Understanding your reproductive health
Female Infertility
Infertility is a fairly common medical condition, affecting 6.1 million women in the U.S. between the ages of 15-44, according to the Centers for Disease Control and Prevention (CDC).1
Recognized as a disease of the reproductive system, female infertility is broadly defined as the inability to achieve pregnancy after one year of unprotected sexual intercourse. However, it may also include women who get pregnant but are unable to carry a pregnancy to term.
When women can’t get pregnant
For many women, family planning can prove more challenging than expected. Health complications may prevent proper ovulation or embryo implantation, leading to an infertility diagnosis. Leading causes of infertility in women include1:
- Dysfunctional ovulation
- Obstructions in the uterus
- Lifestyle and environmental factors
- Sexually transmitted infections (STIs)
Age factors2
Many women choose to wait until their 30s or 40s to begin having children. However, in women aged 35 or older, age has a greater impact on fertility. As a woman ages:
- The number of eggs in her reproductive system decreases
- The health and quality of her remaining eggs diminishes
- She is more likely to have health conditions that affect fertility
- The likelihood of a miscarriage increases
Lifestyle and environmental factors2
Individual lifestyle choices or circumstances can play a role in female infertility. Key considerations vary but may include1:
- Age
- Smoking
- Excess use of alcohol
- Stress
- Unhealthy dietary habits
- Athletic training
- Being overweight or underweight
- STIs
- Hormonal changes due to health problems
Causes of female infertility
There are many reproductive issues that can lead to infertility. See below for a list of some of the most common causes of infertility in women.2,3
Dysfunctional ovulation2
Occurring in about 40% of cases of female infertility, dysfunctional ovulation includes both irregularities in ovulation and the failure to ovulate.1 In typical ovulation, one ovary releases an egg every month, so if you experience fewer than nine menstrual cycles in a year, you may have dysfunctional ovulation. Causes of dysfunctional ovulation include1:
- Ovarian or gynecological medical conditions, such as:
- Polycystic ovarian syndrome (PCOS)
- Endometriosis
- Uterine fibroids o Abnormalities with the uterus
- Blocked fallopian tubes
- The decrease of eggs in a woman’s ovaries as she ages
- Endocrine disorders (e.g., thyroid disease, hyperthyroidism or Cushing’s disease)
- Lifestyle and environmental factors
- Ovarian or gynecological medical conditions, such as:
Polycystic ovary syndrome (PCOS)3
PCOS is leading cause of infertility in women, according to the CDC. Those affected by PCOS often experience irregular or painful menstrual cycles in which ovaries do not release eggs. Instead, the eggs remain in the ovary and form ovarian cysts—sacs filled with fluid that live on the reproductive organ. While not directly hereditary, PCOS is more likely to occur in women whose families have a history of the condition.
Learn more on what a PCOS diagnosis means for your reproductive health.
Endometriosis2
In endometriosis, cells that typically line the uterine cavity—or endometrium—instead grow outside of the uterus. The most common symptoms of the condition are pain and heavy or irregular periods.
When it comes to infertility, studies show that between 25% and 50% of infertile woman have endometriosis and between 30% and 40% of women with endometriosis are infertile. The exact cause of infertility in women with endometriosis is still unknown.
Abnormalities in the reproductive system2
The presence of abnormal tissue in the fallopian tubes or uterus can cause damage or blockages that prevent eggs from moving successfully from the ovaries to the uterus. In these instances, sperm is unable to reach the egg to achieve fertilization.
Structural problems of the uterus, such as endometriosis, polyps and uterine fibroids can also cause infertility by preventing successful embryonic implantation.
Infections2
STIs are another cause of infertility in women. If untreated, infections such as gonorrhea and chlamydia can lead to inflammation of the pelvis that blocks fallopian tubes and prevents eggs releasing easily into the uterus. Untreated syphilis can increase the risk of a stillbirth in pregnant women. If you suspect you may have an untreated STI, contact your care provider.
