egg. Endometriosis can be removed surgically, although the removal of endometriosis can cause scarring, which may block or damage the fallopian tubes and keep the egg and the sperm from uniting.  

Hypothalamic dysfunction

In a woman’s body, there are two hormones produced by the pituitary gland that is responsible for stimulating ovulation every month (FSH and luteinizing hormone). If a woman suffers from excess physical or emotional stress, has a very high or very low body weight, or a substantial change in weight, her hormones can be disrupted – affecting ovulation. The most common symptom of hypothalamic dysfunction is irregular or absent periods.  

Age-related infertility  

Age can affect fertility and is a growing cause of fertility problems as women are waiting longer to have children. It is estimated that around one-third of couples in which a woman is over 35 have problems with infertility.  

As a woman ages, her fertility can be affected in the following ways:  

• The health of her eggs declines  
• Her ovaries become less able to release eggs  
• Reduced number of eggs
• More likely to have additional health problems that can affect fertility
• Higher chances of miscarriage.  

Unexplained infertility

Sometimes, the cause of infertility is unexplained, and the cause cannot be found. This means that doctors have found no obvious cause of infertility, in which case you have unexplained infertility. For many couples, this can be upsetting, and they don’t know what the next steps are. Although it’s confusing and frustrating having unexplained infertility, IVI can discuss the next steps or treatment options available to you to help you have the family you’ve always dreamed.  

Can female infertility be prevented?

Unfortunately, there are no prevention methods that can be used to prevent female infertility caused by genetic problems or illness. However, there are several things that women can do to decrease the possibility of infertility:  

• Prevent sexually transmitted infections  
• Avoid illicit drug use  
• Avoid heavy or frequent alcohol use  
• Maintain a healthy diet and regular exercise regime
• Have annual check-ups with your doctor.  

When to see your doctor

If you are under 35 and have been trying to conceive for one year, you should consult your doctor. Also, if you are aged 35 or older and have been trying to conceive for six months, consult your doctor. A woman’s chances of having a baby decrease rapidly every year after the age of thirty. If you have been struggling to conceive, it is best to consult your doctor for examination.  

Our consultants and embryologists at IVI all specialise in the field of Fertility and Reproductive Medicine. At IVI, we will carry out all the necessary tests in our state-of-the-art laboratories. We make it a priority to offer you support throughout the testing process, helping you find the answers you need.  

How is female infertility diagnosed?

Female infertility is diagnosed at your GP’s surgery through a thorough physical exam and a detailed look at your medical history. Your doctor will also take steps to find out if a woman is ovulating each month. This can be done with blood tests or by taking an ultrasound of the ovaries.  

Hysterosalpingography

For a detailed look at the health of your uterus and fallopian tubes, your doctor may carry out an hysterosalpingography (an x-ray of the uterus and fallopian tubes). Your doctor will inject a special dye into the uterus through the vagina. This dye will show up in the x-ray, and your doctor will watch to see if it moves freely through the uterus and fallopian tubes. This can help signify any physical blocks that may be causing infertility. Blockages in the uterus or fallopian tubes can keep the egg from moving freely from the fallopian tube to the uterus. It can also prevent the sperm from reaching the egg.  

Laparoscopy

This is a minor surgical procedure used to see inside the abdomen and diagnose the cause of infertility through the use of a small tool called a laparoscope. Using the laparoscope, your doctor can check the ovaries, fallopian tubes, and uterus for any disease or problems. Furthermore, doctors can also find scarring and endometriosis by laparoscopy.  

How is female infertility treated?

Infertility in women can be treated by various means, such as medication, surgery, artificial insemination, or assisted reproductive technology. There is not one be-all-and-end-all treatment that fixes or infertility problems. Infertility treatment in women will vary, and therefore, your doctor will recommend the best treatment option for you. Your treatment for infertility will be based on:  

• Infertility test results  
• How long the couple has been trying to conceive  
• The woman’s age  

Female infertility is most often treated using the following methods:  

• Taking hormones to address a hormonal imbalance, short menstrual cycle, or endometriosis  
• Taking medications to help stimulate ovulation.  
• Using supplements to enhance female fertility.  
• Taking antibiotics to remove an infection
• Undergoing minor surgery to remove any blockages or scar tissues from the fallopian tubes, uterus, or pelvic area. 

Contact IVI today

If you are concerned about your fertility and have been trying to conceive without success, IVI are here for you. If you would like to know more about the fertility treatments we offer, you can browse our treatment pages on our website. For further advice or support, please contact our friendly UK Patient Support Services for more information. Alternatively, to arrange a consultation, call 0800 52 00 161.