Causes of Female Infertility

We understand that facing challenges when you’re trying to start a family can be an emotional and stressful experience. You are not alone. Infertility is a common medical condition, and for many couples, the cause is identifiable and, most importantly, treatable.

Female infertility is any health issue in a woman that makes it difficult for her to get pregnant. This journey starts with understanding the “why.” At Ferty9, our first step is always to conduct a thorough and compassionate investigation to identify the root cause of your fertility challenges. Once we know the cause, we can create a personalized and effective treatment plan for you.

Here is a detailed guide to the most common causes of female infertility that we see and treat at our Ferty9 centres.

Problems with Ovulation (The “Egg” Factor)

For pregnancy to occur, a woman’s ovaries must release a healthy, mature egg each month. This process is called ovulation. If ovulation is irregular or doesn’t happen at all, it becomes very difficult to conceive. Ovulation problems are one of the most common causes of infertility.

Signs of an Ovulation Problem: The most common sign is irregular, missed, or absent menstrual periods.

Polycystic Ovary Syndrome (PCOS)

PCOS is the most common cause of ovulation problems and a condition we treat frequently in India. It is a hormonal imbalance that can cause:

• Irregular or absent periods.
• Small cysts form on the ovaries, which can prevent the release of eggs.
• Other symptoms like acne, weight gain, and unwanted hair growth.

How we treat it: Treatment for PCOS is highly effective. It often starts with lifestyle changes and medication to help you ovulate regularly. For others, treatments like IUI or IVF may be the most successful path.

Other Hormonal Imbalances

Your body’s hormones all work together. If one is out of balance, it can affect ovulation.

• Thyroid Problems: Both an overactive (hyperthyroidism) and underactive (thyroidism) thyroid can interfere with your menstrual cycle.
• High Prolactin: Prolactin is the hormone that produces breast milk. If you have high levels when you are not breastfeeding, it can stop ovulation.

How we treat it: These conditions are often easily diagnosed with a simple blood test and managed with medication to restore your hormonal balance.

Diminished Ovarian Reserve (DOR)

A woman is born with all the eggs she will ever have. This number naturally declines with age. DOR means the number of your remaining eggs is low. This is most common in women over 35 but can occur in younger women as well.

How we treat it: While we cannot increase the number of eggs, we can maximize your chances with the eggs you have through treatments like IVF. An AMH (Anti-Müllerian Hormone) blood test helps us understand your egg reserve and create the right plan.

Problems with the Fallopian Tubes (The “Path” Factor)

The fallopian tubes are the pathways where the sperm swims up to meet the egg and where fertilization happens. The resulting embryo then travels down this tube to the uterus. If these tubes are blocked, it’s like a major road being closed—the sperm and egg simply cannot meet.

Blocked Fallopian Tubes

This is a very common cause of infertility. The blockages can be caused by:

• Pelvic Inflammatory Disease (PID): A serious infection of the reproductive organs, often caused by STIs.
• Pelvic Tuberculosis (TB): In India, pelvic TB is a significant and often “silent” cause of severely damaged or blocked tubes.
• Previous Surgeries: Scar tissue from abdominal or pelvic surgeries (like an appendix removal or C-section) can block the tubes.
• Hydrosalpinx: This is when a blocked tube fills with fluid. This fluid can be toxic to an embryo and prevent implantation, even with IVF.

How we treat it: We diagnose blocked tubes using a test called an HSG (Hysterosalpingography) or a laparoscopy. If the tubes are blocked, IVF is the most effective treatment, as it completely bypasses the tubes by fertilizing the egg in the lab.

Problems with the Uterus (The “Home” Factor)

The uterus, or womb, is where the embryo must implant and grow into a baby. Any issue with the shape or lining of the uterus can interfere with this process.

Uterine Fibroids and Polyps

These are non-cancerous growths on or in the wall of the uterus. Depending on their size and location (especially if they are inside the uterine cavity), they can prevent an embryo from implanting or cause miscarriages.

How we treat it: Many fibroids and polyps can be easily and safely removed using a minimally invasive procedure called Hysteroscopy.

Uterine Shape Abnormalities

Some women are born with an unusually shaped uterus. A common example is a septate uterus, where a wall of tissue divides the uterus in two. This can make it difficult to carry a pregnancy.

How we treat it: A septate uterus can often be corrected with a simple hysteroscopic surgery, greatly improving your chances of a successful pregnancy.

Asherman’s Syndrome

This is a rare condition where scar tissue forms inside the uterus, often after a D&C procedure or infection. This scar tissue can damage the uterine lining and prevent implantation.

How we treat it: Scar tissue can be removed using hysteroscopy to restore the uterus to its normal shape.

Endometriosis

Endometriosis is a condition where the tissue that is supposed to line the inside of your uterus (the endometrium) starts growing outside of it, on the ovaries, fallopian tubes, and other pelvic organs.

This condition is very common and causes infertility in several ways:

• It creates inflammation in the pelvis.
• It can cause scar tissue that blocks the fallopian tubes.
• It can form “chocolate cysts” on the ovaries, which damage the egg reserve.
• It can interfere with the embryo’s ability to implant in the uterus.

How we treat it: Treatment depends on the severity. It can range from medication to minimally invasive laparoscopic surgery to remove the endometriosis. For many women with endometriosis, IVF is the most direct path to a successful pregnancy.

Unexplained Infertility

This can be one of the most frustrating diagnoses. “Unexplained” means that all of our standard tests—ovulation, fallopian tubes, and sperm analysis—have come back normal.

This does not mean there is no cause; it simply means the cause is not one we can easily identify with current tests. It could be a subtle issue with egg quality, sperm function, or the implantation process.

How we treat it: You still have excellent treatment options. Many couples with unexplained infertility find success with treatments like IUI (Intrauterine Insemination) or IVF.

Finding the Cause: Your First Step at Ferty9

Finding the “why” behind your infertility is our specialty. Our compassionate team at Ferty9 uses a comprehensive and step-by-step diagnostic approach:

1. Detailed Consultation: We listen to your medical history and lifestyle.
2. Hormone Blood Tests: We check your AMH, thyroid, prolactin, and other key hormones.
3. Pelvic Ultrasound: A simple, painless scan to look at your uterus and ovaries.
4. HSG Test: A special X-ray to check if your fallopian tubes are open.