Infertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to continue pregnancy may also be called relatively infertile.
Pregnancy is the result of a process that has many steps. To get pregnant:
- A woman must release an egg from one of her ovaries (ovulation).
- The egg must go through a Fallopian tube towards the uterus (womb).
- A man's sperm must join with (fertilize) the egg along the way.
- The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can happen if there are problems with any of these steps.
Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman's ovaries stop working normally before she is 40. POI is not the same as early menopause.
Less common causes of fertility problems in women include:
- Blocked Fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
- Physical problems with the uterus
- Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.
What things increase a woman's risk of infertility ?
Many things can change a woman's ability to have a baby. These include—
- Excess alcohol use
- Poor diet
- Being overweight or underweight
- Sexually transmitted infections (STIs)
- Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency.
Effect of age in fertility in women
Women reaching their thirties will experience a decline in their fertility. It could be due to the following problems:
- A decrease in the number and health of the eggs to be ovulated.
- Changes in the hormones resulting in altered ovulation.
- Fewer numbers of eggs.
- A decrease in the frequency of intercourse.
- The presence of other medical and gynecologic conditions, such as endometriosis, which may interfere with conception.