The Top 5 Causes of Female Infertility

By Karen B. Simon, M.D.

Infertility is a devastating blow for couples trying to conceive. The desire to have a child and build a family is a key part of what many people envision for their future. When infertility disrupts that plan, it can create long-lasting pain and disappointment.

According to the Centers for Disease Control and Prevention (CDC), 6.7 million women in in the United States – or roughly 11 percent of the reproductive population – currently cannot have a child. If you’re struggling with infertility, take some comfort in the fact that you are not alone, and research is continuing to move forward to understand the causes and potential solutions.

The following common causes of female infertility may help you recognize when you’re at risk, and may also provide a better understanding of why you’re receiving a specific type of infertility treatment. Keep in mind, however, that these represent only part of the infertility puzzle, since infertility is not just a problem for women. In 40 percent of cases, the male partner is either the sole cause, or a contributing factor, in the inability to have a child.  And in 20 percent of cases, no cause can be found for why a couple is having difficulty becoming pregnant.

Problems with Ovulation

Infertility is sometimes caused by problems with ovulation – either slow, irregular ovulation or no ovulation at all. Ovulation disorders are usually caused by a hormone imbalance. Some of the common causes of these hormone imbalances are:

  • Polycystic ovary syndrome (PCOS): A problem with the endocrine system that causes multiple tiny cysts on your ovaries, elevated levels of male hormones and irregular periods.
  • Hyperthyroidism or hypothyroidism: Too much or too little of the hormones created by the thyroid gland.
  • Excessive exercise or an eating disorder: Having too little body fat or expending too many calories can disrupt normal ovulation cycles.

Fallopian Tube Damage or Blockage

The fallopian tubes pick up the egg after ovulation. Inside the tube, fertilization occurs. Then the tiny embryo needs to travel down the tube to implant in the uterus.  If the tubes are blocked or damaged, the sperm may not be able to reach the egg, thereby preventing a couple from becoming pregnant.  Sometimes fertilization does occur within a damaged tube, but the very early pregnancy may not be able to reach the uterus due to scarring inside the tube.  This may result in an ectopic pregnancy, a dangerous condition.  Tubal damage can be caused by:

  • Pelvic inflammatory disease: An infection of the female reproductive organs often caused by sexually transmitted diseases such as chlamydia or gonorrhea.
  • Adhesions: Scar tissue that may be caused by surgery or endometriosis or certain medical conditions which may cause the tubes to swell.


Endometriosis occurs when tissue that normally lines the uterus grows outside of uterus. This tissue can grow around the fallopian tubes, ovaries and the intestines, causing pain and infertility.

Endometriosis is estimated to be the culprit in 30 to 50 percent of female infertility cases. Researchers don’t know exactly why some women suffer from endometriosis while others don’t, but genetics, problems with the immune and lymphatic systems, and hormone imbalances may contribute.

Early Menopause

Early menopause happens when the ovaries stop working and menstruation ends before age 40. If a woman experiences early menopause, she will be unable to get pregnant without medical intervention. The causes of early menopause are not always known. Immune system diseases and genetic conditions may be a factor, as is smoking cigarettes.

Cancer and Cancer Treatment

Cancers that affect the female reproductive system, such as ovarian and cervical cancer, can cause infertility. Chemotherapy, radiation and surgery can make it more difficult to have a child as well.  Women who required treatment for certain childhood cancers are also at risk for fertility challenges.

Regardless of the reason for infertility, there is always room for hope. Infertility treatment can help. While the success rates vary depending on your age and the type of treatment you receive, the CDC reports that 39 percent of women under 35 who received infertility treatment were able to have a child.

If you have not been able to conceive a child after a year of trying, talk to your doctor or gynecologist for advice.

About the Author

Karen B. Simon, M.D.

Dr. Simon specializes in Obstetrics and Gynecology (OB/GYN). She attempts to help patients become educated about their health and treatment options before they make decisions together.

To schedule an appointment with Dr. Simon, please call 610-872-7660.

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