Female Infertility Causes: Common Reasons & Risk Factors

Understanding Female Infertility

Infertility is an inability to conceive after a specific period of regular, unprotected sex. However, if a woman has uterine factor infertility or another medical problem, they may be diagnosed sooner. For women under 35, this diagnosis period is usually one year, while for women over 35, it is six months.

In women, infertility is caused by age, hormonal imbalances, illnesses, and environmental or lifestyle factors. Infertility doesn't always mean that pregnancy is impossible. With the correct diagnosis, lifestyle adjustments or prescriptions, many women give birth to healthy babies.

How Common Is Female Infertility?

Female infertility has been rising significantly in India, notably in urban and semi-urban regions. A large number of women have fertility issues due to factors like late marriages, lifestyle changes, stress at work, and poor knowledge of reproductive health. Unfortunately, the pressure and stigma from society make it difficult for women to openly talk about it, so they tend to visit a doctor later. In several cases, women continue trying without understanding the underlying cause, which may worsen the condition over time. However, the trend has changed significantly as awareness has risen and healthcare has become more accessible.

Hormonal Imbalances

Hormones regulate the menstrual cycle, the ovulation process and the development of the uterus for pregnancy. Even small imbalances can interfere with fertility.

Hormonal issues may result from:

• Thyroid disorders.
• High levels of certain male hormones.
• Increased stress hormones
• Insulin resistance.

These imbalances may prevent you from ovulating, affect the quality of your eggs, or prevent implantation.

Age and Fertility Decline

Age is also one of the major factors that influences fertility in women. A woman is born with a limited number of eggs, and both the number and quality of eggs diminish with age.

Fertility generally:

• Highest at 20s
• In the early thirties, it starts to decline gradually.
• Sharper falls beyond 35 years.

Ageing predisposes an individual to miscarriage and chromosomal abnormalities. Nevertheless, most women can conceive in later life with adequate medical care.

Conditions Affecting the Ovaries

Some of the conditions may directly affect how the ovaries work and egg production. The majority of ovarian issues include:

• Polycystic ovary disorder (PCOD)
• Premature ovarian insufficiency
• Ovarian cysts
• Reduced ovarian reserve

In some cases, these conditions may disrupt normal ovulation or reduce egg quality, thereby increasing the difficulty of getting pregnant.

Problems with the Fallopian Tubes

Fallopian tubes that are damaged or blocked prevent the sperm from reaching the egg or they block the passage of the fertilised egg to the uterus. Blockage or damage to the fallopian tubes may be caused by:

• Pelvic inflammatory disease: An infection of the uterus and fallopian tubes usually caused by sexually transmitted infections
• Previous Abdominal or Pelvic Surgery: This includes surgery for an ectopic pregnancy, where a fertilised egg implants and grows somewhere other than the uterus, most commonly in a fallopian tube

Uterine and Cervical Causes

The uterus and cervix must be healthy to support implantation and carry a pregnancy to term.

Uterine-related causes include:

• Fibroids affecting the shape of the uterine cavity.
• Polyps affecting implantation.
• Congenital uterine abnormalities.
• Scarring inside the uterus

Cervical factors may include:

• Thick cervical mucus is blocking sperm.
• Structural problems affecting sperm movement.

These conditions can prevent implantation or increase the risk of miscarriage.

Endometriosis

Endometriosis refers to the condition where uterine lining tissue grows abnormally outside of the uterus, most commonly on the ovaries, fallopian tubes, or the lining of the pelvic area. The disease can become a cause of pelvic pain, abnormal cycles, and inability to conceive, as it can result in the formation of scars on reproductive organs and the blockage of egg release or fertilisation.

Lifestyle and Environmental Factors

Daily habits and environmental exposure can significantly impact fertility. Lifestyle factors that are associated with infertility include:

• Smoking, which deteriorates egg quality
• Excessive alcohol consumption
• Poor diet and nutritional deficiencies.
• Lack of physical activity.
• Excessive weight gain or being underweight.

Exposure to various toxins and pollutants in the environment may also cause the reproductive system to become unhealthy.

Medical Conditions Linked to Infertility

Some chronic medical conditions can affect fertility if they aren't under control. Such as:

• Diabetes
• Autoimmune disorders
• High blood pressure
• Chronic kidney disease
• Severe anaemia

These are just a few examples of conditions that can be successfully treated to improve fertility outcomes.

Emotional Health and Fertility

Emotional health is closely linked to reproductive health. Prolonged stress, anxiety, or depression may disrupt hormonal balance and ovulation.

However, emotional stress by itself is not a cause of infertility, but it may exacerbate fertility problems that already exist. Providing emotional support, therapy, and learning stress-management techniques may help improve psychological well-being and fertility outcomes.

When to Seek Medical Help

Medical advice should be sought when any of these circumstances apply:

• If pregnancy has not happened after a year of regular, unprotected sex.
• Women over 35 are unable to conceive after six months.
• In case of irregular menstrual cycles, very rare or absent.
• There is a past or present history of reproductive diseases such as PCOS or endometriosis.
• There are known medical or hormonal conditions.

Early evaluation helps identify the cause and plan appropriate treatment.

Conclusion

The causes of female infertility are very diverse and include hormonal disorders, ovulation dysfunction, ageing, lifestyle, and medical disorders. Although the experience may be emotionally difficult, knowing the reasons makes it all sense and provides some direction. There is a large number of infertility problems that can be treated through early medical intervention, change of lifestyle, and emotional support. Early professional consultation is beneficial, as it makes a successful pregnancy possible and enables women to feel informed and supported throughout their reproductive events.