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Female infertility

Medically reviewed on Mar 8, 2018 Infertility is defined as trying to get pregnant (with frequent intercourse) for at least a year with no success. Female infertility, male infertility or a combination of the two affects millions of couples in the United States. An estimated 10 to 18 percent of couples have trouble getting pregnant or having a successful delivery.

Infertility results from female factors about one-third of the time and male factors about one-third of the time. The cause is either unknown or a combination of male and female factors in the remaining cases.

Female infertility causes can be difficult to diagnose. There are many available treatments, which will depend on the cause of infertility. Many infertile couples will go on to conceive a child without treatment. After trying to get pregnant for two years, about 95 percent of couples successfully conceive.


The main symptom of infertility is the inability to get pregnant. A menstrual cycle that's too long (35 days or more), too short (less than 21 days), irregular or absent can mean that you're not ovulating. There may be no other outward signs or symptoms.


When to seek help sometimes depends on your age:

Your doctor may also want to begin testing or treatment right away if you or your partner has known fertility problems, or if you have a history of irregular or painful periods, pelvic inflammatory disease, repeated miscarriages, prior cancer treatment, or endometriosis.


Each of these factors is essential to become pregnant:

For pregnancy to occur, every step of the human reproduction process has to happen correctly. The steps in this process are:

In women, a number of factors can disrupt this process at any step. Female infertility is caused by one or more of the factors below.

Ovulation disorders

Ovulation disorders, meaning you ovulate infrequently or not at all, account for infertility in about 1 in 4 infertile couples. Problems with the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or problems in the ovary, can cause ovulation disorders.

Damage to fallopian tubes (tubal infertility)

Damaged or blocked fallopian tubes keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include:


Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which may block fallopian tubes and keep an egg and sperm from uniting.

Endometriosis can also affect the lining of the uterus, disrupting implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.

Uterine or cervical causes

Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage:

Unexplained infertility

Sometimes, the cause of infertility is never found. A combination of several minor factors in both partners could cause unexplained fertility problems. Although it's frustrating to get no specific answer, this problem may correct itself with time. But, you shouldn't delay treatment for infertility. Female reproductive system Fertilization and implantation

During fertilization, the sperm and egg unite in one of the fallopian tubes to form a zygote. Then the zygote travels down the fallopian tube, where it becomes a morula. Once it reaches the uterus, the morula becomes a blastocyst. The blastocyst then burrows into the uterine lining — a process called implantation.


Certain factors may put you at higher risk of infertility, including:


If you're a woman thinking about getting pregnant soon or in the future, you may improve your chances of having normal fertility if you:


If you've been unable to conceive within a reasonable period of time, seek help from your doctor for evaluation and treatment of infertility.

Fertility tests may include:

Depending on your situation, rarely your testing may include: A doctor or technician places a slender catheter inside your cervix. It releases a liquid contrast material that flows into your uterus. The dye traces the shape of your uterine cavity and fallopian tubes and makes them visible on X-ray images.


Infertility treatment depends on the cause, your age, how long you've been infertile and personal preferences. Because infertility is a complex disorder, treatment involves significant financial, physical, psychological and time commitments.

Although some women need just one or two therapies to restore fertility, it's possible that several different types of treatment may be needed.

Treatments can either attempt to restore fertility through medication or surgery, or help you get pregnant with sophisticated techniques.

Fertility restoration: Stimulating ovulation with fertility drugs

Fertility drugs regulate or stimulate ovulation. Fertility drugs are the main treatment for women who are infertile due to ovulation disorders.

Fertility drugs generally work like the natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. They're also used in women who ovulate to try to stimulate a better egg or an extra egg or eggs. Fertility drugs may include:

Risks of fertility drugs

Using fertility drugs carries some risks, such as:

Fertility restoration: Surgery

Several surgical procedures can correct problems or otherwise improve female fertility. However, surgical treatments for fertility are rare these days due to the success of other treatments. They include:

Reproductive assistance

The most commonly used methods of reproductive assistance include:


Dealing with female infertility can be physically and emotionally exhausting. To cope with the ups and downs of infertility testing and treatment, consider these strategies:


For an infertility evaluation, you'll likely see a reproductive endocrinologist — a doctor who specializes in treating disorders that prevent couples from conceiving. Your doctor will likely want to evaluate both you and your partner to identify potential causes and treatments for infertility.


To prepare for your appointment:

Some basic questions to ask include:

Don't hesitate to ask your doctor to repeat information or to ask follow-up questions.


Some potential questions your doctor or other health care provider might ask include:


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