Infertility in Women

In the U.S., about 10% of women ages 15 - 44, or about 6.1 million women, have problems getting pregnant or carrying a baby to term.

Risk Factors

Risk factors for female infertility include:

• Age. Fertility begins to decline when a woman reaches her mid-30s, and rapidly declines after her late 30s.
• Weight. Extreme weight levels, either high or low, can contribute to infertility.
• Smoking. Cigarette smoking can impair a woman's fertility.

Causes

Infertility may be caused by an underlying medical condition that damages the fallopian tubes, interferes with ovulation, or causes hormonal complications. These medical conditions include:

• Pelvic inflammatory disease
• Endometriosis
• Polycystic ovary syndrome
• Premature ovarian failure
• Uterine fibroids

Diagnosis

If you have been unable to conceive after 1 year of unprotected sex, talk with your doctor about having your fertility evaluated. Fertility testing should especially be performed if a woman is over 35 years old or if either partner has known risk factors for infertility. An analysis of the man's semen should be performed before the female partner undergoes any invasive testing.

In addition to medical history and physical examination, specific diagnostic tests for female infertility include:

• Blood and urine tests to evaluate hormonal levels
• Imaging and ultrasound tests, (such as ultrasound, hysterosalpingography, hysteroscopy, or laparoscopy), to examine the uterus and fallopian tubes

Treatment

Treatment for infertility should first address any underlying medical condition that may be contributing to fertility problems. If this step does not restore fertility, there are several treatment approaches:

• Lifestyle measures (healthy lifestyle, planning sexual activity with ovulation cycle, managing stress and emotions)
• Drugs to induce ovulation, such as clomiphene and gonadotrophins
• Assisted reproductive technologies (ART) such as in vitro fertilization (IVF)