Causes, Diagnosis & Treatment
Female factor infertility accounts for approximately 40% of all infertility cases. With early diagnosis and advanced reproductive technologies, the vast majority of female fertility issues can be treated successfully.
1 in 6
Couples face infertility
25%
Caused by ovulation disorders
~75%
Our IVF success rate
35+
Age when fertility declines faster
Click on a condition to learn more about causes, symptoms, and treatment
PCOS is one of the most common hormonal disorders affecting women of reproductive age, causing irregular ovulation and reduced fertility.
Endometriosis causes tissue similar to the uterine lining to grow outside the uterus, leading to pain, scarring, and fertility challenges.
Uterine fibroids are non-cancerous growths in the uterus that can distort the uterine cavity and interfere with implantation and pregnancy.
Blocked fallopian tubes prevent the egg and sperm from meeting, making natural conception impossible and requiring assisted reproduction.
Poor ovarian reserve means fewer eggs are available for fertilisation, but specialised IVF protocols can still achieve pregnancy.
Premature ovarian failure (POF) causes the ovaries to stop functioning before age 40, but parenthood is still possible with donor eggs.
Underactive thyroid (hypothyroidism) disrupts menstrual cycles and implantation, but is easily treated to restore fertility.
Elevated prolactin levels suppress ovulation and can cause milky discharge from the breasts, but respond well to medication.
Uterine polyps are soft growths in the uterine cavity that can prevent embryo implantation and are easily removed hysteroscopically.
A thin uterine lining (endometrium) prevents embryo implantation. Targeted therapies can build the lining to support a successful pregnancy.
Cervical factor infertility occurs when the cervical mucus prevents sperm from reaching the egg, often addressed successfully with IUI or IVF.
Recurrent implantation failure (RIF) is when embryos repeatedly fail to implant during IVF, requiring specialised investigation and personalised treatment.
Insufficient progesterone production after ovulation shortens the luteal phase, preventing adequate endometrial preparation for embryo implantation.
A mild late-onset form of CAH caused by 21-hydroxylase deficiency, resulting in androgen excess that can mimic PCOS and impair ovulation.
A common PCOS subtype where cells do not respond effectively to insulin, leading to elevated androgen levels that disrupt ovulation.
PCOS occurring in women of normal body weight. Often underdiagnosed because the classic overweight presentation is absent, yet anovulation still impairs fertility.
Excess androgen (male hormone) levels in women, disrupting ovulation and causing hirsutism, acne, and menstrual irregularity.
Loss of menstruation due to suppressed GnRH secretion, often triggered by extreme energy deficit, excessive exercise, or psychological stress.
Prolonged exposure to high cortisol levels disrupts the HPG axis, suppressing ovulation and causing metabolic and reproductive dysfunction.
Underactive thyroid elevates TSH and prolactin, disrupting the menstrual cycle and reducing egg quality. Even subclinical hypothyroidism reduces IVF success rates.
Excess thyroid hormone disrupts the menstrual cycle and increases miscarriage risk. Graves disease is the most common cause in women of reproductive age.
Elevated anti-TPO antibodies — even with normal TSH — are associated with implantation failure, recurrent miscarriage and reduced IVF success.
Fibroids growing into the uterine cavity distort the endometrial lining, reducing implantation rates and increasing miscarriage risk.
Fibroids embedded within the myometrium; those >4 cm or distorting the cavity can reduce IVF implantation rates and increase preterm labour risk.
Intrauterine adhesions formed after uterine surgery or infection obliterate the cavity, blocking implantation and causing recurrent pregnancy loss.
A midline fibrous partition within the uterine cavity is the most common Müllerian anomaly and consistently associated with increased miscarriage rate.
Partial fusion failure of Müllerian ducts creates a heart-shaped uterus, increasing miscarriage and preterm birth rates.
A Müllerian anomaly where only half the uterus forms, significantly increasing risks of miscarriage, preterm birth, and malpresentation.
A mild uterine anomaly with a small midline indentation of the uterine fundus. Associated with second-trimester loss; impact on first-trimester loss is debated.
Narrowing of the cervical canal impedes sperm entry and embryo transfer procedures, and can cause retrograde menstruation contributing to endometriosis.
Blockage at the cornual end of the fallopian tube prevents sperm from reaching the egg. Often due to tubal spasm, polyps, or salpingitis isthmica nodosa.
Blockage at the fimbrial end of the tube prevents egg pick-up. Often results from adhesions secondary to endometriosis or pelvic infection.
Fibrous bands around the fallopian tubes impair their mobility even when the tubal lumen is patent, reducing natural conception rates.
Overgrowth of the uterine lining due to unopposed oestrogen. Atypical hyperplasia carries malignant risk and must be treated before IVF.
Persistent low-grade inflammation of the endometrial lining caused by bacteria, impairing embryo implantation. Often asymptomatic and missed on routine investigation.
A displaced window of implantation where the endometrium reaches peak receptivity earlier or later than assumed. Detected by the ERA test.
An IVF complication where excessive follicle recruitment causes fluid shift, ovarian enlargement, and in severe cases cardiovascular compromise.
Twisting of the ovary on its ligamentous supports cuts off blood supply and can cause irreversible ovarian damage if not surgically corrected promptly.
Follicular or corpus luteum cysts form during normal ovarian activity. Most resolve spontaneously but can delay IVF stimulation.
Loss of normal ovarian function before age 40, causing oestrogen deficiency and infertility. Spontaneous pregnancy is rare (5–10%).
Fewer than 3 oocytes retrieved in a stimulated IVF cycle despite maximal stimulation. Classified by the Bologna criteria.
