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What Are the Most Common Causes of Infertility in Women?

What is the most common causes of infertility in females

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Infertility is a common problem. When you decide to have a baby, it is natural to hope it will happen quickly. But in some couples, pregnancy does not occur. A woman under the age of 35 who has not been pregnant for a year despite regular sexual intercourse without the use of contraceptives is called infertility. If you are 35, doctors will assess your fertility after six months of unsuccessful pregnancy attempts.

The cause of infertility is in 40% of men, 40% of women, and 10% of both, and in 10% of couples, infertility is unknown. If pregnancy does not occur after a year of constant couples trying to conceive, they should see an infertility specialist.

Causes of infertility in women

Causes of infertility in women

Women are born with a certain number of eggs. The number and quality of eggs decrease with age. After the age of 30, the chances of having children decrease every year, and after the age of 40, the decline in fertility continues more severely. In addition to age, infertility in women may be due to the following reasons:

1. Ovulation problems

Ovulation problem occurs when an egg does not mature in the ovary, or the ovary cannot release a mature egg, such as a  blighted ovum. They are common among infertile women. This condition is usually accompanied by symptoms such as irregular menstruation or lack of menstruation, bleeding more or less than usual during menstruation. Factors that cause ovulation problems include:

  • Polycystic ovary syndrome (PCOS): PCOS causes hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance, abnormal hair growth on the face or body, obesity, and acne. Polycystic ovary syndrome is one of the most common causes of infertility in women.
  • Premature ovarian failure: This disorder is usually caused by an autoimmune response or premature loss of eggs from the ovaries. The ovaries no longer produce eggs and reduce estrogen in women under 40.
  • Hypothalamic dysfunction: luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are hormones the pituitary gland is responsible for stimulating ovulation each month. Very high or very low weight, excessive physical or emotional stress, and increased or decreased significant weight can disrupt the production of these hormones and affect ovulation.
  • Too much prolactin: The pituitary gland may overproduce prolactin, which reduces estrogen production and may cause infertility.

2. Endometriosis

Endometriosis is a complication in which endometrial tissue, naturally present in the uterine wall, grows outside the uterus. Women with endometriosis may experience painful menstruation, pain during intercourse, heavy bleeding or abnormal spotting, and pain in the genital area. However, in some women, there are no symptoms.

Endometriosis can make it difficult to get pregnant because it can cause disrupt implantation, block fallopian tubes, inflammation in the pelvis, and perhaps impact egg quality. The treatment of endometriosis is different. Surgery, the opening of the fallopian tubes, and in vitro fertilization are some things that increase the chance of pregnancy.

3. Damage fallopian tube

Obstruction or damage to the fallopian tubes prevents sperm from reaching the egg and the egg from reaching the uterus. Endometriosis, pelvic inflammatory disease or genital tract infection, past uterine surgery, and a history of sexually transmitted diseases such as chlamydia or obstruction of the fallopian tubes to prevent pregnancy are significant causes of fallopian tube problems. The doctor will surgically open the fallopian tubes to treat this problem.

4. Unhealthy body weight

Poor nutrition and an inactive lifestyle can lead to being overweight and obese, which increases the risk of infertility and miscarriage. If you have an eating disorder like anorexia or bulimia or follow a very low-calorie or restrictive diet, you are at risk of infertility. Obese women may ovulate after losing at least 5% of their body weight. Therefore, reaching the ideal weight increases the chances of fertility.

5. Abnormal cervical mucus

Cervical mucus allows sperm to survive in the acidic environment of the vagina. Abnormal cervical mucus can prevent sperm from reaching the egg. Intrauterine fertilization can increase the chances of pregnancy.

6. Uterine fibroids

Fibroids may be involved in the implantation of a fertilized egg. Fibroids are usually noncancerous masses of muscle tissue that can form in the uterus wall. Depending on the number of fibroids in the womb and their specific size and location, they may be associated with reproductive problems. Fibroids can cause very heavy periods and problems with implantation or pregnancy complications. Fibroids may also increase the risk of miscarriage or infertility.

