Infertility in Women

Infertility in women at a glance

  • A woman is considered to have the disease of infertility if she does not get pregnant after having unprotected sex on a regular basis for a year if under age 35, or after 6 months for a woman 35 or older.
  • An estimated 12% of reproductive age women (15-44) are infertile.
  • About one-third of infertility cases are due solely to female factors and another third of cases are due to combined female and male factors.
  • The primary causes of infertility in women are age, ovulation disorders, hormone imbalances and structural abnormalities of the reproductive system, including fallopian tube disorders and endometriosis.
  • Our fertility specialists utilize a variety of tests to check a woman’s fertility or determine the cause of infertility, and work with her to decide on the best treatment options.

Topic guide

What is female infertility? 
 Causes of infertility in women.
 Female infertility treatment.


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What is female infertility?

Infertility is a disease preventing a woman from conceiving or carrying a pregnancy to term. Many women have difficulty getting pregnant, but infertility is said to exist if a woman under age 35 doesn’t conceive after having somewhat frequent, unprotected sex for 12 months. For a woman 35 or older, it is diagnosed after six months of trying.

The difference in these time periods relates to the strong effects aging has on a woman’s fertility. Women who meet these criteria should seek evaluation and treatment by a fertility specialist.

It is not unusual for women to have infertility. The Centers for Disease Control and Prevention reports that about 12% of reproductive age women (15-44) are infertile. About one-third of infertility cases are due solely to female infertility and another third are due to a combination of female and male infertility factors.

Conception is a complicated process. In addition to the male meeting all criteria for fertility, the following conditions need to be met for the woman to conceive:

  • She ovulates a healthy mature egg.
  • Her fallopian tubes allow sperm to reach the egg for fertilization.
  • The resulting embryo travels to, and implants in, her uterus (womb) for pregnancy.
  • The embryo is healthy and the woman’s hormones create a nurturing environment for its development.
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Causes of infertility in women

Many factors can cause female infertility: age, hormonal imbalances, ovulation problems, fallopian tube damage, structural abnormalities in the reproductive system, lifestyle issues and more. Often a combination of these factors is at play.

For example, ovulation disorders are a major cause of infertility. These can be caused or influenced by medical conditions, hormonal imbalances, genetics, lifestyle factors and medical treatments.

A clear-cut listing of causes may be too simplistic. But it is helpful to know the major causes of female infertility.

Below is information on, and links to, our pages on these issues:

  • Age.
  • Ovulation disorders.
  • Hormonal imbalance.
  • Structural issues.
  • Fertility treatments.

Age & Infertility

Age reduces the number of eggs a woman has and also affects the quality of those eggs. Both can cause infertility. This decline in quality and quantity begins around a woman’s mid-30s and accelerates as she gets older. About one-third of couples have infertility if the woman is older than 35. The average 25-year-old woman may have a 25% chance per month of conception, but that drops to 5% for the average 40-year-old woman. In addition older women experience an increased incidence of miscarriage.

Causes of Infertility (Hormonal)

Infertility can result from an imbalance in a woman's hormones. This can interfere with ovulation and embryo implantation in the uterine lining. Several health conditions affect the endocrine (hormonal) system of the body, including hyperprolactinemia and thyroid disease. Hyperprolactinemia is over production of prolactin, which can cause infertility. Thyroid disease can cause anovulation and other fertility issues.

Causes of Infertility (Structural)

Diseases of the fallopian tubes cause 25% to 35% of female infertility. Hydrosalpinx is one specific form of fallopian tube blockage. Untreated infection of the tubes (salpingitis), including sexually transmitted infections, can cause adhesions and scarring within the tubes resulting in infertility. Lesions, cysts and PCOS can also affect fertility.

Ectopic Pregnancy

Ectopic pregnancy occurs when the embryo (fertilized egg) does not implant in the uterus but somewhere else, usually in a fallopian tube. RSC of the San Francisco Bay Area provides treatment options depending on the severity.

Endometriosis

Medical conditions like endometriosis can arise in a woman’s reproductive system that cause infertility. Endometriosis occurs when the tissue lining the inside of the uterus spreads to the outside, often attaching to the ovaries, fallopian tubes, the uterus' outer surface, or other parts of the lower abdomen. Endometriosis affects fertility in several ways.

Miscarriage

A miscarriage occurs whenever a pregnancy ends from natural causes before the 20th week of pregnancy. Miscarriages commonly occur in the first few days or weeks in the pregnancy, and can be caused by my factors.

Ovulation Disorders

Ovulatory dysfunction causes 25% - 40% of female infertility. Ovulation begins in the endocrine (hormone) system of the body, culminating with the release of a mature egg from a follicle at the surface of the ovary. If the body does not produce these hormones in exactly the right way, a hormonal imbalance or deficiency can cause infertility. Anovulation is when no ovulation occurs. But irregular ovulation can also cause infertility.

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) affects a woman's endocrine (hormonal) system, and in turn affects other body functions such as the reproductive and cardiovascular systems. Ovaries in women with PCOS sometimes contain many small follicles or cysts. The eggs contained in these follicles don’t grow normally, causing infertility.

Uterine Fibroids

Structural issues from birth can result in uterine abnormalities affecting fertility, but more often such issues as uterine fibroids show up during a woman’s reproductive years. Uterine fibroids are firm, benign (noncancerous) growths that can develop on the inner or outer wall of a woman’s uterus and cause infertility. Not every woman with uterine fibroids will experience infertility, but fibroids are present in about 5%-10% of infertile women.

Other causes of female infertility

Lifestyle factors can also cause female infertility, such as weighing too much or too little and smoking cigarettes. Recurrent miscarriage is another cause of infertility, especially affecting older women. Sexually transmitted diseases or other diseases, such as cancer or its treatment, can also cause infertility.

Fertility doctors can’t always pinpoint a cause for infertility, in which case the couple may receive a diagnosis of unexplained infertility. This occurs in about 15% of infertility cases.

Female infertility treatment

Most people think of in vitro fertilization (IVF) as the main treatment for infertility. And while beneficial for many women, IVF and similar treatments account for only about 3% of infertility services, according to the Society of Reproductive Surgeons. Conventional treatments, like surgery and fertility medications, are used in 85%-90% of infertility cases.

We offer a full range of infertility treatments, performed by compassionate experts in fertility medicine. In addition to infertility treatments, we provide reproductive services for the LGBTQ+ community. We also offer wellness and mental health services related to infertility.

Treatments

When it comes to treating infertility, RSC is a leading pioneer and we'll work with you to help achieve your dreams of having a baby. Our services include several fertility treatment options, such as IVF and ICSI, as well as counseling and alternative family building options.

 

Related Fertility Edge Podcast: Fertility Treatments