Female Infertility

What is female infertility?

Infertility is a disease that makes a person unable to get pregnant. For people assigned female at birth (AFAB), an infertility diagnosis comes after:

Six months of trying to get pregnant if you’re older than 35.
One year of trying to get pregnant if you’re younger than 35.

Trying to get pregnant means you’re regularly having sex without birth control. Some people receive a diagnosis sooner if they have a medical condition or uterine factor infertility.

Causes of infertility can be due to either partner. In fact, infertility occurs due to a problem with the male reproductive system just as frequently as it occurs due to a problem with the female reproductive system.

Infertility in women can result from age, hormone conditions, medical conditions, and lifestyle or environmental factors.

When the cause of infertility is thought to come from the person with a uterus, healthcare professionals consider it female infertility or “female factor” infertility.

What are the types of female infertility?

Infertility can be either primary or secondary:

Primary infertility means you’ve never been pregnant and can’t get pregnant after six months (older than 35) or one year (younger than 35) of trying.

Secondary infertility occurs when you can’t get pregnant again after having at least one successful pregnancy and birth.

How common is female infertility?

Infertility is a common disease. At least 10% of women and people assigned female at birth deal with infertility of some kind. The chances of infertility increase with age.

Symptoms and Causes

What are the signs of infertility in women?

The most common sign of infertility is being unable to get pregnant despite having regular, unprotected sex. Other signs may include absent or irregular periods.

What causes female infertility?

There are many possible causes of infertility. However, it can be difficult to pinpoint the exact cause, and some couples have unexplained infertility. Some possible causes of female infertility can include:

Problems with your uterus: This includes uterine polyps, fibroids or adhesions (scarring) inside the cavity of your uterus. Polyps and fibroids can form on their own at any time. Adhesions can form after a surgery like a dilation and curettage (D&C).
Problems with your fallopian tubes: The most common cause of “tubal factor” infertility is pelvic inflammatory disease (PID). Untreated chlamydia and gonorrhea are common causes of PID. Endometriosis can also cause scarring of your fallopian tubes.
Problems with ovulation: There are many reasons why a person may not ovulate (release an egg) regularly. Hormonal imbalances, an eating disorder, substance use disorder, thyroid conditions, severe stress and pituitary tumors are all examples of things that can affect ovulation.
Problems with egg count and quality: You’re born with all the eggs you’ll ever have, and this supply can run out early, before the natural age of menopause (around 51). In addition, some eggs will have the wrong number of chromosomes and be unable to fertilize and grow into a healthy fetus.

What is the leading cause of female infertility?

Most cases of infertility in people with a uterus involve problems with producing and releasing eggs (ovulation). It can be due to a condition like polycystic ovary syndrome (PCOS) or other conditions like primary ovarian insufficiency (POI), a condition in which an extremely low egg supply makes your ovaries stop functioning before the age of 40.

What are risk factors for infertility?

Many factors can increase your risk for infertility. General health conditions, genetic (inherited) traits, lifestyle choices and age can all contribute to infertility. Specific factors can include:

Age. Generally, fertility begins to decline in your 30s.
Hormone issues that prevent ovulation.
Abnormal menstrual cycle.
Obesity.
Having underweight.
Overexercise or intense exercise.
Endometriosis.
Structural problems (physical problems with your fallopian tubes, uterus or ovaries).
Uterine fibroids.
Ovarian cysts.
Tumors.
Autoimmune disorders (lupus, rheumatoid arthritis, Hashimoto’s disease).
Sexually transmitted infections (STIs) causing pelvic inflammatory disease.
Polycystic ovary syndrome (PCOS). PCOS is a hormonal disorder that can cause infertility.
Primary ovary insufficiency (POI).
Excessive substance use (heavy drinking or misuse of drugs).
Smoking.
A past ectopic pregnancy.

How does age impact female infertility?

Your chances of becoming pregnant decrease with age. Research shows that age is becoming a more common factor in infertility because many couples are waiting to have children until their 30s or 40s. People over age 35 have a higher risk of having fertility issues. The reasons for this include:

Overall number of eggs is lower.
More eggs have an abnormal number of chromosomes.
An increased risk of other health conditions. The older a person gets, the greater their chance of acquiring a health condition.