Female Infertility: Understanding Top Causes and Reasons

Introduction

For many women, becoming a mother is one of life’s greatest joys. But when one is unable to get pregnant, it can lead to a mix of confusion, frustration, and heartbreak. Infertility issues in females are more common than most people think, still it’s not openly talked about enough. If you’re facing this challenge, then you’re not alone. In this blog, we’ll discuss about various causes of female infertility, and why some women have trouble conceiving, starting from Age, Genetics, hormonal issues and ovulation problems to conditions affecting the uterus or fallopian tubes. The purpose of this blog is to help you understand what might be going wrong and what steps you can take to fulfil your dream of becoming a mother.

Female Infertility Causes

A woman gets pregnant when the male partner’s sperms meet her egg at the right time and with all the steps in perfect sync. Trouble at any step can keep women from experiencing the joys of motherhood. A woman not conceiving after one year of active trying or having repeated miscarriages should see a fertility specialist. Female factor infertility accounts for about 30-40% of infertility cases. Common risk factors are:

Age:

Women are putting childbearing plans on the back burner until their 30s, a rising trend of the 21st century. The advancing age of a woman is the foremost cause of female infertility because your eggs are ageing with you. They are 9 months older, as egg development starts in your mother’s womb. Also, a woman is born with a fixed set number of eggs; thus, as she grows older, she depletes her egg stores and quality.

The most fertile age is touted to be the 20s, after which it starts falling. By 40 years, the chance of pregnancy reduces to less than 5% per cycle. Even the chances of miscarriage and chromosomal problems in the baby increase with age due to poor egg quality.

Genetics:

Genetic factors can play a significant role in female infertility, often affecting hormone regulation, ovulation, or the development of reproductive organs.

1. Turner syndrome, where one X chromosome is missing or incomplete, can impair ovarian function. Androgen insensitivity syndrome results in a genetically male individual (XY chromosomes) developing female physical traits but without ovaries or a uterus, making pregnancy impossible.
2. Kallmann syndrome affects hormone production and may delay or prevent puberty and ovulation.
3. Other genetic issues like balanced translocations (rearrangement of chromosomes) can lead to repeated miscarriages or increase the risk of abnormalities in the baby.
4. Additionally, congenital adrenal hyperplasia can cause irregular periods, PCOS-like symptoms, and anovulation, often requiring treatment to achieve pregnancy.
5. Premature ovarian failure, where ovarian function stops before age 40, can also have a genetic link, severely impacting fertility potential.

Endometriosis:

In this condition, the endometrial tissue, which forms the uterus’ lining, grows on the other organs outside the uterus as well (ovaries, fallopian tubes, abdomen). The incorrectly lined endometrial tissue thickens every month like normal tissue. When the normal lining sheds during periods, the abnormal tissues also bleed internally. This leads to scar tissue formation and swelling, which can block the reproductive organs and affect their function. It can also cause chemical changes in the normal uterine lining and affect implantation into the uterus, making maintaining pregnancy difficult. Women may experience abdominal pain pre-period, which becomes worse during periods and intercourse. The risk of endometriosis increases with family history.

Autoimmune conditions:

The body’s immune system attacks the ovaries or egg cells, disrupting their function, leading to ovulation problems. Women can produce anti-sperm antibodies against sperm, damaging them before they reach the egg.

Problems with Ovulation (Most common cause – 25% of females with infertility)

If periods don’t start in time, they stop early or are not regular each month, a woman should visit a gynaecologist to check for ovulation problems.

1. Polycystic Ovarian Syndrome (PCOS):

• Occurs due to hormonal issues
• Instead of a single mature egg follicle, ovaries produce many follicles with immature eggs and liquid. → Increase in size of the ovaries → More secretion of the male hormone, androgen → Increased androgen in a woman’s body causes trouble with ovulation.
• Women suffer from irregular or absent periods, heavy bleeding and fertility issues. Other symptoms include excess hair growth, weight gain, acne, skin darkening, and increased diabetes risk.
• The exact cause is not quite understood, but the risk factors are lifestyle, family history and high insulin levels.

For PCOS, it is best to take an opinion from a PCOS specialist for timely treatment.

2. Premature ovarian failure (POF): Ovaries stop producing eggs and estrogen (hormone helping egg production) at a much earlier age, usually before 40 years, commonly due to:

• Problem with X chromosome (Turner syndrome, Fragile X syndrome)
• Autoimmune conditions
• Side effects of chemotherapy/ radiation therapy

Turner syndrome: 

There are 2 sex chromosomes in an individual, and in the absence of one of them, the condition is called Turner syndrome. Women have non-functional or streak ovaries, so periods do not initiate. They may also have a small uterus.

Hormonal problems: 

The brain (hypothalamus or pituitary gland) or the ovaries produce hormones controlling the female reproductive cycles. There needs to be a delicate balance in the hormone levels, and any disruption can cause infertility in females.

