Female Infertility: Causes, Symptoms, Diagnosis and Treatment

What Causes Female Infertility?

Female infertility can result from problems with ovulation, the fallopian tubes, the uterus, age-related changes or lifestyle factors. Since reproduction depends on the coordinated function of multiple organs and hormones, conception becomes difficult when any part of this system does not work as expected.

1. Why Do Ovulation Problems Cause Infertility?

Ovulation disorders cause infertility by preventing the release of a mature egg, which is essential for fertilisation. They account for about 25 percent of female infertility cases. Common causes include:

• Polycystic Ovary Syndrome (PCOS), which disrupts normal ovulation
• Hypothalamic dysfunction, where the brain does not produce enough hormones to trigger ovulation
• Primary ovarian insufficiency, in which ovarian function declines before the age of 40
• Hyperprolactinaemia, where high prolactin levels suppress ovulation and lead to irregular or absent periods

2. How Does Your Age Affect Your Ability to Conceive?

Age affects fertility by reducing both the number and quality of eggs. Fertility declines gradually after 30, more noticeably after 35 and sharply after 40. As egg quality declines with age, the risk of chromosomal abnormalities also increases, making conception and healthy pregnancy more difficult.

3. Can Blocked Fallopian Tubes Prevent Pregnancy?

Yes, blocked or damaged fallopian tubes can prevent pregnancy by stopping sperm from reaching the egg or blocking the fertilised egg from reaching the uterus. They account for about 30 percent of female infertility cases. Common causes include pelvic inflammatory disease, endometriosis, scar tissue from previous surgeries and damage from ectopic pregnancies.

4. What Uterine Conditions Can Prevent Pregnancy?

Uterine conditions can prevent pregnancy by interfering with embryo implantation or increasing the risk of miscarriage. These include fibroids, uterine polyps, scar tissue such as Asherman’s syndrome and congenital uterine abnormalities that affect the shape or function of the uterus.

5. Does Lifestyle Impact Female Fertility?

Yes, lifestyle factors affect fertility by influencing hormone balance, ovulation and implantation. Being underweight or obese can disrupt ovulation, smoking damages egg quality and the uterine lining, heavy alcohol use affects hormone regulation and chronic stress can delay ovulation and reduce implantation success.

What Are the Symptoms of Female Infertility?

The primary symptom of female infertility is the inability to conceive after trying for the recommended period of time. Other symptoms often point to underlying reproductive or hormonal issues.

• Irregular or absent periods are a key sign. Menstrual cycles shorter than 21 days or longer than 35 days usually indicate irregular ovulation.
• Severe menstrual pain (dysmenorrhoea) or pelvic pain between periods may suggest endometriosis, a common cause of infertility.
• Changes in menstrual flow, such as very light periods or heavy bleeding with clots, can indicate hormonal imbalances or uterine conditions.
• Hormonal symptoms including acne, excess facial hair, unexplained weight gain or hair thinning may be linked to PCOS or thyroid disorders.

Some women with infertility have no noticeable symptoms at all. Even when periods appear normal, underlying issues may prevent conception, which is why medical evaluation is important if pregnancy does not occur within the expected timeframe.

What Are The Treatment Approaches for Female Infertility?

Female infertility is treated based on age, duration of infertility, underlying cause and personal preferences. Treatment options include medications, lifestyle changes, surgical procedures and assisted reproductive technologies.

1. How Are Ovulation Disorders Treated?

Ovulation disorders are treated by stimulating egg release, correcting hormonal imbalances and addressing contributing lifestyle factors.

• Clomiphene citrate (Clomid) is used to induce ovulation.
• Letrozole is a first-line oral treatment, especially for women with PCOS.
• Gonadotropins (FSH and LH) are injectable hormones used when oral medications are ineffective.
• Metformin helps improve ovulation by regulating insulin levels in women with PCOS.
• Lifestyle modifications play an important role in managing PCOS-related infertility.

2. What Surgical Treatments Are Available?

Surgery is used to correct structural problems that interfere with conception.

• Laparoscopic surgery can improve fertility in mild to moderate endometriosis.
• Hysteroscopic surgery allows removal of uterine polyps without external incisions.
• Myomectomy removes fibroids while preserving the uterus and may be necessary when fibroids affect fertility.

3. How Do Assisted Reproductive Technologies Work?

Assisted reproductive technologies help achieve pregnancy by assisting or bypassing natural conception.

• Intrauterine insemination (IUI) involves placing processed sperm into the uterus around ovulation.
• In vitro fertilisation (IVF) involves fertilising an egg in a laboratory and transferring the embryo to the uterus.
• Intracytoplasmic sperm injection (ICSI) is used with IVF, particularly for male factor infertility, by injecting sperm directly into an egg.
• Egg freezing (oocyte cryopreservation) allows women to preserve fertility for future use.

Conclusion

Female infertility is a medical condition with identifiable causes and effective treatment options. Understanding the underlying issue helps you take timely action and avoid unnecessary delays that can affect outcomes. Early evaluation improves the chances of simpler and more successful treatments. If you are under 35, seek medical advice after 12 months of trying or after 6 months if you are above 35, or sooner if you have known risk factors.

With expert guidance, informed decisions and emotional support, many women successfully overcome fertility challenges and move forward with confidence toward parenthood.