Infertility refers to the inability to conceive after 12 months of unprotected intercourse, and it can be extremely difficult to deal with, taking both a physical and emotional toll on your mind and body.

If you have been struggling to get pregnant, there may be a reason why it’s not happened for you yet. It’s important that you understand how your body works and if you have any underlying health conditions that might be getting in the way of your dreams of starting a family.

Check out this article to find out more about some of the causes of infertility and get tips on how to conceive.

Causes of infertility in women

The truth is, there are many different reasons why a woman may struggle with infertility. In some cases, a cause cannot be identified, making it especially difficult to conceive.

To learn about some of the most common causes of infertility, how to spot the symptoms and what can be done to improve your chances of getting pregnant, keep reading.

Ovulation problems

For some women, infertility is caused by ovulation problems. Ovulation is the process in which an egg is released from one of the ovaries. There are a number of health conditions that can disrupt the ovulation process, making it more difficult to conceive, including:

• Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) affects how a woman’s ovaries work, and it can mean they don’t release an egg at the end of the menstrual cycle, making it harder to get pregnant. It can be tricky to know if you have PCOS, as your symptoms may be mild. In fact, you may not realise you have this condition until you start trying for a baby. The most common symptoms of PCOS include irregular periods, or no periods at all, excessive facial hair, hair loss, acne and weight gain.

Although PCOS can affect fertility, it does not mean that a woman can’t ever get pregnant. PCOS is a treatable condition, and there are a number of things you can do to keep your symptoms under control and increase your chances of getting pregnant. For example, you could try using a fertility supplement for women or a specific medication recommended to you by your doctor. It’s also a good idea to make some lifestyle changes, such as maintaining a healthy weight by sticking to a balanced diet and exercising regularly.

• Thyroid issues

Thyroid issues can make it harder to conceive. Both an overactive thyroid gland and an underactive thyroid gland can affect ovulation, making it more difficult for a woman to get pregnant, especially if it is an undiagnosed thyroid condition.

If you have an overactive thyroid gland, you might notice that your periods are light and they may be irregular. Meanwhile, if you have an underactive thyroid, your periods may be longer and heavier, which in turn can cause other problems, such as anaemia. Alternatively, you might find that your periods stop completely. In some cases, you may not realise you have a thyroid problem until you start trying for a baby and struggle to conceive.

With the right treatment, it’s possible to get a thyroid condition under control, and it is likely you will still be able to get pregnant and have a healthy pregnancy.

• Premature ovarian failure

Premature ovarian failure is when the ovaries no longer work like they should before age 40. This condition means that the ovaries do not produce the normal amount of oestrogen or release it as regularly as they should, which in turn can lead to infertility.^[1]

Premature ovarian failure can be caused by an immune system response whereby the immune system produces antibodies against your ovarian tissue, harming the follicles which contain eggs and in turn damaging them. Other causes can include chromosome changes due to genetic disorders or exposure to toxins such as during chemotherapy or radiation therapy.

The symptoms of premature ovarian failure are quite similar to the signs of the menopause. Aside from difficulty getting pregnant, these can include irregular or skipped periods, hot flushes, night sweats, vaginal dryness and decreased sexual desire.

Oestrogen therapy is one of the main treatment options for premature ovarian failure. This treatment can encourage your periods to return and increase your chances of getting pregnant, however this is not guaranteed.

Scarring from surgery

Medically referred to as uterine scarring, it is possible for the uterus to become scarred after some types of surgery. The scar tissue can sometimes change the shape and function of the uterus, making it more difficult to conceive.

For example, c-section surgery can cause scar tissue to develop on the uterus, while cervical surgery can cause scarring and also shorten the neck of the womb. Some types of pelvic surgery can damage and scar the fallopian tubes.

Your doctor will be able to advise the best treatment for your uterine scarring. The type of treatment you may be offered can include medication, hormone therapy and even further surgery to remove the scar tissue. Some women are still able to get pregnant afterwards.

