Struggling with infertility can feel lonely and isolating, but it’s a more common experience than many people realize. In the United States, millions of couples experience difficulty getting pregnant each year. When pregnancy does not occur after 12 months of regular, unprotected intercourse (or after six months for women over 35), healthcare providers may recommend an evaluation for infertility.
Female infertility can occur for many reasons. Some causes involve ovulation or hormone balance, while others relate to the reproductive organs themselves. In many cases, infertility is treatable once the underlying cause is identified.
Understanding the most common causes can help you understand when it may be time to speak with a healthcare provider.
Ovulation Disorders and Infertility
Ovulation disorders are one of the most common causes of female infertility. Ovulation occurs when the ovary releases an egg during the menstrual cycle. If ovulation does not happen regularly, pregnancy becomes much more difficult.
Several conditions can disrupt ovulation:
Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome is a hormonal condition that affects how the ovaries function. Women with PCOS may experience irregular periods, excess androgen (male hormone) levels, and multiple small cysts on the ovaries.
PCOS can interfere with ovulation, making it harder for the body to release an egg during the cycle.
Hormonal Imbalances
Hormones like estrogen, progesterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) all play a role in regulating ovulation. When these hormones become unbalanced, ovulation may occur irregularly or not at all.
Conditions affecting the thyroid gland or pituitary gland can also influence hormone levels and menstrual cycles.
Fallopian Tube Problems and Infertility
After ovulation, the egg travels through the fallopian tube, where fertilization typically occurs.
If the fallopian tubes are blocked or damaged, sperm may not be able to reach the egg. Even if fertilization occurs, the embryo may not be able to travel safely to the uterus.
Imaging studies or specialized procedures can help determine whether the fallopian tubes are functioning normally. Common causes of fallopian tube damage include:
- Pelvic inflammatory disease (PID)
- Previous pelvic or abdominal surgery
- Endometriosis
- Certain infections affecting the reproductive organs
Endometriosis and Infertility
Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. This tissue may appear on the ovaries, fallopian tubes, or other pelvic structures.
Endometriosis can contribute to infertility in several ways: it may create inflammation, scar tissue, or structural changes that affect the movement of eggs or sperm. Some people with endometriosis also experience pelvic pain, painful periods, or pain during intercourse.
Although endometriosis can make conception more challenging, many individuals with this condition still achieve pregnancy with appropriate treatment.
Uterine or Structural Conditions and Infertility
Certain conditions affecting the uterus may interfere with implantation or pregnancy. These structural issues can sometimes make it difficult for a fertilized egg to implant or develop normally. Imaging tests such as ultrasound or hysteroscopy may be used to evaluate the uterus.
Examples include:
- Uterine fibroids
- Uterine polyps
- Congenital uterine abnormalities
- Scar tissue inside the uterus
Age-Related Fertility Changes
Age is one of the most significant factors influencing fertility. Women are born with a finite number of eggs, and both egg quantity and quality naturally decline over time.
Fertility gradually decreases in the early 30s and declines more rapidly after age 35. This does not mean pregnancy is impossible, but it may take longer and sometimes requires medical support. For this reason, healthcare providers often recommend earlier evaluation for women over 35 who have been trying to conceive for six months without success.
Lifestyle & Health Factors That Impact Fertility
Certain lifestyle factors can also affect fertility. Maintaining overall health can support reproductive function.
Factors that may influence fertility include:
- Smoking or tobacco use
- Excessive alcohol consumption
- Significant weight changes
- Chronic stress
- Certain medications
Addressing these factors can sometimes improve the chances of conception.
When to Seek Care for Infertility Issues
If you have been trying to conceive without success, speaking with a healthcare provider can help identify possible causes and guide the next steps.
You may want to schedule an evaluation if:
- You have been trying to conceive for one year without pregnancy
- You are over age 35 and have been trying for six months
- You have irregular or absent periods
- You have known conditions such as PCOS or endometriosis
- You have experienced recurrent pregnancy loss
Fertility evaluations often include medical history, hormone testing, imaging studies, and discussions about menstrual cycles and reproductive health.
Female Infertility: Finding the Right Path Forward
Facing infertility can feel overwhelming, but many causes of female infertility are treatable. Advances in reproductive medicine have made it possible for many individuals and couples to achieve pregnancy with the right care and guidance.
If you have concerns about fertility, we can help evaluate your reproductive health and discuss options that support your goals for starting or growing your family. Get in touch with our thoughtful team to learn more: Contact us at Women’s Care OBGYN at (913) 384-4990 today.