What Are 4 Causes of Female Infertility? Symptoms, Diagnosis, and Treatments
Infertility can be emotionally challenging, particularly for women who are trying to conceive. While many factors contribute to infertility, there are four primary causes that are frequently identified in clinical settings. Recognising these causes can help women seek timely diagnosis and treatment, improving their chances of achieving pregnancy.
This guide will walk you through the four most common causes of female infertility — what they are, how they’re diagnosed, and the best treatment options available today.
1. Ovulation Disorders
Ovulation disorders are one of the most prevalent causes of infertility in women. These disorders involve problems with the release of eggs from the ovaries, making conception difficult or impossible.
Common Types of Ovulation Disorders:
- Hypothalamic dysfunction: Disruption in hormone signals that control ovulation.
- Premature Ovarian Insufficiency (POI): Early menopause before the age of 40.
- Hyperprolactinemia: Excess prolactin that suppresses ovulation.
- Thyroid dysfunction: Both hypothyroidism and hyperthyroidism can interfere with ovulation.
Symptoms:
- Irregular or absent periods
- Low basal body temperature or irregular ovulation patterns
- Difficulty tracking ovulation
Diagnosis:
- Hormone blood tests (FSH, LH, TSH, Prolactin)
- Ultrasound scans to check follicle development
- Ovulation predictor kits or basal temperature charting
Treatment:
- Ovulation-inducing medications (e.g., Clomiphene, Letrozole)
- Lifestyle changes — weight regulation and stress reduction
- Hormonal therapy to balance thyroid or prolactin levels
Addressing ovulation issues early can drastically improve conception rates.
2. Polycystic Ovary Syndrome (PCOS)
PCOS is a hormonal disorder that affects 8–13% of women of reproductive age. It is a leading cause of female infertility due to its impact on ovulation and hormonal balance.
Symptoms of PCOS:
- Irregular or missed periods
- Excessive hair growth (hirsutism)
- Acne or oily skin
- Weight gain, especially around the abdomen
- Multiple cysts on ovaries (visible on ultrasound)
Why PCOS Causes Infertility:
Women with PCOS often experience irregular ovulation or anovulation (no ovulation), which prevents the release of eggs necessary for fertilisation.
Diagnosis:
- Ultrasound scan showing polycystic ovaries
- Hormone blood tests (androgen, insulin, LH/FSH levels)
- Menstrual cycle tracking
Treatment:
- Weight loss and exercise to improve insulin sensitivity
- Metformin to regulate insulin levels
- Ovulation inducers like Clomid or Letrozole
- IVF or IUI for severe or unresponsive cases
With early intervention, most women with PCOS can conceive with medical support.
Explore more in our dedicated article on how women should manage PCOD.
3. Endometriosis
Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. This can lead to inflammation, adhesions, and scarring that may impact reproductive organs, especially the ovaries and fallopian tubes.
Symptoms:
- Severe pelvic pain, especially during menstruation
- Painful intercourse
- Heavy periods
- Digestive issues like bloating and constipation
- Fatigue
How It Affects Fertility:
Endometrial growths can distort the pelvic anatomy, block tubes, and damage egg quality. Inflammation can impair fertilisation and embryo implantation.
Diagnosis:
- Pelvic ultrasound (though may miss small lesions)
- Laparoscopy (minimally invasive surgery for diagnosis and treatment)
Treatment:
- Pain relief with NSAIDs
- Hormonal therapy to slow tissue growth
- Laparoscopic surgery to remove lesions
- Fertility treatments such as IVF for moderate to severe cases
Women with endometriosis often require a multidisciplinary approach involving gynaecologists and fertility specialists.
4. Blocked or Damaged Fallopian Tubes
The fallopian tubes play a vital role in transporting the egg to the uterus and facilitating fertilisation. If one or both tubes are blocked or damaged, natural conception becomes difficult.
Causes:
- Pelvic Inflammatory Disease (PID)
- Sexually transmitted infections (e.g., chlamydia, gonorrhoea)
- Previous abdominal or pelvic surgery
- Endometriosis-related scarring
- History of ectopic pregnancy
Symptoms:
In most cases, tubal blockage is asymptomatic and only discovered during fertility testing. In some instances, chronic pelvic pain may be present.
Diagnosis:
- Hysterosalpingography (HSG): X-ray with dye to detect blockages
- Laparoscopy: Direct visualisation and potential repair of tubes
Treatment:
- Microsurgical tubal repair (in certain cases)
- IVF — often the most effective solution when both tubes are blocked
Women with damaged or removed fallopian tubes often have excellent success rates with IVF treatment.
Other Factors That May Contribute to Infertility
- Uterine fibroids or polyps
- Autoimmune disorders
- Obesity or being underweight
- Excessive physical stress or extreme exercise
- Lifestyle factors like smoking, alcohol use, or poor diet
In some cases, a combination of factors may contribute to unexplained infertility, where no definitive cause is found despite thorough testing.
When Should You Seek Medical Help?
It’s advisable to consult a fertility specialist if:
- You’re under 35 and haven’t conceived after 12 months of unprotected sex
- You’re over 35 and haven’t conceived after 6 months
- You have known conditions like PCOS or endometriosis
- Your periods are irregular, painful, or absent
Early diagnosis improves treatment success and offers more reproductive options.
Conclusion
Female infertility is complex, but understanding its most common causes — including ovulation disorders, PCOS, endometriosis, and blocked fallopian tubes — can help you take proactive steps. With early diagnosis and modern treatment options, many women struggling with infertility go on to have healthy pregnancies.
Whether you're just beginning your fertility journey or considering assisted reproductive technology, speaking with a fertility specialist is the best way to identify the right path for you.
To dive deeper, read our articles on chances of becoming infertile after abortion and top 5 causes of female infertility.
FAQs
What is the most treatable cause of female infertility?
Ovulation disorders are often treatable with medications and lifestyle changes, making them one of the easiest causes to manage.
Is PCOS a permanent condition?
While PCOS cannot be cured, its symptoms and effects on fertility can be managed through diet, exercise, and medications.
Can blocked tubes be unblocked naturally?
No. Tubal blockages usually require surgical intervention or are bypassed using IVF.
How long should I try before seeing a fertility doctor?
If you're under 35, try for 12 months; if over 35, try for 6 months before seeking professional help.
Is infertility only a female issue?
No, male factors contribute to about 30–40% of infertility cases. Both partners should be evaluated.