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Female Fertility

What is infertility in women?

Infertility in women is defined by the inability to get pregnant after regularly having unprotected intercourse for at least one year. After a woman reaches the age of 35, she is considered infertile if she and her partner are unable to get pregnant after six months of trying.

The chances of becoming pregnant decrease significantly after a woman reaches the age of 40. According to the CDC, infertility affects nearly 11 percent of U.S. females of reproductive age.

According to the American Society for Reproductive Medicine (ASRM), 1 in 7 couples (about 14 percent) experience infertility. In these cases, one-third of infertility cases are caused by female factors. Nearly as many cases are due to factors involving both partners, and male factor infertility accounts for roughly 20 percent of cases. Male infertility factors make it necessary for both partners to have fertility testing prior to a woman beginning fertility treatment.

Symptoms of infertility in women

Many women experiencing infertility show no symptoms, other than the inability to conceive. If a woman does show infertility symptoms, they may include:

  • Irregular menstrual cycles or no menstrual cycle
  • Menstrual cycles are longer than 35 days or less than 21 days
  • A history of pelvic inflammatory disease, endometriosis, or pain during menstruation
  • Obesity
  • Recurrent miscarriages

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  • Female infertility occurs if a woman lacks the ability to get pregnant after regularly having unprotected intercourse for 12 months, or six months for women older than 35.
  • The Center for Disease Control and Prevention (CDC) found that infertility affects nearly 11 percent of reproductive-age women in the United States.
  • A fertility specialist will conduct tests to help evaluate symptoms and determine a cause for infertility in a woman struggling to conceive.
  • Common causes of infertility in women include ovulatory dysfunction, imbalance of hormones, and structural issues of the reproductive system.
  • Treatments available for infertility in women include fertility drugs, reproductive surgery, intrauterine insemination (IUI), and in vitro fertilization (IVF).

ASRM reports that 85 percent of female infertility cases under medical attention are treated with either fertility drugs or surgery. The recommended course of treatment will vary for each woman based on her individual circumstances, including age, duration of infertility, and overall health.

Some treatments for infertility in women include:

  • Lifestyle changes may help alleviate and manage chronic health problems that can cause infertility, such as obesity or smoking.
  • Ovulation induction uses hormone drugs to help signal the ovaries to develop and release eggs that have reached maturation.
  • Intrauterine insemination (IUI) is a type of artificial insemination in which a fertility specialist will insert sperm from a partner or donor into the woman’s uterus. It is often performed to combat male infertility conditions that make it difficult for sperm to reach the woman’s egg.
  • Minimally invasive surgery can remove or repair a woman’s damaged organs or tissue that cause her reproductive system to not function properly.
  • In vitro fertilization (IVF) is an assisted reproduction technology (ART) involving fertilizing a woman’s egg(s) outside her body in an IVF lab, and then implanting a healthy embryo(s) in her uterus.
  • Intracytoplasmic sperm injection (ICSI) is a lab procedure used during some IVF cycles in which one healthy sperm (collected from the male partner) is inserted into the cytoplasm of a woman’s egg (collected during the first part of IVF) for a better chance at fertilization and development of a healthy embryo.
  • Preimplantation genetic diagnosis (PGD) determines if a certain genetic condition exists in an embryo(s) prior to implantation during IVF.
  • Preimplantation genetic screening (PGS) is a test that evaluates an embryo(s) for all chromosomal abnormalities and can also be used to determine the sex of an embryo (to avoid gender-specific genetic conditions in the baby).
  • Assisted hatching is a treatment during IVF where the outer layer of an embryo is punctured to assist in its attachment (called hatching) in the uterus, increasing the likelihood of implantation and pregnancy.
  • Donor eggs or donor embryos may be used in women who are unable to conceive with their own eggs or embryos.
  • Gestational carriers or surrogates are women who carry a pregnancy to term for a woman who may not have the ability to carry a pregnancy due to health issues or reproductive system problems.

Causes and Conditions

Many factors can cause infertility in women, including:

Anovulation is the cause of about 25 percent of female infertility and occurs when a woman’s ovaries are not producing or releasing an egg at a regular rate during menstruation.
Female Aging
Female aging causes the number and quality of eggs to diminish. When a woman is age 35 or older, her fertility decreases, affecting her ability to have a healthy pregnancy.
Diminished Ovarian Reserve
Diminished ovarian reserve occurs when a woman does not have enough potential eggs left in the ovaries, or the eggs are low quality, lessening chances to conceive.
Fibroids or Polyps
Fibroids or polyps are noncancerous tumors that develop in the uterus and can alter the shape of the uterus or affect the ability of the endometrium to receive an embryo (fertilized egg) properly for implantation.
Hormone Imbalance
Hormone imbalance occurs when a woman’s reproductive system produces less than or more than the number of hormones needed to become pregnant.
Menopause occurs when a woman ceases to have menstrual periods (when the ovaries no longer have viable eggs). Most women reach menopause by age 51.
Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is an endocrine disorder that can impair a woman’s fertility by causing her eggs to fail to reach maturation. According to ASRM, nearly 10 percent of women of childbearing age in the U.S. have PCOS.
Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is an infection in the female reproductive system, usually resulting from sexually transmitted infections or diseases. PID can lead to the fallopian tubes, ovaries and/or uterus becoming scarred or damaged.
Recurrent Miscarriage
Recurrent miscarriage is when a woman experiences at least two pregnancy losses consecutively due to an infertility condition or genetic disorder.
Unexplained Infertility
Unexplained infertility is determined after both female and male partners have been tested for infertility but no known cause is determined. Unexplained infertility affects nearly 10 percent of couples experiencing infertility.
Tubal Factor Infertility

Tubal factor infertility occurs when the fallopian tube(s) prevents sperm from reaching the egg for fertilization or prevents a fertilized egg (an embryo) from reaching the uterus for pregnancy.

Uterine Fibroids Surgery
Uterine fibroids are growths of muscle on and/or within the uterus, or womb, and are one of the most common uterine issue that may cause infertility.
Ectopic Pregnancy
An ectopic pregnancy occurs when a fertilized egg attaches itself somewhere outside of the uterus, usually in the fallopian tubes. Ectopic pregnancies are usually treated with medical injections or laparoscopic surgery to end the pregnancy.
Endometriosis occurs when the tissue of a woman’s endometrium, or uterine lining, grows on the outside of the uterus, sometimes in adjacent organs. The most common location for endometriosis is the lining of the uterus, or endometrium.
Irregular Periods and Fertility
Irregular periods and menstrual disorders are conditions that disrupt the normal menstrual cycle in women, which plays a key role in fertility. These conditions include amenorrhea, oligomenorrhea, and menorrhagia.