Thick cervical mucus

The mucus produced by the cervix is normally thick and impenetrable up until ovulation. Just before ovulation and the release of an egg, this mucus changes to become clear, elastic and thinner, allowing sperm to pass through it more easily into the uterus and fallopian tubes where the egg can be fertilised and conception can take place. However, if the mucus is too thick, it can make it harder for the sperm to pass through, which in turn can make it more difficult to conceive.

There are a number of factors that can affect your cervical mucus, including vaginal infections, such as yeast infections, bacterial vaginosis and some sexually trasmitted infections (STIs). The cervical mucus can also be impacted by some medications, such as hormonal contraceptives. Your diet and stress levels may also play a role in the production and quality of cervical mucus.

If you’re struggling to conceive and suspect there is a problem with your cervical mucus, a doctor will be able to carry out a pelvic examination. They will be able to check the cervix for signs of infection and scarring to reach a diagnosis.

To improve the quality of your cervical mucus, your doctor may recommend a supplement or specific medication. Increasing your water intake and eating plenty of healthy foods, such as fruit and vegetables, is also thought to naturally improve cervical mucus.

Endometriosis

Endometriosis is a condition whereby pieces of tissue that are similar to the womb lining start growing elsewhere, such as the ovaries and fallopian tubes. As a result, this can damage the ovaries and fallopian tubes, which can then cause fertility problems.

A long-term condition that can affect women of any age, endometriosis can be particularly bad for some, while others may not have many noticeable symptoms. The most common symptoms include pain in the lower abdomen or back which is often worse during your period, period pains that prevent you from doing normal activities, particularly heavy periods, pain during or after sex, pain when using the toilet, feelings of nausea, constipation and diarrhoea, as well as difficulty getting pregnant.

While there is no cure for endometriosis, there are treatments that can help relieve your symptoms, including painkillers like paracetamol and ibuprofen, contraceptives such as the combined pill - an oral contraceptive pill which contains artificial versions of oestrogen and progesterone. Surgery to remove endometriosis tissue can help improve your chances of conceiving.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection of the upper female genital tract. This includes the ovaries, fallopian tubes and womb. In most cases, PID is caused by a bacterial infection, such as an STI, that spreads from the vagina or cervix up towards the reproductive system. PID can damage and in turn scar the fallopian tubes, and as a result, make it impossible for an egg to travel down into the womb, causing infertility.

The symptoms of PID are often mild, although you may experience pain in the lower abdomen or pelvis, heavy or painful periods, unusual vaginal discharge, as well as discomfort during sex, pain when peeing and bleeding after sex or between periods.

If it’s detected early, PID can be treated with a course of antibiotics. You may be given a mixture of antibiotics to cover the most likely infections, including an injection and tablets.

Unfortunately, PID can cause the fallopian tubes to become scarred and therefore narrowed, making it harder for eggs to move from ovaries to the womb. This means there is an increased risk of an ectopic pregnancy (when a pregnancy occurs in the fallopian tubes instead of the womb) and it can make some women infertile. However, while the delayed treatment of PID, or repeated episodes, can make it more difficult to conceive, most women who are treated for PID are still able to get pregnant.

How many women are infertile?

If you’re struggling to get pregnant, you may feel lonely, even if you have the support of a partner. However, it’s important to know that you’re not alone, and infertility is more common than you might think. According to the NHS, one in seven couples may struggle to conceive, while the Journal of Human Reproductive Sciences reports that over 70 million couples worldwide experience infertility problems.

Identifying the root cause of your fertility struggles is the first step to trying to conceive, so don’t hesitate to speak to your doctor for support, advice and further testing to help reach a diagnosis. There are many different types of treatment options that can significantly increase your chances of getting pregnant and starting a family.

^[1] https://patient.info/womens-health/menopause/premature-ovarian-insufficiency