Learn more about STIs
Autoimmune disorders2
Autoimmune disorders cause the body's immune system to attack normal body tissues. Examples of autoimmune disorders that may affect fertility include:
- Lupus
- Hashimoto's and other types of thyroiditis
- Crohn’s disease
- Rheumatoid arthritis
Dysfunctional ovulation2
Occurring in about 40% of cases of female infertility, dysfunctional ovulation includes both irregularities in ovulation and the failure to ovulate.1 In typical ovulation, one ovary releases an egg every month, so if you experience fewer than nine menstrual cycles in a year, you may have dysfunctional ovulation. Causes of dysfunctional ovulation include1:
- Ovarian or gynecological medical conditions, such as:
- Polycystic ovarian syndrome (PCOS)
- Endometriosis
- Uterine fibroids o Abnormalities with the uterus
- Blocked fallopian tubes
- The decrease of eggs in a woman’s ovaries as she ages
- Endocrine disorders (e.g., thyroid disease, hyperthyroidism or Cushing’s disease)
- Lifestyle and environmental factors
Polycystic ovary syndrome (PCOS)3
PCOS is leading cause of infertility in women, according to the CDC. Those affected by PCOS often experience irregular or painful menstrual cycles in which ovaries do not release eggs. Instead, the eggs remain in the ovary and form ovarian cysts—sacs filled with fluid that live on the reproductive organ. While not directly hereditary, PCOS is more likely to occur in women whose families have a history of the condition.
Learn more on what a PCOS diagnosis means for your reproductive health.
Endometriosis2
In endometriosis, cells that typically line the uterine cavity—or endometrium—instead grow outside of the uterus. The most common symptoms of the condition are pain and heavy or irregular periods.
When it comes to infertility, studies show that between 25% and 50% of infertile woman have endometriosis and between 30% and 40% of women with endometriosis are infertile. The exact cause of infertility in women with endometriosis is still unknown.
Abnormalities in the reproductive system2
The presence of abnormal tissue in the fallopian tubes or uterus can cause damage or blockages that prevent eggs from moving successfully from the ovaries to the uterus. In these instances, sperm is unable to reach the egg to achieve fertilization.
Structural problems of the uterus, such as endometriosis, polyps and uterine fibroids can also cause infertility by preventing successful embryonic implantation.
Infections2
STIs are another cause of infertility in women. If untreated, infections such as gonorrhea and chlamydia can lead to inflammation of the pelvis that blocks fallopian tubes and prevents eggs releasing easily into the uterus. Untreated syphilis can increase the risk of a stillbirth in pregnant women. If you suspect you may have an untreated STI, contact your care provider.
Learn more about STIs
Autoimmune disorders2
Autoimmune disorders cause the body's immune system to attack normal body tissues. Examples of autoimmune disorders that may affect fertility include:
- Lupus
- Hashimoto's and other types of thyroiditis
- Crohn’s disease
- Rheumatoid arthritis
When to consult a doctor4
You should talk to a care provider about infertility if any of the following applies to you:
- You are 35 or older and have been trying to conceive for six months or longer
- You are experiencing irregular or absent periods
- You have had previous fertility issues in the past
- You have been diagnosed with endometriosis or pelvic inflammatory disease
- You have had multiple miscarriages
Take charge of your reproductive health
You are not alone. There are millions of people working through the same symptoms as you and many providers who are prepared to help. Speak with your doctor about how to best support your body as you are trying to conceive.
Find reproductive health and fertility support whether you're trying to conceive or just tracking.
If you are trying to conceive, it can be helpful to track your health indicators in an app like Ovia Fertility and Cycle Tracker. In Ovia, you can stay on top of all your symptoms—cycle irregularity, mood changes and more—and identify patterns.
References:
U.S. Department of Health and Human Services. Infertility. Office on Women’s Health. Accessed June 29, 2022. https://www.womenshealth.gov/a-z-topics/infertility.
U.S. Department of Health and Human Services. What are some possible causes of female infertility? National Institute of Child Health and Development. Accessed June 20, 2022. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/causes/causes-female.
Centers for Disease Control and Prevention. PCOS (Polycystic Ovary Syndrome) and Diabetes. Accessed April 19, 2022. https://www.cdc.gov/diabetes/basics/pcos.html.
- Centers for Disease Control and Prevention. Reproductive Health Infertility FAQs. Accessed June 20, 2022. Available at: https://www.cdc.gov/reproductivehealth/infertility/index.htm.