The biggest symptom of female infertility is the inability of conceiving a child in a year of trying. Although there are no outward symptoms of infertility, for the most part, there are some signs to consider. These signs typically mean another underlying condition that may be cause issues towards pregnancy. Signs include:

• Pain during sex (dyspareunia)
• Heavy, long, or painful periods
• Dark or pale menstrual blood
• Irregular menstrual cycle (irregular ovulation)
• Hormone changes

Female infertility can be caused by a wide range of things. But before that, it’s good to know what are the essential parts of getting pregnant. These include:

• Ovulation: Your body’s ovaries need to produce and release an egg.
• Sperm from your partner: Your partner needs to produce a healthy amount of sperm. In some cases being unable to conceive is due to male fertility.
• Having regular intercourse: Regular intercourse will increase your chances of getting pregnant especially when you’re most fertile.
• Open fallopian tubes and a normal uterus: The fallopian tubes are where the sperm reaches the egg and a healthy uterus is needed for the embryo to grow.

Aside from the essential parts of getting pregnant, there is a proper reproduction process that needs to happen. These things are:

• The release of a mature egg from the ovaries.
• The egg goes to the fallopian tube.
• Sperm swim up the cervix, through the uterus and into the fallopian tube to reach the egg for fertilization.
• The fertilized egg moves to the uterus by going down the fallopian tube.
• The fertilized egg implants and grows in the uterus.

When it comes to the causes of female infertility, it has to do with the disruption of the natural process above. The causes of female infertility can be one or more of the following below.

Ovulation Disorders

Ovulation disorder is a condition that causes irregular ovulation or no ovulation at all. Ovulation disorders were found to be the most common causes of female infertility where they affected 1 out of 4 couples struggling with infertility. Here are some common ovulation disorders:

• Polycystic ovary syndrome (PCOS): PCOS is the most common cause of female infertility. It is a condition that causes an imbalance of hormones that affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and common skin conditions.
• Hypothalamic dysfunction: Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are two important hormones for starting the process of ovulation every month. Things like stress and body weight can disrupt the pituitary gland’s production of these hormones and affect ovulation. The most common signs of hypothalamic dysfunction can be irregular or absent periods.
• Premature ovarian failure (primary ovarian insufficiency): Premature ovarian failure is the result of an autoimmune response or by premature loss of eggs from your ovary (maybe due to genetics or chemotherapy). Your body’s ovaries stop producing eggs, and estrogen levels decrease in women under the age of 40.
• Excess prolactin: The pituitary gland can start producing too much prolactin (hyperprolactinemia), which reduces estrogen level and may result in female infertility. This can be due to a pituitary gland problem but some medication can cause this issue.

Damage To Fallopian Tubes (Tubal Infertility)

Tubal infertility can be caused by damage to the fallopian tubes. This damage or blockage can prevent the sperm from fertilizing the egg. Damage to fallopian tubes can be the result of:

• Pelvic inflammatory disease (due to chlamydia, gonorrhea or other sexually transmitted infections)
• Previous surgery in the abdomen or pelvis (surgery for ectopic pregnancy)
• Pelvic tuberculosis

Endometriosis

This is an issue where tissue that normally grows in the uterus implants and grows in other locations which causes blockage in fallopian tubes and prevents fertilization. This may also cause damage to the sperm and the egg.

Uterine Or Cervical Causes

These things can influence infertility by causing issues with implantation. It may also increase the chances of miscarriage. Causes include:

• Benign polyps or tumors (fibroids or myomas)
• Endometriosis scarring or inflammation
• Uterine abnormalities present from birth
• Cervical stenosis
• Unable to produce the mucus that allows the sperm to travel through the cervix into the uterus.

Unexplained Infertility

In some cases, it can be due to unexplained infertility. It can be from factors from both partners and time may solve the issue. But, don’t hold back in getting fertility treatment.

There are some things that can increase your chances of infertility. Here are some things that influence your fertility:

• Age
• Smoking
• Weight (over- and underweight)
• Sexually transmitted disease (STD)
• Alcohol

If you may be considering using fertility medication, there are some risks in taking them. Here are some things to consider when choosing fertility drugs:

• Chance of multiples (twins, triplets, or more)
• Ovarian hyperstimulation syndrome (OHSS)
• Long-term risks of ovarian tumors

[1] “Infertility.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Jan. 2019, http://www.cdc.gov/reproductivehealth/infertility/index.htm.

[2] Yun, Liu et al. “Acupuncture for infertile women without undergoing assisted reproductive techniques (ART): A systematic review and meta-analysis.” Medicine vol. 98,29 (2019): e16463. doi:10.1097/MD.0000000000016463