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  • Ovulation problems: The lack of ovulation and its timely occurrence is the primary cause of female infertility. This can happen as a result of diseases such as diabetes, thyroid condition, hypertension, and pituitary tumours leading to hormonal imbalances.
  • Age: Females are born with a fixed number of eggs in their ovaries; one matures every month after hitting puberty and is released during ovulation. Hence, the number is depleted every month due to ovulation, as well as some getting damaged or becoming degenerate. As females hit mid-thirties, the number dwindles down further and faster, and fewer eggs lacking genetic anomalies exist. This can decrease the chances of getting pregnant naturally and also increases the probability of miscarriage.
  • Menopause, perimenopause & premature menopause: Menopause is a biological process and is the complete cessation of menses in females, that is, ovulation and associated monthly hormonal cycles are absent. Before the onset of menopause, there is a transitional phase characterised by irregular menses called perimenopause. The age of menopause and perimenopause can vary; the latter can happen any time between ones 40s and 50s. When menopause occurs before the age of 40 years due to low levels of oestrogen or due to unavailability of eggs, the phenomenon is called premature menopause.
  • Obesity: Obesity increases the incidences of anovulation (lack of ovulation) as well as menstrual dysfunction, impacting conception and pregnancy complications. This is due to disruption in hormone balance.
  • Underweight: Being underweight can hamper the production of hormones in adequate quantities, leading to infertility.
  • Structural problems: Structural problems observed in reproductive organs and accessory ducts can provide hindrance to a natural conception. Such problems can be congenital (existing from birth) or can be a result of medical procedures. This includes blockage in fallopian tube, presence of septum in uterus, post-surgery adhesions in uterus, and underdeveloped ovaries among others.
  • Autoimmune disorders: Autoimmune disorders wherein the body attacks its own cells under the false assumption that they are disease-causing cells. Females going through lupus, rheumatoid arthritis, Hashimoto’s disease, and conditions of the thyroid gland can experience complications with fertility.
  • Sexually transmitted infections and diseases (STI/Ds): STI/Ds do not cause infertility directly however, if left untreated in time can lead to it. These infections can move up the reproductive organs, spreading from the cervix to uterus, fallopian tubes and ovaries, causing inflammation and damage.
  • Cancer treatment: Certain cancer therapies such as chemotherapy and radiation therapy when applied for cancers in the pelvic region can destroy cells of reproductive significance, minimising the probability of conception. Furthermore, cancers of the reproductive system can lead to surgical removal of whole or parts of the compromised organ(s), rendering them unable to conduct normal reproductive function.
  • Substance abuse, smoking and drinking: While alcohol consumption in minimal quantities can be considered as having no effect on female fertility, its heavy consumption is. Additionally, use of illicit drugs and smoking, including passive smoking, can have negative consequences on fertility.

In addition to these causes, there are medical and structural complications that can cause infertility in women such as endometriosis, polycystic ovary syndrome (PCOS), blockage in fallopian tube, uterine fibroids, and adenomyosis.

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