Female Infertility – Symptoms and Causes

ByJanis Updated

Overview

Infertility happens when a couple tries to have a baby through regular unprotected sex for at least one year without success.

About one-third of cases stem from issues with the female partner, another third from both partners, and the remaining cases have unknown causes or a mix of factors.

Finding the exact cause of female infertility can be challenging for doctors. However, several treatment approaches exist based on the specific diagnosis. Many couples who struggle with infertility eventually conceive without medical intervention.

Treatment options might include:

  • Medication to help with ovulation
  • Surgery to fix structural problems
  • Assisted reproductive technology like in vitro fertilization
  • Lifestyle changes that may improve fertility naturally

Symptoms

The primary sign of infertility is difficulty conceiving despite trying for some time. Women might notice changes in their menstrual cycle that suggest ovulation problems, such as:

  • Cycles lasting more than 35 days
  • Cycles shorter than 21 days
  • Irregular periods
  • Absent periods

Many people with infertility experience no other noticeable symptoms at all, making it important to seek medical advice if pregnancy hasn’t occurred after regular unprotected intercourse over several months.

When to See a Doctor

The timeline for seeking help varies by age:

  • Under 35 years old: Try for about one year before seeking medical help.
  • Between 35 and 40 years old: Talk to a doctor after six months of trying.
  • Over 40 years old: Consider getting help right away.

Some conditions might require immediate attention regardless of your age. See a doctor sooner if you or your partner has:

  • Known fertility issues
  • Irregular or painful periods
  • History of pelvic inflammatory disease
  • Previous miscarriages
  • Past cancer treatment
  • Endometriosis

Why Pregnancy May Not Happen

The Female Body’s Reproductive Parts

The female reproductive system includes several key parts. The ovaries store and release eggs. The fallopian tubes carry eggs toward the uterus. The uterus is where a baby grows.

The cervix connects the uterus to the vagina, which forms the birth canal. When these parts work together properly, pregnancy can occur.

How Eggs Meet Sperm and Attach to the Uterus

For pregnancy to start, a sperm must join with an egg in one of the fallopian tubes. This creates a zygote that travels to the uterus. The zygote changes into a morula and then a blastocyst.

Finally, the blastocyst burrows into the uterine wall – a process called implantation. If any part of this journey fails, pregnancy won’t happen.

Problems with Egg Release

Not releasing eggs regularly or at all causes most fertility problems in women. Several conditions can affect egg release:

  • Polycystic Ovary Syndrome (PCOS): This common condition creates hormone imbalances that prevent regular egg release. Women with PCOS often have insulin resistance, unusual hair growth, and acne.

  • Hormone Production Issues: The brain produces hormones that trigger egg release. Stress, major weight changes, or other factors can disrupt these hormones, leading to irregular or missing periods.

  • Early Ovary Failure: Sometimes ovaries stop working before age 40. This might happen because of immune system problems, genetics, or cancer treatments.

  • High Prolactin Levels: Too much prolactin (a hormone) can lower estrogen and prevent egg release. Certain medications can cause this problem.

Blocked or Damaged Tubes

If fallopian tubes are blocked or damaged, eggs and sperm can’t meet. Common causes include:

  • Pelvic infections from sexually transmitted diseases like chlamydia
  • Previous surgeries in the abdomen or pelvis
  • Scarring from past ectopic pregnancies (when an embryo grows outside the uterus)

Endometriosis

Endometriosis happens when uterine tissue grows outside the uterus. This can cause:

  1. Scarring that blocks fallopian tubes
  2. Problems with embryo implantation
  3. Damage to eggs or sperm
  4. Inflammation that affects fertility

The extra tissue and resulting scar tissue can seriously impact a woman’s ability to become pregnant.

Uterus and Cervix Issues

Several problems with the uterus or cervix can make pregnancy difficult:

  • Fibroids or Polyps: These non-cancerous growths in the uterus may block tubes or prevent implantation.
  • Unusual Uterus Shape: Some women are born with differently shaped uteruses that make pregnancy harder.
  • Narrow Cervix: A cervix that’s too narrow (cervical stenosis) can block sperm from entering the uterus.
  • Poor Cervical Mucus: Sometimes the cervix doesn’t produce the right kind of mucus to help sperm travel through.

While many women with these issues do become pregnant, these conditions can create challenges.

When No Cause Is Found

In about 10-30% of cases, doctors can’t find a specific reason for fertility problems. This is called unexplained infertility. It might result from several minor factors working together. Even without a clear cause, treatment can still help.

Risk Factors

Several factors can increase your chances of experiencing fertility problems:

  • Age: Women’s egg quality and quantity decrease with age, especially after the mid-30s. This decline makes pregnancy harder to achieve and raises miscarriage risks.
  • Smoking Habits: Tobacco use harms reproductive organs, including the cervix and fallopian tubes. Smoking can cause eggs to age faster and increases risks of miscarriage and ectopic pregnancy. Quitting before fertility treatment improves success rates.
  • Body Weight: Having a weight that’s too high or too low can disrupt normal ovulation patterns. Achieving a healthy BMI often helps restore regular ovulation and improve pregnancy chances.
  • Sexual Health History: STIs like chlamydia and gonorrhea can cause fallopian tube damage. Having multiple partners without protection increases your risk of infections that might affect fertility later.
  • Alcohol Consumption: Drinking too much alcohol can lower fertility in both men and women. Reducing intake may help improve reproductive function.

Prevention

Taking steps to protect your fertility can improve your chances of getting pregnant. Here are some key actions to consider:

Reach a Healthy Weight

Being too heavy or too light can disrupt ovulation patterns. If you need to lose weight, try moderate exercise. Just avoid very intense workouts, as these might reduce ovulation.

Stop Smoking Completely

Tobacco harms fertility in multiple ways. It also damages overall health and can hurt a developing baby. If you’re planning a pregnancy, it’s important to quit now.

Avoid Alcoholic Drinks

Heavy drinking may lower fertility. Any amount of alcohol can affect a developing baby’s health. It’s best to stop drinking when planning pregnancy and throughout pregnancy.

Manage Stress Levels

Research suggests stress might negatively impact fertility treatment results. Try these stress-reduction techniques:

  • Regular, gentle exercise
  • Meditation or mindfulness practices
  • Adequate sleep (7-8 hours nightly)
  • Connecting with supportive friends and family

Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.