Female Infertility

When a couple has been unsuccessful in efforts to conceive for more than a year, the condition is defined as infertility.  Infertility can result from female factors, male factors, or a combination of both.  Infertility that is the result of female factors is called female infertility.  

Female factors cause infertility 33 percent of the time.  Factors can include ovulation dysfunction, anatomical problems, endometriosis, uterine defects, infection, immunological problems, or unknown causes. 

What Causes Female Infertility?

Some potential factors in female infertility include the following:

• Ovulation dysfunction: With this condition, a woman’s reproductive system does not produce the proper amounts of hormones necessary to develop, mature, and release a healthy egg. Ovulation dysfunction is the most common cause of female infertility. The most common condition associated with ovulation dysfunction is polycystic ovarian syndrome (PCOS).  Other causes are hypothyroidism, hyperprolactinemia (high prolactin levels), and irregular or absent menstrual cycles (hypothalamic amenorrhea). A rarer cause of ovulation dysfunction can be primary ovarian insufficiency or premature menopause.
• Tubal Problems: Abnormal development or function of the female anatomy can prevent egg and sperm from meeting for fertilization to occur. However, the most common reason sperm cannot get to the egg is due to blocked fallopian tubes caused by previous surgery, pelvic infections, or endometriosis. The most common pelvic infections are due to chlamydia and gonorrhea, but these can be asymptomatic.
• Endometriosis: Endometriosis can cause fertility issues and is a condition in which the tissue that lines the uterus develops outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle by building up and breaking down, resulting in internal bleeding which can cause scar tissue and inflammation that affects how the reproductive organs function.
• Uterine defects: Uterine defects may be associated with infertility and/or recurrent pregnancy loss. Some women are born without a uterus or have an irregular shaped uterus such as a bicornuate (heart shaped) uterus or a septate (divided) uterus. Over time, women may also develop uterine abnormalities such as uterine fibroids, endometrial polyps, and uterine scarring. Uterine fibroids are benign tumors that can grow in areas of the uterus that could prevent implantation of an embryo. Endometrial polyps result from an overgrowth of the tissue that lines the uterus; they too can interfere with the implantation of an embryo. These can be treated with a minor surgery call hysteroscopy.
• Recurrent pregnancy loss: Recurrent pregnancy loss is defined as two or more consecutive pregnancy losses. Most times a pregnancy loss is a result of chromosomal abnormalities in the embryo, but there are other factors that can contribute to pregnancy loss. Besides genetic/chromosomal factors, other factors associated with recurrent pregnancy losses included anatomical defects of the uterus, immunological causes and thrombophilia (predisposition to forming blood clots). It is important that a couple with more than two consecutive pregnancy losses consult with a fertility specialist before attempting a third pregnancy.
• Infection: Pelvic inflammatory disease (PID) is an infection and can affect the uterus, fallopian tubes and/or the ovaries and can impact fertility. It can lead to pelvic adhesions and scar tissue that develops between internal organs, causing ongoing pelvic pain and the possibility of an ectopic pregnancy (when a fertilized egg becomes implanted outside the uterus). The most common causes of PID are the sexually transmitted infections gonorrhea and chlamydia.

How Is Female Infertility Treated?

If you suspect you are experiencing issues with your fertility or are concerned about preserving your fertility for a future pregnancy, it is highly recommended that you seek a medical consultation as soon as possible. It is generally recommended to seek a fertility evaluation after one year of attempting pregnancy, or after six months for women 35 years and older; however, if you have reason to suspect a fertility problem or want to discuss options for preserving your fertility there is no need to wait. Our doctors are experts in the treatment of female infertility, taking on even the most complex cases, and will discuss the available options based on your specific diagnosis.

If our doctors discover that female factors are affecting your fertility, your physician may use several different methods to help you achieve a successful pregnancy, including:

• Ovulation induction
• Intrauterine insemination (IUI)
• In vitro fertilization (IVF)
• Surgical treatment
• Egg donation
• Preimplantation genetic testing