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Female Infertility

QUICK FACTS

What is it?

  • Infertility is not being able to become pregnant.
  • Ovulation problems or blocked fallopian tubes.
  • Testing is available.
  • Medication or surgery. Sometimes no treatment.

What is female infertility?

Infertility is defined as not being able to become pregnant after having regular intercourse (sex) without birth control after one year (or after six months if a woman is 35 years or older).

Fertility means being able to become pregnant (conceive), and it involves many steps, which must work just right for a woman to become pregnant. About 90 out of 100 couples will be able to get pregnant within 12 months of trying.

More about infertility:

  • Infertility is common. Out of 100 couples in the United States, about 12 to 13 of them have trouble becoming pregnant.
  • About ten in 100 (6.1 million) women in the United States ages 15–44 have difficulty becoming pregnant or staying pregnant, according to the Centers for Disease Control and Prevention.
  • About one-third of infertility cases are caused by fertility problems in women, and another one-third of fertility problems are due to fertility problems in men. The other cases are caused by a mixture of male and female problems or by problems that cannot be determined.
  • Primary infertility is infertility in a woman who has never had a pregnancy.
  • Secondary infertility is infertility in a woman who has had one or more pregnancies, but cannot become pregnant again.

What causes infertility in women?

Ovulation problems 

Most cases of infertility are caused by problems with ovulation.  Ovulation is the release of the egg from the woman’s ovary, which occurs once per month, about 12–14 days before the first day of each menstrual period. Without ovulation, a woman cannot become pregnant. Ovulation problems can be caused by hormone imbalances from a variety of causes.

Blocked fallopian tubes

Although less common, blocked fallopian tubes can also cause female infertility. To become pregnant, a woman’s egg must move from the ovary through the fallopian tube to the uterus. The fallopian tube is where the egg and sperm meet and fertilization occurs. If the fallopian tube is blocked due to infection, surgery, or other problems, then sperm cannot reach the egg to fertilize it.

Other less common causes of fertility problems in women can include physical problems with the uterus, or uterine fibroids, which are non-cancerous tumors made of fibrous tissue and muscle cells that develop on the walls of the uterus.

What decreases a woman’s chance of becoming pregnant?

  • Being age 30 or older (at age 40 there is a big drop in the chance of being able to become pregnant).
  • Smoking.
  • Heavy alcohol use (more than three to four drinks a day).
  • Stress.
  • Poor diet.
  • Diabetes.
  • Too much athletic training. 
  • Being significantly overweight or underweight.
  • History of certain sexually transmitted diseases (STDs), especially ones that have caused pelvic inflammatory disease (PID).
  • History of endometriosis (growth of uterine tissue outside of the uterus).
  • Health problems that cause changes in the hormones in a woman’s body, such as thyroid problems or polycystic ovary syndrome (PCOS).
  • Radiation treatment and/or chemotherapy for cancer.

Are there tests for female infertility?

In many cases, tests can help find the cause(s) of infertility. Testing may begin with a physical exam and questions about past medical problems.   
Healthcare providers may also conduct other tests, including:

  • Pelvic exam.
  • Ovulation predictor kit that can test blood to determine a woman’s progesterone level on day 21 of her menstrual cycle. This test can tell whether ovulation has occurred and whether the ovaries are producing a normal amount of this hormone.
  • Tests may also measure levels of other hormones that are important for fertility.  The levels of follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH) in the blood can help determine the quantity of a woman’s remaining egg supply.
  • Tests may also be conducted to examine the fallopian tubes and determine whether there is blockage that prevents movement of the egg from the ovaries. These may include:
    • X-ray hysterosalpingogram (HSG): A health care provider injects a dye into the uterus through the cervix and simultaneously takes X-ray pictures to see if the dye moves freely through the fallopian tubes.
  • Chromopertubation is similar to an HSG but is done in the operating room at the time of a laparoscopy, which is a procedure where a small camera is inserted into the abdomen—belly area—to examine the fallopian tubes, ovaries, and uterus. A woman’s uterus may be evaluated to look for fibroids or other anatomic abnormalities using the following procedures:
    • Transvaginal ultrasound: An ultrasound that looks at the internal organs using sound waves.  A wand inserted into the vagina applies sound waves to the body.  This provides a better view of the female reproductive organs, including the uterus and ovaries.
    • Hysteroscopy: A hysteroscope is a long, thin camera that is inserted through the vagina and into the uterus.
    • Saline sonohysterogram: A health care provider injects saline into the cervix to fill the uterus. Once the uterine cavity is full, it is easier to see its inner lining. The pelvic organs are visualized with transvaginal ultrasound.

How is female infertility treated?

Female infertility is treated in many ways and depends on the cause of infertility. Many cases are treated with medication or surgery. Unfortunately, sometimes there is no successful treatment for female infertility.

A couple should see their healthcare provider if they have not been able to become pregnant after 12 months of having sex regularly without birth control. If the woman is 35 years or older, she should see a healthcare provider after six months of trying to get pregnant. After ruling out female infertility concerns, tests for male infertility may be needed.

Is there a way to increase a couple’s chance of becoming pregnant?

Having sex near the time of ovulation is the best way to increase the chance of becoming pregnant. Ovulation occurs about two weeks before the next period starts. If a woman gets her period every 28 days, ovulation happens about 14 days after she starts her period. Fertility awareness can help women and couples become more familiar with the signs of ovulation and menstrual cycle patterns.

The couple should have sex at least every two days between the 10th and 18th day after the woman starts her period. The couple should make sure to have sex during the three days before ovulation. Ovulation test kits available at pharmacies can help a woman determine her fertile time.

 

Did You Know?

Problems with the male reproductive system can also contribute to fertility issues.

Learn More About Male Infertility

 

Content created by Office of Population Affairs
Content last reviewed on November 30, 2017