Infertility & Reproduction Health Center

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Causes of Female Infertility

Female infertility can be caused by a number of factors, including the following:

Fertility Testing

Q. What goes into a fertility evaluation?
A. A standard fertility evaluation includes physical exams and medical and sexual histories of both partners. Men undergo a semen analysis that evaluates sperm count and sperm movement. "We look at the percent that are moving and how they are moving--are the sperm sluggish? Are they wandering?" says Robert G. Brzyski, M.D., Ph.D., associate professor of obstetrics and gynecology at the University of Texas Health Science Center at San Antonio. "Often, it's not possible to identify a specific reason for a sperm disorder," he says. "But there is new recognition that very low sperm or no sperm may be related to genetics--an abnormality of the Y chromosome."

For women, doctors first check to see whether ovulation is occurring. This can be determined and monitored through blood tests that detect hormones, ultrasound examinations of the ovaries, or an ovulation home test kit. "An irregular menstrual pattern would make us suspicious of an ovulation problem, but it's also possible for a woman with regular periods to have an ovulation disorder," Brzyski says.

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Damage to fallopian tubes. Damage to the fallopian tubes (which carry the oocytes from the ovaries to the uterus) can prevent contact between the oocyte and sperm. Repetitive pelvic infections, endometriosis and multiple pelvic surgeries may lead to scar formation and fallopian tube damage.
Hormonal causes. Some women have problems with ovulation. Synchronized hormonal changes leading to the release of an oocyte from the ovary and the thickening of the endometrium (lining of the uterus) in preparation for the fertilized egg do not occur. These problems may be detected using basal body temperature charts, ovulation predictor kits, and blood tests to detect hormone levels.
Cervical causes. A small group of women may have a cervical condition in which the sperm cannot pass through the cervical canal. Whether due to abnormal mucus production or a prior cervical surgical procedure, this problem may be treated with intrauterine inseminations (see below).
Unexplained infertility. The cause of infertility in approximately 20% of couples will not be determined using the currently available methods of investigation.