The journey toward parenthood is deeply personal, and when conception doesn’t happen as expected, it can feel overwhelming and isolating. If you’re wondering what causes infertility in women, you’re not alone—approximately 12-15% of couples experience fertility challenges, according to the NIH, with female infertility accounting for about one-third of all cases. Understanding the various factors that can affect fertility is the first step toward finding answers and exploring your options.
Before exploring what can go wrong, it’s helpful to understand how the female reproductive system normally functions. Each month, your reproductive organs work in harmony through a carefully orchestrated process. The pituitary gland releases hormones that signal your ovaries to mature an egg, while hormones produced by your ovaries prepare the uterine lining for potential pregnancy. When ovulation occurs, the egg travels through the fallopian tubes, where fertilization may happen if sperm are present. This fertilized egg then travels to implant in the prepared uterine cavity.
This complex menstrual cycle depends on precise timing and healthy function of multiple reproductive organs. When any part of this process is disrupted, it can affect fertility and make conception more challenging.
Ovulation disorders are among the most common causes of female infertility, affecting approximately 25% of women with fertility problems, according to the NIH. Several conditions can disrupt the normal ovulation process:
Polycystic Ovary Syndrome (PCOS) is the most frequent cause of ovulation disorders. This hormonal disorder affects how your ovaries function, often preventing regular ovulation. Women with polycystic ovarian syndrome may experience irregular menstrual periods, elevated male hormone levels, and multiple small cysts on their ovaries. The exact cause of PCOS isn’t fully understood, but it significantly increases your risk of fertility challenges—prompting the question, is infertility genetic in these cases?
Primary ovarian insufficiency, previously called premature ovarian failure, occurs when your ovaries stop functioning normally before age 40. This condition affects the hormones produced by your ovaries and can lead to irregular ovulation or complete cessation of egg release. While the exact cause often remains unknown, genetic defects, autoimmune disorders, or previous cancer treatment can contribute to this condition.
Hormonal imbalances involving your pituitary gland, thyroid, or adrenal glands can also affect ovulation. Thyroid disease, whether overactive or underactive, can disrupt your menstrual cycle and impact fertility. Similarly, issues with follicle-stimulating hormone production can prevent proper egg maturation and release.
Related Article: How Fast Do Ovarian Cysts Grow?
Your fallopian tubes serve as the highway where sperm and egg meet, and where early embryo development begins. When these tubes are damaged or blocked, it can prevent fertilization or cause complications like ectopic pregnancy.
Pelvic inflammatory disease (PID) is a serious infection of the female reproductive organs that can cause significant scar tissue formation in and around the fallopian tubes. This condition is often caused by sexually transmitted infections and can permanently damage the delicate structures needed for conception.
Scar tissue from previous surgeries, endometriosis, or pelvic infections can also block or damage your fallopian tubes. Even partial blockages can affect fertility by preventing the egg and sperm from meeting or interfering with the fertilized egg’s journey to the uterus.
Uterine fibroids are non-cancerous growths in the uterine wall that can affect fertility depending on their size and location. Large fibroids or those that grow into the uterine cavity can interfere with implantation or increase the risk of miscarriage.
Some women are born with an unusually shaped uterus or other structural abnormalities that can make pregnancy more difficult. These congenital conditions might affect how the uterine lining develops or how a fertilized egg implants and grows.
Problems with the uterine lining itself, like chronic inflammation or abnormal tissue growth, can also impact fertility by creating an environment unsuitable for embryo implantation.
While medical conditions are often the primary culprits, several secondary factors can significantly affect fertility:
Age is one of the most significant factors affecting female fertility. As women age, both egg quantity and quality decline, particularly after age 35. This natural aging process affects all reproductive-age women, though the timeline varies individually.
Lifestyle factors play a crucial role in reproductive health. Maintaining a healthy weight is important, as being significantly over- or underweight can affect ovulation. If you drink alcohol regularly or smoke, these habits can negatively impact fertility. Research shows that even moderate alcohol consumption can affect your ability to conceive.
Medical treatments, particularly cancer treatment including chemotherapy and radiation, can damage reproductive organs and affect fertility. If you’ve undergone such treatments, it’s important to discuss your fertility options with a reproductive medicine specialist.
Autoimmune disorders can sometimes affect fertility by causing your immune system to attack reproductive tissues. Additionally, certain medications used to treat chronic conditions might impact fertility as an unintended side effect.
If you’ve been trying to get pregnant without success for a year (or six months if you’re over 35), it’s time to seek evaluation. The diagnostic process typically involves:
Unfortunately, even after thorough testing, some couples receive a diagnosis of unexplained infertility, meaning no specific cause can be identified. This doesn’t mean there’s no hope—it simply means that current medical knowledge and testing may not be able to pinpoint the exact issue.
The good news is that many fertility problems can be addressed with appropriate treatment. Options range from simple lifestyle modifications to advanced assisted reproductive technologies.
For ovulation disorders, medications can often stimulate regular ovulation. If fallopian tubes are blocked, surgical procedures might restore function. For more complex cases, in vitro fertilization (IVF) and other reproductive technologies offer hope for conception.
It’s important to remember that male and female infertility often coexist, so comprehensive evaluation should include both partners. Male infertility factors, including low sperm count, poor sperm quality, or sperm production issues, contribute to fertility challenges in many couples.
Understanding what causes infertility in women is empowering, but it’s just the beginning of your journey. Fertility awareness and education can help you make informed decisions about your reproductive health. Whether you’re just starting to think about pregnancy or have been trying for some time, maintaining open communication with your healthcare provider or OBGYN who specializes in reproductive medicine is crucial.
Remember that seeking help for fertility challenges is a sign of strength, not weakness. Many women who experience infertility go on to have successful pregnancies with appropriate treatment and support. Each situation is unique, and what works for one person may not be the best approach for another.
Your fertility journey is deeply personal, and having a compassionate, knowledgeable healthcare team makes all the difference. If you’re ready to explore your options or simply want to better understand your reproductive health, consider consulting with specialists who can provide personalized guidance based on your specific situation and needs.
For comprehensive fertility evaluation and compassionate care in the Columbus area, Columbus OBGYN offers specialized reproductive health services to support you on your journey toward parenthood.
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