7. Autoimmune disorders

Autoimmune disorders cause the immune system to attack the body’s natural tissues. Such as lupus, Hashimoto’s, and rheumatoid arthritis, which may affect fertility. The reasons for this are not fully understood and vary between diseases, but both men and women can make antibodies that attack sperm or the reproductive organ and prevent it from forming or implanting.

Treatments for female infertility

Treatments for female infertility

Infertility treatment can be done in different ways, depending on the cause of this problem in women. Here are some common methods of infertility treatment


This treatment is usually given to people with an ovulation problem or substances whose infertility problems are unknown. In this method, the doctor prescribes drugs to stimulate the ovulation process. Usually, after prescribing medication, the doctor will ask the man and woman to try to get pregnant again. By stimulating the ovaries, these drugs increase the number of eggs released, which increases a woman’s chances of having a baby.

Intrauterine insemination of sperm or IUI

When the doctor considers infertility a problem in the cervix or the sperm reaching the fallopian tubes, he or she may use intrauterine insemination. In this method, on the day of ovulation, the doctor, after collecting the sperm from the man and washing them, discharges the sperm into the uterus through a long, narrow plastic catheter through the cervix. Your doctor may use medication to stimulate ovulation to increase your chances of getting pregnant before the insemination.

In vitro fertilization, or IVF

Sometimes, the doctor uses the IVF method to get the woman pregnant. the eggs are transferred to the mother’s uterus after fertilization by sperm in the laboratory. Your doctor will first release a large number of eggs by prescribing a course of ovulation-stimulating drugs. After the eggs mature, the doctor removes the eggs through a vaginal puncture with the help of an ultrasound.
Sperm is collected from the male and washed, then added to the eggs in the laboratory for fertilization. A few days later, after fertilization and cell division, a device transfers one or more fertilized eggs into the mother’s uterus.

Microinjection (ICSI)

This method is used if the number of healthy male sperm is low. The microinjection method is similar to IVF, except that healthy sperm is injected precisely into the egg. In this case, the chances of fertilizing the egg are greatly increased.


In women with diseases of the fallopian tubes or genitals, the doctor will perform laparoscopic surgery to repair the genitals’ problem. After laparoscopic surgery and genital problems, your doctor may determine that you need other methods to get pregnant.


In this procedure, a doctor inserts a hysteroscope through the cervix to remove polyps, and fibroid tumors, divide scar tissue, and open blocked tubes.

Egg donation

Women over 40 have ovarian failure, and as a result, their ovaries are not working properly, or their eggs are not good quality, but their uterus is healthy. They can become pregnant through egg donation.

The bottom line

You should see a gynecologist to diagnose the cause of infertility in women. After identifying the cause of infertility, the doctor selects the appropriate treatment method and begins the treatment process.

Dr. Arjang Naim, according to his experience and knowledge of infertility treatment, after performing the necessary examinations and tests and diagnosing the cause of infertility, helps infertile couples solve the problem and get pregnant.

Additional questions

  1. What is the cause of infertility in men?
    Infertility in men is often caused by:
  • Varicocele
  • Other factors cause a man to produce very little sperm or no sperm at all.
  • Movement of the sperm.

2. What things increase the risk of infertility in women?

Many things can change a woman’s ability to have children. This includes:

  • Age
  • Smoking
  • Excess alcohol use
  • Stress
  • Poor diet
  • Athletic training
  • Being overweight or underweight
  • Sexually transmitted infections (STIs)
  • Health problems that cause hormonal changes

3. What medications are used to treat infertility in women?
Some of the common medications used to treat infertility in women include:

  • Clomiphene citrate
  • Human menopausal gonadotropin or hMG
  • Follicle-stimulating hormone or FSH
  • Gonadotropin-releasing hormone (Gn-RH) analog
  • Metformin
  • Bromocriptine (Parlodel)

4. What is Intrauterine Insemination (IUI)?
Intrauterine insemination (IUI) is an infertility treatment often called artificial insemination. In this method, specially prepared sperm is injected into the woman. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI.

5. What are the different types of assisted reproductive technology (ART)?

  • In vitro fertilization (IVF)
  • Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer
  • Gamete intrafallopian transfer (GIFT)
  • Intracytoplasmic sperm injection (ICSI)
  • Donor eggs
  • Donor sperm
  • Frozen embryos