What causes infertility in women?

Dr. Evelyn Minaya, MD
OBGYN (Obstetrician & Gynecologist)

There are many causes of infertility in women, but one in particular stands out. Find out the most common reason a woman might have trouble getting pregnant by watching this video featuring obstetrician and gynecologist Evelyn Minaya, M.D.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)
Women can have problems with infertility due to several issues. Here are some of the most common causes of female infertility:
  • An infection that irritates the uterus so the eggs cannot attach.

  • Some type of chemical reaction that doesn't allow egg cells to mature well enough to be released.

  • A structural issue or blockage in the Fallopian tube that prevents the fertilized egg from traveling to its destination.

  • Fibroids, or benign, spongy tissue that frequently distort normal uterine or Fallopian tube anatomy. They can grow to the size of grapefruit and change the anatomy to make the uterus less receptive to eggs.
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Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility.

Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman's ovaries stop working normally before she is 40. POI is not the same as early menopause.

Less common causes of fertility problems in women include:

  • Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
  • Physical problems with the uterus
  • Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus

This answer is based on source information from the National Women's Health Information.

The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Infertility can be caused by many different things in women, and in 20% of the cases the cause is never identified. One of the most common reasons is damage to the fallopian tubes, which makes it difficult or impossible for the egg to pass down into the uterus. Another common cause can be hormonal problems causing the woman not to ovulate (which is when an egg is released from the ovary). There can also be cervical abnormalities in which the sperm cannot pass through the cervix into the uterus (this can be overcome by in vitro fertilization). And finally, there can be abnormalities with the uterus, causing difficulty in implantation of the fertilized embryo.

Here are some top causes of infertility in women:

  • Ovulation problems: Ovulation issues may be caused by polycystic ovary syndrome, or PCOS. Primary ovarian insufficiency (also known as premature ovarian failure, or POI) can also cause ovulation problems. Hyperprolactinemia is where women have too much prolactin, the hormone that stimulates breast milk, and that may also interfere with ovulation. Thyroid issues—like too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism)—can affect the menstrual cycle, too.
  • Older age: The mere act of waiting to get pregnant contributes to infertility. About one-third of couples in which the woman is over 30 have fertility problems. Time and biology are on a woman's side during her 20s. At this stage, the body is ready for pregnancy.
  • Endometriosis: With endometriosis, the tissue lining the uterus starts to grow in other places like behind the uterus, in the fallopian tubes, in the abdomen, in the pelvis or the ovaries. That causes irritation and scar tissue development, making it difficult to get pregnant.
  • Unhealthy bodyweight: Keeping an inactive lifestyle and being overweight or obese can raise the risk of infertility and increase the risk of miscarriage. An eating disorder like anorexia or bulimia or following a very low-calorie or restrictive diet, increases the risk for fertility problems.
  • Abnormal cervical mucus: Cervical mucus, a fluid secreted by the cervix when estrogen stimulates production, allows sperm to survive in the hostile, acidic environment of the vagina. Abnormal cervical mucus can prevent sperm from reaching the egg.
  • Tubal issues: Damaged or blocked fallopian tubes can prevent sperm from getting to eggs and prevent the fertilized egg from getting to the uterus.
  • Uterine abnormalities: Fibroids may interfere with the implantation of the fertilized egg. Fibroids may be associated with reproductive problems depending on the number of fibroids in the uterus and on their size and specific location. Fibroids near the endometrial lining may cause very heavy periods and problems with an embryo implanting or pregnancy complications.
  • Male reproductive issues: One-third of infertility cases are caused by male reproductive issues. Some reasons include infections that interfere with sperm production or sperm health, ejaculation issues, tumors, hormone imbalances and certain medications.

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Dr. Kevin W. Windom, MD
OBGYN (Obstetrician & Gynecologist)

The most common cause of female infertility is anovulation. This is a condition where the ovary does not release an egg on a monthly basis. Other common causes of female infertility are blocked fallopian tubes, endometriosis, or problems with the cervix such as cervical stenosis or abnormal cervical mucus. Some women harbor certain bacteria in their vagina such as Ureaplasma and mycoplasma. These bacteria can cause a hostile environment in the vagina and can affect sperm motility.

Infertility in a woman could have one or more causes. These include:

  • Ovulation: In 25-30 percent of couples, there are problems with the production of the woman's egg, or ovulation. This may be the result of an abnormality in the woman's ovary (such as polycystic ovary syndrome), or other hormonal causes. These defects are treated by giving medications to stimulate ovulation.
  • Tubal defect: Infertility is caused by an abnormality of the Fallopian tubes, the tubes that connect the ovaries to the uterus, in 20-30 percent of couples. Tubal defects can be caused by scarring from previous surgery, infection or a previous tubal ligation ("tying of the tubes").
  • Unexplained infertility: There is no obvious cause of infertility in about 10-20 percent of couples.
  • Endometriosis: This is a disorder in which pieces of the lining of the uterus implant themselves onto pelvic organs, including the Fallopian tubes, the ovaries and sometimes even the intestines. This is the cause of infertility in 5-10 percent of couples.

Another possible cause for infertility in a couple might be male factor infertility. In about 25-40 percent of couples, a problem with the sperm is the cause of the infertility. The problem may be the number of sperm, the shape of the sperm or their ability to move effectively.

Infertility can be caused by many conditions that affect the fallopian tubes, hormones or any other part of ovulation. Infections such as chlamydia may damage the fallopian tubes, making it impossible for the fertilized egg to travel to the uterus. Endometriosis and uterine fibroids also cause infertility. Hormone problems, such as polycystic ovary syndrome, overproduction of prolactin and early menopause may also lead to infertility in women. Sometimes, infertility may be caused by environmental factors like taking certain medications or drinking too much caffeine. Often, no clear cause can be found for the infertility.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.