Tubal problems:

Sperm meets the egg, and pregnancy is achieved in the fallopian tube. Damage/ blockage in the fallopian tubes hampers this union.

If fertilisation does happen, transfer of the embryo into the uterus is blocked, and pregnancy continues in the fallopian tube, which has other major complications for the woman. Blockages in the tube mainly arise as a result of scarring, which is the growth of extra tissue in response to injury/surgery.

Certain rare conditions damage the hair cells (cilia) in the tube, which help push the egg into place to meet the sperm, and make conception difficult.

Uterine problems:

Any problems in the uterus can cause difficulty in attachment of the formed embryo to the inner endometrial lining for growth (implantation), and the risk of miscarriage increases.

• Fibroids: Harmless, commonly occurring tumours in the uterus, which impact fertility depending on their size and location. If the fibroids are jutting into the uterine cavity and blocking a large part of it, implantation and the embryo’s growth become difficult. The chance of pregnancy becomes half, and the risk of miscarriage becomes higher. They may also lead to heavier bleeding during periods and painful intercourse.
• Uterine abnormalities by birth (congenital): The uterus might be very small/absent, divided in the middle or have an abnormal shape by birth. Variations in the shape of the uterus can make it difficult to hold the pregnancy and lead to miscarriages.

MRKH syndrome is a condition with absent uterus and vagina, normal ovaries and secondary sexual characters, sometimes there may also be absence of fallopian tubes.

Cervical problems:

The cervix is the opening to the uterus through which sperm enter. Infertility can occur if the cervix doesn’t produce enough mucus to support the sperm to reach the uterus, or the opening of the cervix is very narrow or closed due to scarring/ injury/ by birth, thus sperm cannot travel up.

Lifestyle:

• Smoking: Smoking causes exhaustion of the ovaries’ capacity to produce eggs, leading to early ovarian ageing and poor egg quality. Damaged DNA in the eggs formed may also increase the risk of miscarriage. Smoking women experience menopause earlier. It can also affect the cervix and fallopian tubes, leading to a risk of pregnancy growing in the tube (ectopic) instead of the uterus.
• Alcohol: Alcohol is known to affect egg quality, reduce the rate of conception, and heighten the risk of miscarriages.
• Body weight and diet: It is an important factor influencing female infertility, as it can mess with your hormones. Women’s obsession with reducing weight can sometimes impact their childbearing dreams. Underweight women have lower estrogen levels, their ovaries may not function properly and may suffer from absent or irregular periods.

Women with higher body weight have higher estrogen levels, which prevent ovulation entirely. They are also at risk of developing or worsening PCOS.

A diet rich in processed foods, high sugar content, caffeine, and lacking iron, vitamins, and folic acid is known to cause infertility in women. Research has also linked high cholesterol levels with infertility. Some other factors that can hamper a woman’s fertility are:

• Exercise: Heavy exercise causes a rush of happy hormones but a decline of reproductive hormones and can disturb natural ovulation cycles. It causes a decrease in progesterone levels important for maintaining pregnancy. Women should avoid heavy exercise for more than 5 hours a week.
• Stress: It is long known that stress causes irregular menstrual cycles. It may also affect other lifestyle factors like diet, sleep and exercise, indirectly leading to infertility.
• Lubricants: Certain lubricants contain chemicals that hamper the sperm’s quality and number, which makes conception difficult.

A lot of the harm caused by these factors can be prevented or made better just by making the right lifestyle choices.

Conclusion

The onus of fertility is usually put on women. Recognising the causes helps to provide the right infertility treatment in time and reduce this burden on women. These conditions require specialised treatment, and Femcare fertility is the best infertility clinic in Pune and Kolkata for all your infertility-related needs. At Femcare Fertility, we house one of the best infertility specialists to provide modern solutions to fertility problems with a human touch.

FAQ (Frequently Asked Questions):

Question: What are the most common reasons for infertility in women?
>>>>>>>Answer: Some of the most common causes are PCOS, endometriosis, blocked fallopian tubes, thyroid disorders, uterine abnormalities, premature ovarian failure, and decline in egg quality due to age.

Question: How is female infertility diagnosed?
>>>>>>>Answer: To diagnose the causes of infertility in a female involves a combination of blood tests (to check hormone levels and AMH value), pelvic ultrasound, ovulation tracking, and imaging tests like HSG to examine the uterus and fallopian tubes.

Question: Where can I get expert care for female infertility treatment in India?
Answer: Femcare Fertility, with the best infertility specialist doctors, has centres in Pune and Kolkata. That provides advanced diagnostic tools and personalised treatment for all female infertility issues. Our team helps women achieve their dream of motherhood. This makes us one of the best fertility centers in the region.