1.4 Common Causes of Female Infertility

The most common causes of female infertility include gynecological factors, hormonal dysregulation, sexually transmitted diseases, diet and lifestyle.

  • Age: Fertility is greatly influenced by age. After the age of 35, fertility decreases rapidly, and by age 45, the monthly chance of becoming pregnant naturally is approximately 5%.
  • Early menopause: The absence of menstruation and the early depletion of ovarian follicles before age 35 can result in infertility. Although the cause is often unknown, immune system diseases, radiation, chemotherapy and smoking are often associated with this condition.
  • Elevated prolactin: High levels of prolactin, the hormone that stimulates breast milk production, in women who are not pregnant or nursing can negatively affect ovulation. High levels may result from a pituitary tumor or as a side effect of various drugs.
  • Emotional stress: Prolonged emotional stress may interfere with the normal production of FSH and LH hormones required for reproduction.
  • Endometriosis: Affecting the function of the entire reproductive system, endometriosis is the growth of uterine tissue outside of the uterus. This tissue responds to the hormonal cycle and grows, sheds and bleeds in sync with the lining of the uterus each month. Endometriosis can lead to inflammation, pelvic pain and infertility.
  • Ovulation disorders: Hypothalamic-pituitary disorders can result in low levels of LH and FSH, disrupting normal ovulation.
  • Polycystic Ovary Syndrome (PCOS): Is a special form of ovulation disorder with a classic characteristic of polycystic appearing ovaries on ultrasound. In most patients this syndrome goes along with irregular or absent menstrual periods. It is further associated with endocrine anomalies like changes in sugar and fat metabolism. Once normal menses are resumed, the patients should have excellent chances to get pregnant. In addition, patients with PCOS can have excessive reaction to gonadotropins.
  • Smoking: The chemical components of cigarettes have been isolated in the fluid surrounding developing oocytes (eggs) and smoking has been shown to cause DNA damage during oocyte cell division.
  • Pelvic adhesions: Bands of scar tissue can bind organs after pelvic infection, such as gonorrhea or Chlamydia, appendicitis or abdominal or pelvic surgery and may impact fertility.
  • Thyroid disorders: Hyperthyroidism and hypothyroidism can disrupt the menstrual cycle and cause infertility.
  • Tubal factors: Scarring in the fallopian tubes can lead to difficulty in the the transport of an oocyte, impeding the sperm from reaching the oocyte, preventing fertilization. If the sperm and the oocyte do meet, it may not be able to travel to the uterus. Such scarring may result from chronic pelvic inflammatory disease. Benign uterine fibroids may also block the fallopian tubes. This often leads to an ectopic pregnancy. Tubal infection may have long term effects on fertility since the risk of ectopic pregnancy increases with each occurrence of tubal infection.
  • Weight management: Being over or underweight can disrupt the menstrual cycle, which can interfere with ovulation and hormone regulation. Women who are excessively lean or anorexic can reduce pituitary hormones such as FSH and LH and halt ovulation.
  • Other medical conditions: Fertility may be impaired as a result of various health conditions such as autoimmune disorders, sexually transmitted diseases, cancer treatments, diabetes, anemia and irregular shape of reproductive organs such as the uterus.