Understanding Female Infertility: Causes & Your Options

Key Points:

• 12% of women experience difficulties getting pregnant or carrying a baby to term.
• There are many causes of infertility among women in the U.S.
• Surrogacy is an alternative family-building option that can help fulfill your dreams of becoming parents.

If you’ve been trying to conceive for a year (or 6 months if you’re over 35) without success, it’s natural to feel concerned.

Causes of female infertility are varied, ranging from age and hormonal imbalances to physical issues. But remember, even with these challenges, you still have options for building your family.

Ready to explore how surrogacy can circumvent most causes of female infertility? We’re here to guide you every step of the way.

Speak with a specialist today

What are Causes of Infertility in Women? Categorizing the Challenges

Female infertility often stems from issues affecting the reproductive system’s ability to ovulate, allow sperm to reach the egg, facilitate fertilization or support embryo implantation.

These factors can originate in the ovaries, fallopian tubes, uterus or cervix, and sometimes involve multiple areas. The complexity of these issues is why a thorough diagnosis is crucial to identify the specific challenges you may face.

Female infertility can often be categorized based on the primary factor affecting conception:

Ovulatory Factor Infertility

This is one of the most common types and occurs when a woman doesn’t ovulate regularly or at all. The following conditions can cause ovulatory infertility:

• Polycystic Ovary Syndrome (PCOS):A hormonal disorder causing enlarged ovaries with small cysts on the outer edges, often leading to irregular or absent ovulation.
• Premature ovarian insufficiency (POI): When ovaries stop functioning normally before age 40, leading to a loss of regular egg production.
• Hypothalamic dysfunction: Issues with the part of the brain that regulates ovulation hormones, often due to extreme stress, weight, or exercise.

Tubal Factor Infertility

This type involves blockages or damage to the fallopian tubes, preventing eggs from reaching the uterus or sperm from reaching the egg.

Causes often include:

• Pelvic inflammatory disease (PID): An infection of the female reproductive organs, often caused by STIs, which can lead to scarring and damage to the fallopian tubes.
• Endometriosis: This condition can cause adhesions and scarring that block or damage the tubes.
• Previous abdominal surgeries: Surgeries (e.g., appendectomy, C-section) can sometimes lead to adhesions (scar tissue) that block or kink the fallopian tubes.

Uterine Factor Infertility

This refers to conditions affecting the uterus’s ability to support a pregnancy. Examples include:

• Uterine fibroids: Non-cancerous growths in the uterus that can distort its shape or block fallopian tubes, affecting implantation.
• Polyps: Small, benign growths in the uterine lining that can interfere with embryo implantation.
• Congenital uterine abnormalities: Structural problems with the uterus that are present from birth, such as a septate uterus (a wall dividing the uterus).
• Asherman’s syndrome: The formation of scar tissue (adhesions) inside the uterus, often due to previous uterine surgery or infection, which can reduce uterine volume and inhibit implantation.

Cervical Factor Infertility

Problems with the cervix, such as abnormalities in cervical mucus that impede sperm movement, cervical insufficiency or previous cervical surgeries (e.g., for abnormal Pap tests), can contribute to infertility.

Endometriosis-Related Infertility

Endometriosis, a condition where uterine-like tissue grows outside the uterus, can cause inflammation, scarring and anatomical distortion, impacting fertility in various ways.

Unexplained Infertility

In about 10-15% of cases, standard diagnostic tests do not identify a clear cause for infertility. This doesn’t mean there’s no problem, but rather that current diagnostic methods haven’t pinpointed it.

How Common is Female Infertility?

Infertility affects a significant number of women, highlighting the widespread nature of these challenges.

• Approximately 1 in 8 women (or about 12%) in the U.S. experience difficulties getting pregnant or carrying a pregnancy to term.
• Infertility affects at least 10% of women overall.
• About one-third of Americans have either sought fertility treatments themselves or know someone who has.

Diagnosis of Female Infertility: Uncovering the Root Cause

When conception proves challenging, a thorough diagnostic process helps pinpoint the underlying causes of female infertility. This typically involves a series of consultations, examinations and specialized tests:

Initial Consultation and Medical History

Your fertility specialist will begin by discussing your medical history, menstrual cycles, past pregnancies, lifestyle factors and any previous attempts at conception. Your partner’s medical history will also be relevant.

Physical Exam

A general physical examination and a pelvic exam are standard procedures to assess overall health and reproductive organ health.

Blood Tests

• Hormone Levels: Tests for hormones like Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Anti-Müllerian Hormone (AMH), prolactin and thyroid hormones provide insight into ovarian reserve and ovulatory function.
• Ovulation Confirmation: Progesterone levels may be checked to confirm ovulation has occurred.

Imaging Tests

• Transvaginal Ultrasound: This internal ultrasound assesses the uterus for fibroids or polyps, evaluates ovarian health and counts antral follicles to estimate ovarian reserve.
• Hysterosalpingography (HSG): An X-ray procedure where a special dye is injected into the uterus to check if the fallopian tubes are open and to identify any uterine abnormalities.
• Saline Infusion Sonohysterography (SIS): Also known as a sonohysterogram, this ultrasound uses saline solution to expand the uterine cavity, allowing for a clearer view of its lining for polyps, fibroids or scar tissue.

Laparoscopy

In some cases, a minimally invasive surgical procedure called laparoscopy may be recommended.

This allows the doctor to directly visualize the reproductive organs, identify conditions like endometriosis, adhesions or blockages, and sometimes treat them during the same procedure.

Treatment Options for Female Infertility: Pathways to Parenthood

Once a diagnosis is made, various treatment options are available, tailored to your specific situation and goals. These pathways aim to enhance your chances of conception:

• Medications: Often used to induce or regulate ovulation (e.g., Clomiphene, Letrozole, Gonadotropins) or to manage underlying conditions affecting fertility.
• Surgical Procedures: Minimally invasive surgeries can correct anatomical issues like uterine fibroids, polyps, or endometriosis, or repair blocked fallopian tubes.
• Intrauterine Insemination (IUI): Specially prepared sperm are placed directly into the uterus during ovulation.
• In Vitro Fertilization (IVF): Eggs are fertilized with sperm in a lab, and the resulting embryo(s) are transferred to the uterus. IVF can also involve using donor eggs when necessary.
• Surrogacy: For those unable to carry a pregnancy, gestational surrogacy provides a path to parenthood, where another woman carries the pregnancy.

Your fertility specialist will discuss the most suitable options based on your diagnosis and family-building aspirations.

Surrogacy: An Option When You’re Ready

The journey through infertility can be emotionally challenging, especially after trying various treatments.

If you’re wondering what’s next, surrogacy can be a powerful option. Many individuals and couples choose surrogacy when medical treatments, such as IVF, haven’t been successful.

Deciding to pursue surrogacy and let go of the dream of carrying a pregnancy yourself is a deeply personal and often difficult choice. There’s no pressure to rush this decision.

Remember:

• You’re in control: Only you can decide what’s right for your path to parenthood.
• Support is available: Infertility counselors can help you explore all your options and provide emotional support.

Surrogacy is always an option, and you can take your time to make the choice that feels right for you.

Ready to learn more about how surrogacy can help you become a parent quicker? Contact a surrogacy professional today.