Fertility declines sharply after 35 due to reduced ovarian reserve and rising oocyte aneuploidy rates. IVF success rates fall steeply after 40.
Low AMH and AFC in women under 35, years before expected menopause. Requires urgent fertility evaluation and possible egg banking.
An autoimmune prothrombotic condition that causes placental microthrombi, leading to recurrent miscarriage (especially second-trimester) and thrombosis.
Elevated uterine or peripheral NK cells are associated with recurrent miscarriage and implantation failure. Immunological protocols may help.
SLE can reduce ovarian reserve, cause recurrent pregnancy loss, and increase preterm birth risk. Requires multidisciplinary management.
Absence of one X chromosome causes premature ovarian insufficiency. Spontaneous pregnancy is rare; egg donation is the principal fertility option.
Women with 55–200 CGG repeats in FMR1 have a 20% risk of premature ovarian insufficiency and a 50% chance of passing the full mutation to sons.
Inherited or acquired clotting disorders cause placental microthrombi, resulting in miscarriage or foetal growth restriction.
Implantation outside the uterine cavity is life-threatening and may result in tube removal, reducing future natural fertility.
3 or more consecutive pregnancy losses before 12 weeks. A structured investigation finds a treatable cause in ~50% of cases.
Two or more pregnancy losses between 12–24 weeks. More likely to have structural or thrombotic causes than first-trimester losses.
Fluid from a hydrosalpinx drains into the uterine cavity and is embryotoxic, reducing implantation rates by up to 50%.
A benign pituitary adenoma that hypersecrets prolactin, suppressing GnRH and causing amenorrhoea, galactorrhoea, and infertility.
Elevated prolactin without a pituitary tumour suppresses ovulation. Drug causes must always be excluded before treatment.
Ascending genital tract infection damaging the fallopian tubes, leading to tubal factor infertility in up to 20% of affected women.
Mycobacterium tuberculosis infection of the female genital tract causes severe tubal occlusion and endometrial scarring — a significant cause of infertility in India.
Involuntary spasm of vaginal muscles prevents penetration, making natural intercourse impossible. Requires medical and psychological management.
Elective oocyte cryopreservation allows women to preserve fertility before age-related decline, providing flexibility for later parenthood.
IVF using eggs from a young donor offers the highest success rates (~50–60% per transfer) for women with poor reserve or premature ovarian failure.
The dominant follicle undergoes luteinisation but does not rupture to release the egg despite normal LH surge and progesterone rise.
Cycles longer than 35 days indicate infrequent ovulation, common in PCOS and hypothalamic amenorrhoea. Significantly reduces monthly chances of conception.
The most common hormonal disorder in women of reproductive age affecting 8–13%, diagnosed by the Rotterdam criteria. The leading cause of anovulatory infertility.
Endometriosis implants penetrating >5 mm into peritoneal tissue affect the uterosacral ligaments, rectovaginal septum, bowel, or bladder, causing severe pain and reduced fertility.
Stage I–II endometriosis with peritoneal implants. Altered peritoneal environment and inflammatory cytokines may impair fertilisation.
Endometrial glands and stroma within the uterine muscle impair uterine contractility, reducing embryo implantation rates and increasing miscarriage risk.
The sella turcica appears empty on MRI due to CSF herniation. May be associated with hypopituitarism causing FSH/LH deficiency and infertility.
Women with family history of early menopause, FMR1 premutation, or autoimmune conditions should have proactive ovarian reserve testing and fertility counselling.
Understanding the root cause helps our specialists create a targeted treatment plan
PCOS, hormonal imbalances, and thyroid disorders can prevent regular ovulation, the most common cause of female infertility.
Blocked or damaged fallopian tubes prevent the egg from meeting sperm, often caused by infections or endometriosis.
Tissue similar to the uterine lining grows outside the uterus, causing inflammation, scarring, and reduced fertility.
Low egg count or poor egg quality, indicated by low AMH levels, which naturally declines with age.
Fibroids, polyps, or structural issues in the uterus can interfere with implantation or pregnancy maintenance.
Female fertility naturally declines after 35, with a significant drop after 40 due to reduced egg quality and quantity.
Our comprehensive female fertility evaluation includes
Blood test that measures ovarian reserve — the quantity of eggs remaining. A key indicator of fertility potential.
Blood tests for FSH, LH, estradiol, progesterone, prolactin, and thyroid hormones to assess the hormonal environment.
Imaging of the uterus and ovaries to check for fibroids, polyps, cysts, and to perform antral follicle count (AFC).
X-ray with contrast dye to evaluate whether the fallopian tubes are open and the uterine cavity is normal.
Direct visualisation of the uterine cavity using a thin camera to diagnose and treat polyps, fibroids, or adhesions.
Minimally invasive surgery to diagnose endometriosis, tubal damage, ovarian cysts, and other pelvic abnormalities.
A woman's fertility is closely linked to her age. Understanding this relationship helps in making informed decisions about family planning.
*Per-cycle conception rates are approximate and vary by individual
Personalised treatment plans based on your specific diagnosis and age
Medications like Clomiphene or Letrozole to stimulate regular ovulation in women with ovulatory disorders.
Processed sperm is placed directly in the uterus during ovulation, ideal for mild infertility or unexplained cases.
Eggs are retrieved, fertilised in the lab, and embryos are transferred to the uterus. Gold standard for many causes.
Preserve your fertility by freezing eggs at their current quality for future use, especially recommended before 35.
Minimally invasive treatment for endometriosis, fibroids, tubal blockages, and ovarian cysts.
Using donated eggs for IVF when ovarian reserve is severely depleted or egg quality is compromised.
Consider consulting a fertility specialist if:
Our women's health specialists provide compassionate, personalised care with advanced diagnostics
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