Common causes of fertility problems in women

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Eleven percent of reproductive-age couples in the United States have trouble conceiving or sustaining a pregnancy. About one-third of these cases are due to female fertility problems, one-third to male fertility problems, and the rest to factors involving both partners or to unexplained causes.

If you've had regular, unprotected sex for more than a year without conceiving (or six months if you're older than 35), see your doctor. About 65 percent of couples that get treatment for a fertility problem are eventually able to have a successful pregnancy, according to Resolve, the national infertility association.

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The success rates below are based on averages gathered from large groups of patients. Each couple is unique, so think of the success rate for any treatment as a general snapshot, not a prediction of your chances of having a baby. Read on to learn more about female infertility and available fertility treatments.

Ovulation problems

An ovulation problem occurs when eggs don't mature in the ovaries or when the ovaries fail to release a mature egg. This is sometimes known as premature ovarian failure. Ovulation problems are common in women with infertility.

Possible symptoms: Absent or infrequent periods, unusually light or heavy menstrual bleeding, or lack of such premenstrual symptoms as bloating or breast tenderness.

Possible solutions: Managing body weight if it's too low or too high, taking fertility drugs (with or without artificial insemination), and having in vitro fertilization (IVF).

Success rates: Thirty to 40 percent of women taking clomiphene citrate to induce ovulation become pregnant by the third treatment cycle. When fertility drugs to increase egg production are combined with artificial insemination, the pregnancy rate is between 10 and 20 percent per treatment cycle.

The percentage of IVF treatment cycles resulting in a live birth (in which one or more babies are born) is about:

  • 40 percent for women age 34 and under
  • 31 percent for women age 35 to 37
  • 21 percent for women age 38 to 40
  • 11 percent for women age 41 to 42
  • 5 percent for women age 43 and over
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Endometriosis is a condition that occurs when tissue normally found in the lining of the uterus (endometrial tissue) grows outside the uterus, usually in the abdomen or pelvis.

Possible symptoms: Some women have no symptoms, while others have painful periods or intercourse, heavy bleeding or unusual spotting, and general pelvic pain.

Possible solutions: Surgery to remove endometrial tissue or open blocked fallopian tubes, fertility drugs (with or without artificial insemination), and IVF.

Success rates: A large study found that 30 percent of women with infertility related to early stage endometriosis conceived naturally within three years after having laparoscopic surgery to remove endometrial tissue.

When women with early stage endometriosis are treated with fertility drugs and artificial insemination, the pregnancy rate is between 9 and 15 percent per treatment cycle. The live birth rate per treatment cycle for women with endometriosis who undergo IVF ranges from 2 to 42 percent, depending on the woman's age.

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Poor egg quality

The quality and number of eggs the ovaries produce – naturally or with fertility treatment – declines significantly after age 35.

Possible symptoms: None.

Possible solutions: Fertility drugs, IVF using your own eggs, IVF with donor eggs or donor embryos.

Success rates: Women who have IVF using donor eggs have an approximate 55 percent chance of having a baby per IVF cycle.

Polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is a condition in which small follicles in the ovaries don't develop into the larger, mature follicles that release eggs. It's also characterized by hormone imbalances and unpredictable ovulation patterns.

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Possible symptoms: irregular periods, excessive hair growth, acne, and obesity.

Possible solutions: Lifestyle modifications (like diet and exercise), clomiphene citrate, injected fertility drugs, ovarian drilling (a surgical procedure that can trigger ovulation), and IVF. In women with glucose intolerance, the diabetes drug metformin (Glucophage) can also help restore regular ovulation.

Success rates: Many overweight patients who lose 5 to 10 percent of their body weight start ovulating regularly. For women with PCOS who take clomiphene citrate, the pregnancy rate per treatment cycle is about 18 percent. For women treated with ovarian drilling, about 50 percent get pregnant within one year.

Tubal factors

Blocked or damaged fallopian tubes prevent sperm from getting to your egg and also prevent the fertilized egg from getting to your uterus. Leading causes of tube problems include pelvic inflammatory disease, sexually transmitted infections (such as chlamydia), and previous sterilization surgery.

Possible symptoms: None.

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Possible solutions: Surgery to open the tubes. If surgery fails, or if the tubes are too damaged to repair, they may be removed before having IVF in order to improve your chances of pregnancy.

Success rates: Conception rates after surgery vary widely, depending on the location and severity of the tube blockage and the amount of postoperative scar tissue that develops.

Couples with tubal factor infertility who try IVF have a 22 percent chance on average of having a baby per IVF treatment cycle. This depends on the woman's age, extent of tubal disease or whether the tubes have been removed, and several other factors.

Unexplained fertility problems

Your doctor may diagnose an unexplained fertility problem if there's no obvious reason for your infertility (meaning all test results are normal).

Some experts believe subtle differences in the way the reproductive system works may cause this type of infertility. This can include differences in follicle development, sperm function, or the fertilization process.

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Experts also theorize that lifestyle factors – such as being significantly underweight or overweight, regularly consuming too much caffeine or alcohol, and smoking – may be contributing factors as well.

Possible symptoms: None.

Possible solutions: Fertility drugs (with or without artificial insemination) or IVF.

Success rates: For couples with unexplained infertility, the pregnancy rate is between 9 and 26 percent per treatment cycle when fertility drugs are used in combination with artificial insemination.

With IVF, the live birth rate is about 30 percent per treatment cycle, but that figure varies depending on age.

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.

SART. 2013. Fertility data table. Society for Reproductive Medicine. a new window [Accessed 2016]

CDC. 2014. ART cycles using donor eggs. U.S. Centers for Disease Control and Prevention. a new window [Accessed 2015]

CDC. 2015. ART success rates. U.S. Centers for Disease Control and Prevention. a new window [Accessed 2015]

UpToDate. 2016. Assisted reproductive technologies. [Accessed 2015]

Karisa Ding

Karisa Ding is a freelance health writer and editor with expertise in preconception, pregnancy, and parenting content. A mother of two, Ding finds great joy in supporting new and expectant parents by providing information they need for the life-changing journey ahead. Ding lives in San Francisco with her family.