What Are the Top Five Causes of Female Infertility?
Infertility in women is defined by the inability to conceive after 12 months of regular, unprotected intercourse (or 6 months if over age 35). It can stem from a range of medical and lifestyle factors.
Top 5 Causes of Female Infertility
- Ovulatory disorders (especially PCOS): Polycystic ovary syndrome is the most common cause, accounting for a major share of ovulatory infertility. It leads to irregular or absent ovulation due to hormonal imbalance :contentReference[oaicite:2]{index=2}.
- Tubal factor infertility: Blocked or damaged fallopian tubes—often resulting from pelvic inflammatory disease, untreated STIs, or surgeries—cause 25–30% of cases :contentReference[oaicite:3]{index=3}.
- Endometriosis and uterine abnormalities: Endometrial tissue growing outside the uterus, fibroids, adhesions, or congenital structural issues can impair fertilization or implantation :contentReference[oaicite:4]{index=4}.
- Primary ovarian insufficiency (premature ovarian failure): When ovarian follicles fail before age 40, egg supply diminishes early. Causes include genetic factors, autoimmune conditions, or chemotherapy :contentReference[oaicite:5]{index=5}.
- Hormonal and endocrine disorders: Hypothyroidism, hyperprolactinemia (pituitary issues), adrenal excess hormones, or functional hypothalamic amenorrhea due to weight extremes or stress contribute to infertility :contentReference[oaicite:6]{index=6}.
Other Contributing Factors
- Age and diminished ovarian reserve: Fertility declines as egg quality and quantity decrease over time, especially after age 35 :contentReference[oaicite:7]{index=7}.
- Lifestyle & environmental influences: Smoking, obesity or being underweight, poor diet, high stress, and exposure to endocrine disruptors (e.g. BPA, phthalates) can impair fertility :contentReference[oaicite:8]{index=8}.
- Unexplained infertility: In up to 15% of couples, no exact cause is identified. Often multiple subtle factors in both partners interplay :contentReference[oaicite:9]{index=9}.
Why It Matters
Understanding the cause helps in selecting treatment strategies—such as lifestyle change, hormone therapy, surgical correction, fertility medications, or assisted reproduction (e.g. IVF).
When to Seek Medical Evaluation
- If you're under 35 and haven't conceived after a year—or over 35 after six months.
- If menstrual cycles are irregular or absent.
- If there's a history of STIs, pelvic pain, surgery, or endometriosis symptoms.
- If you have known endocrine conditions (like thyroid issues, PCOS) or unexplained risk factors like high stress or weight issues.
Takeaway
The most prevalent causes of female infertility include ovulatory disorders (especially PCOS), tubal damage, endometriosis or uterine structural issues, ovarian insufficiency, and hormonal dysfunction. Many of these are manageable or treatable, so early diagnosis and tailored care can significantly improve chances of conception.