Female infer­tility: causes

Causes of infer­tility in women

The causes of infertility are many, and often a combination of different factors is responsible.
The most common causes of female infertility are listed below.

The woman’s age

Today many women have a child at an older age than in the past, because of their studies or work, or simply because the right moment came later. As a woman gets older, her fertility declines. This happens because the ovaries begin to work less well, so fewer hormones and follicles are produced.

Other common causes

• Hormonal disorders. Women with hormonal disorders more often have cycles without ovulation (anovulatory cycles), menstrual disorders and corpus luteum insufficiency. Thyroid disorders, being underweight or overweight, excessive exercise, stress, nicotine or certain medicines can affect the body’s hormonal balance.
• Problems with the fallopian tubes, ovaries and uterus. An equally common cause is fallopian tubes that are not fully open (reduced tubal patency). The main reasons are infections, adhesions, an ectopic pregnancy or previous surgery.
  In very rare cases, congenital malformations of the reproductive organs are responsible for infertility.
• Endometriosis. Endometriosis is the presence of cells of the uterine lining outside the uterus, e.g. in the fallopian tubes, ovaries, bowel or bladder. Endometriosis is one of the most common causes of infertility.
• Polycystic ovary syndrome (PCOS). In PCOS, many small cysts appear in the ovaries. Usually there is no normal ovulation. High levels of male hormones, increased body weight and excess hair growth are often found.
• Uterine fibroids. Fibroids are benign tumours that arise from the smooth muscle fibres of the uterus. Whether fertility is affected depends mainly on their number, size and position.
• Immunological reasons. In this rare disorder, the body develops antibodies against the eggs or the sperm and the embryo.
• Genetic causes. Genetic disorders, such as chromosomal abnormalities, are also a rare cause.