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Female Infertility - Symptoms and Causes

June 7, 2024

Trying to conceive can be exciting, but it can become stressful and filled with doubt for some. Infertility is a medical term used when a couple has been unable to conceive after a certain time. Conception challenges can stem from either partner. In women, several factors can influence their ability to conceive, including age, hormonal imbalances, underlying medical conditions, and lifestyle choices.

Book an online appointment with Dr. Dhanyatha G S for Pregnancy & Gynecology related issues.

What is Infertility in Females?

Females who are under the age of 35 and unable to conceive after trying for about a year, those over 35 and unable to conceive after trying for over six months, those who have had a history of two or more miscarriages or who have had previous fertility treatments without success are considered to experience infertility.

If you have irregular periods or a history of gynaecological problems like endometriosis, pelvic infection surgery, or tubal pregnancies, it's wise to consult a doctor.

Did You Know

Studies show that infertility affects a significant portion of the global population, with roughly one in six individuals of reproductive age facing this challenge at some point in their lives.

What are the Causes of Female Infertility?

Infertility, while a common challenge, can be frustrating due to the difficulty of pinpointing the exact cause. In terms of female infertility, several factors can play a role:

Uterine Issues

Blockage or problems with the uterus can prevent implantation. This includes fibroids, polyps, or scar tissue inside the uterine cavity. These may develop on their own or even after a dilation and curettage surgery or cesarean section.

Also read: How Do You Maintain Emotional Stability During Infertility?

Fallopian Tube Blockage

Blocked fallopian tubes stop the egg and sperm from meeting. Pelvic inflammatory disease due to untreated chlamydia or gonorrhoea is a common culprit. Endometriosis is another cause of tubal scarring.

Ovulation Problems

Irregular or absent ovulation disrupts the egg release cycle. Hormonal imbalances, medical conditions like thyroid issues and lifestyle factors like severe stress or eating disorders can all contribute. PCOS/PCOD patients have anovulation which causes infertility.

Decreased Egg Quality Or Count

Women are born with a finite number of eggs. This supply can diminish prematurely, or some eggs might have chromosomal abnormalities that prevent fertilisation or healthy fetal development. There are certain environmental factors, like exposure to toxins or radiation, that can also potentially damage egg quality and quantity and hence cause female infertility.

Female Infertility Diagnosis and Evaluation

A woman's ability to conceive depends on several factors. Healthy eggs must be released from the ovaries and travel through the fallopian tubes to meet the sperm. If fertilisation occurs, the resulting embryo needs to implant successfully in the lining of the uterus. Fertility tests for women will try to identify issues with any of these steps.

Diagnostic Tests

Fertility evaluation involves a range of tests to pinpoint potential causes. Blood tests assess hormone levels (ovulation assessment, thyroid function test, hormonal profile) to identify hormonal imbalances. Imaging techniques like pelvic ultrasound and saline infusion sonogram visualise the uterus and ovaries for abnormalities like fibroids or polyps. Additionally, ovarian reserve testing evaluates the remaining egg supply, and hysterosalpingography (a radiology procedure used to view the inside of the uterus and fallopian tubes) uses an X-ray to check for blockages in the fallopian tubes. These tests work together to provide a comprehensive picture of your reproductive health.

Advanced Evaluations

In some cases, a more in-depth examination may be necessary. Hysteroscopy is a minimally invasive procedure where a thin, lighted scope is inserted through the cervix to directly view the uterine lining for polyps, fibroids, or scar tissue. Laparoscopy takes a surgical approach, using a small abdominal incision to visualise the pelvic organs – fallopian tubes, ovaries, and uterus – allowing for a closer look at potential issues like endometriosis or scar tissue that might not be visible with other tests.

The specific tests recommended will depend on the individual situation and medical history. A healthcare provider will work with the patient to determine the most appropriate course of evaluation.

Treatment and Management of Female Infertility

Following a fertility diagnosis with an underlying cause identified, your healthcare provider will recommend a personalised treatment plan. These plans vary depending on the specific cause, and infertility treatment for females may include:

Hormone-based Treatments

For females struggling with ovulation, fertility treatments can address the root cause. Medications can stimulate ovulation in those with irregular or absent cycles, potentially correcting hormonal imbalances. Additionally, treatment plans can be specifically designed to manage Polycystic Ovary Syndrome (PCOS), a common factor behind ovulation dysfunction.

In-vitro Fertilization (IVF)

IVF is a widely used assisted reproductive technology (ART) for various infertility causes, including severe fallopian tube damage, unexplained infertility, and male factor infertility. Its success rates have contributed to its increased use as a first-line treatment.

Surgical Interventions

Advanced surgical techniques, often laparoscopic or microsurgical, are used to remove blockages caused by scar tissue (adhesions) or cystectomy in endometriosis. These procedures can sometimes reconstruct fallopian tubes or the uterus.

Intrauterine Insemination (IUI)

A fertility treatment where specially prepared sperm is inserted directly into the uterus, strategically timed around ovulation to increase the chance of fertilisation. This procedure can be tailored to your menstrual cycle or combined with fertility medications, depending on the cause of infertility.

Egg Donation

In some cases, the ovaries may stop releasing eggs due to depletion. While there's no reversal for this condition, early diagnosis and support are crucial. When pregnancy with a patient's eggs is not possible, using donor eggs becomes an option.


The unknown nature of fertility testing and treatments can make coping incredibly difficult. To manage the emotional toll, be prepared by discussing the process with your doctor. Opt for treatments you can afford financially and emotionally. Finally, seek support through groups or counselling to cope with potential grief.

Frequently Asked Questions

What are the top 5 causes of female infertility?

The top 5 causes of female infertility are:

  • Ovulation problems
  • Uterus condition
  • Polycystic ovary syndrome
  • Blockage or damage of fallopian tubes
  • Endometriosis

How do I know if I'm infertile?

While the inability to conceive after a year is a key sign of infertility, there often aren't other obvious symptoms. Some women might experience irregular or absent periods. It is advised to see a healthcare professional if you've been unsuccessful in conceiving despite trying for over a year.

Why am I not conceiving?

Infertility can stem from various factors, and sometimes the cause remains unexplained. The most common time frame for seeking professional help is after one year of trying to conceive without success (under 35) or after six months (over 35).

How to overcome infertility in females?

There are several approaches to explore depending on the underlying cause. It is crucial to consult with a healthcare professional to determine the cause of infertility to overcome it.

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