Infertility can have a variety of causes but some of the most common reasons include:
- problems with ovulation
- damage to the womb or fallopian tubes
- medicines and drugs
One quarter of couples have unexplained infertility.
Problems with ovulation
Ovulatory disorders are the most common cause of female infertility. Problems can include:
- very light, irregular or absent periods (known as amenorrhoea)
- polycystic ovary syndrome (PCOS) - a condition that makes it more difficult for the ovaries to produce an egg
- thyroid problems – both an overactive and an underactive thyroid can prevent ovulation
- premature ovarian failure – where a woman’s ovaries stop working before she is 40.
Damage to the womb or fallopian tubes
It may be difficult to conceive naturally if the womb or the fallopian tubes are damaged. This can occur due to a number of factors, including:
- Endometriosis - a condition where small pieces of the womb lining start growing in other places, such as the ovaries. These new growths form sticky areas of tissue or cysts and can cause infertility by blocking the pelvis making it difficult for an egg to be released and become implanted into the womb.
- Pelvic inflammatory disease (PID) which is an infection of the upper female genital tract, (including the womb, fallopian tubes and ovaries). PID can damage and scar the fallopian tubes, making it almost impossible for an egg to travel to the womb.
- Scarring from surgery - pelvic or cervical surgery can sometimes cause damage and scarring to the fallopian tubes and/or cervix making it more difficult to conceive.
- Cervical mucus defect - When you are ovulating, mucus in your cervix becomes thinner so that sperm can swim through it more easily. If there is a problem with your mucus, it can make it harder to conceive.
- Submucosal fibroids - Fibroids are non-cancerous (benign) tumours that grow in, or around, the womb. They can reduce fertility, although exactly how they do this is not yet known. It is possible that a fibroid may prevent an embryo from implanting itself into your womb.
Medicines and drugs can affect your fertility as outlined below:
- Antipsychotic medicines drugs used to treat psychosis can sometimes cause missed periods or infertility.
- Chemotherapy cancer medicines can cause ovarian failure, which can be permanent.
- Illegal drugs such as marijuana and cocaine can seriously affect fertility.
- Long-term use or a high dosage of non-steroidal anti-inflammatory drugs (NSAIDs). such as ibuprofen or aspirin, can make it more difficult to conceive.
- Spironolactone used to treat fluid retention can cause fertility problems.
- Sterilization can cause infertility.
Fertility in women declines with age especially during the mid-thirties. Infertility in women is also linked to age. The biggest decrease in fertility begins during the mid-thirties.
95% of women who are 30 will get pregnant after three years of having regular unprotected sex. Only 75% of women who are 38, will get pregnant after three years of having regular unprotected sex.
The good news is that almost all the known causes of infertility are responsive to treatment - and that most women can be helped by fertility treatment to have a baby.
Read about male infertility.
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