Nashville Fertility

Causes of Female Infertility

Female infertility can be caused by hormonal, structural and genetic factors 

Female infertility affects 40% of infertile couples, male factor affects 40% and the remaining 20% have a combination of factors.  There are many factors that can affect female fertility, the major ones are listed here.

Ovulatory Dysfunction – Polycystic Ovarian Syndrome, Luteal Phase Defect, Diminished Ovarian Reserve and Premature Ovarian Failure.

Tubal Abnormalities – Hydrosalpinx and Tubal blockage

Uterine Abnormalities – Fibroids, Polyps, Intrauterine Adhesions and Congenital Abnormalities.

Chemotherapy – Many cancer treatments can impair or destroy ovarian function.  If you are facing cancer treatment, you may want to discuss options for fertility preservation with your NFC physician.

Endometriosis is one of the most common causes of infertility and pelvic pain.  It occurs when tissue from the lining of the uterus, (endometrium), implants and grows outside the uterus, resulting in decreased fertility and often painful periods and painful intercourse.  Inflammatory responses to the implants may cause scarring and pelvic adhesions, which in turn cause distortion in pelvic anatomy and decreased fertility.  In general, it is thought that the more severe a woman’s endometriosis, the lower her chance for pregnancy may be.

Hypothalamic-pituitary factors – The hypothalamus controls ovulation.  It releases GnRH (Gonadotropin Releasing Hormone) which triggers the pituitary gland to secrete FSH and LH which act on the ovary to induce ovulation. Sometimes the hypothalamus never starts making GnRH or stops making it for a variety of reasons such as stress, low body weight or low percentage of body fat, resulting in anovulation.  About 10% of the general population has pituitary tumors called prolactinomas that secrete excess prolactin, which may interfere with ovulation.  If a blood test shows a very high prolactin level, you may need an MRI to see if you have this common benign tumor.

Cervical factors – Cervical mucus provides a barrier that protects the uterus and pelvic cavity from infection.  In order for sperm to be able to swim through to fertilize the egg, mucus becomes thinner around the time of ovulation.  If this doesn’t occur, sperm cannot pass.  Antisperm antibodies may also impede the progress of sperm.

Genetic factors – Carriers of Fragile X may have irregular or absent ovulation and premature ovarian failure.  A translocation or chromosome rearrangement may result in infertility or recurrent miscarriage. Other genetic factors can result in absent periods or early loss of ovarian function.

Our job is to educate you and your partner about the causes of infertility and treatment options.  Please feel free to ask your physician or our nurses any questions that you may have about your diagnosis or treatment.

ASRM has created a video explaining some of the common causes of female infertility.

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