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Getting pregnant and carrying a pregnancy to term are actually very complicated processes. Many things can go wrong during these processes to lead to infertility. For this reason, the following list includes only some of the common causes of infertility in females; it is not meant to be all-inclusive. A woman who is having difficulty getting pregnant or carrying a pregnancy to term should talk with her health care provider about possible treatments.
Problems with the menstrual cycle, the process that prepares the female body for pregnancy, can lead to infertility. The menstrual cycle includes several phases, and problems at any one of the stages can lead to difficulty getting pregnant or to infertility.
If the fallopian tubes are blocked, eggs are not able to move from the ovaries to the uterus and sperm is not able to reach the egg for fertilization. Structural problems with the uterus, such as those that may interfere with implantation, can also cause infertility.
Untreated gonorrhea and chlamydia in women can lead to pelvic inflammatory disease, which might cause scarring that blocks the fallopian tubes. Untreated syphilis increases the risk for a pregnant woman to have a stillbirth. More information about infections that may affect fertility can be found on the sexually transmitted infections (STIs) health topic page.
Chronic infections in the cervix and surgical treatment of cervical lesions associated with human papillomavirus (HPV) infection can also reduce the amount or quality of cervical mucus. Problems with this sticky or slippery substance that collects on the cervix and in the vagina can make it difficult for women to get pregnant.1
The Centers for Disease Control and Prevention recommends that all boys and girls age 11 or 12 be vaccinated against HPV. Men and women who weren't vaccinated as preteens can also get the vaccine into their early to mid-20s.2
Implantation failure refers to the failure of a fertilized egg to implant in the uterine wall to begin pregnancy. While the specific cause of implantation failure are often unknown, possibilities include:3,4,5
Endometriosis occurs when the cells that normally line the uterine cavity, called the endometrium, are found outside the uterus instead. A more detailed description of endometriosis can be found at the NICHD endometriosis topic page.
Research has found a link between infertility and endometriosis. Studies show that between 25% and 50% of infertile woman have endometriosis and between 30% and 40% of women with endometriosis are infertile.6,7,8 Scientists do not know the exact cause of infertility in women with endometriosis.
PCOS is one of the most common causes of female infertility.9 It is a condition in which a woman's ovaries and, in some cases, adrenal glands produce more androgens (a type of hormone) than normal. High levels of these hormones interfere with the development of ovarian follicles and release of eggs during ovulation. As a result, fluid-filled sacs, or cysts, can develop within the ovaries. A more detailed description can be found on the NICHD PCOS topic page.
Researchers estimate that 5% to 10% of women in the United States have PCOS.10 The exact cause of PCOS is unknown, but current research suggests that a combination of genetic and environmental factors leads to the disease.
POI is a condition in which a woman's ovaries stop producing hormones and eggs at a young age. Women with POI ovulate irregularly, if at all, and may have abnormal levels of ovarian and pituitary hormones due to problems with their ovaries.
Uterine fibroids are noncancerous growths that form inside the uterus. Uterine fibroids can cause symptoms in some cases, depending on their size and location. Scientists do not know what causes fibroids to form, but it is believed that there may be a genetic basis.
Fibroids can contribute to infertility and are found in 5% to 10% of infertile women.12 Fibroids located in the uterine cavity (as opposed to those that grow within the uterine wall) or those that are larger than 6 centimeters in diameter are more likely to have a negative effect on fertility. Fibroids are more likely to affect a woman's fertility if they12:
Autoimmune disorders cause the body's immune system to attack normal body tissues it would normally ignore. Autoimmune disorders, such as lupus, Hashimoto's and other types of thyroiditis, or rheumatoid arthritis, may affect fertility. The reasons for this are not fully understood and differ between diseases, but they are thought to involve inflammation in the uterus and placenta or medications used to treat the diseases. Both men and women can make antibodies that attack sperm or the reproductive organs.13
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