What is the Leading Cause of Female Infertility?

by | Sep 8, 2025 | Blog | 0 comments

What is the Leading Cause of Female Infertility?

Starting a family is a long-awaited dream for many women. When this dream faces challenges, it brings different feelings like self-doubt, stress, worry, and more. Infertility cannot just be summed up just as a medical challenge. Because it touch every aspect of your life, from confidence to relationships. And one question that comes up is, ‘why am i not able to conceive?’

Understanding Female Infertility

Infertility can have many causes. But the leading cause can be irregular ovulation. It happens when the process of releasing eggs is disrupted. And eventually, conception becomes much harder. Among these conditions, the most common is Polycystic Ovary Syndrome (PCOS). It accounts for a large proportion of infertility cases worldwide.

In simple words, infertility is the inability to conceive after 12 months of regular, unprotected intercourse. In India and globally, studies signal that around one in six couples faces infertility at some point. In women, the causes can range from issues in the uterus, fallopian tubes, or ovaries. It can also happen because of hormonal imbalances or age-related decline in egg quality. Sometimes, no clear reason is found. And this can be even more frustrating.

While all these factors play a role, irregular ovulation is consistently the leading cause. This means that the ovaries either do not release eggs regularly or do not release them at all. Without a healthy egg, fertilisation and pregnancy cannot happen, no matter how healthy the sperm or uterus may be.

Why Ovulation Matters So Much

Each month, during your menstrual cycle, hormones signal the ovaries to mature and release an egg. The egg then travels into the fallopian tube. And here, it meets sperm and is fertilized.

If ovulation does not happen, or happens unpredictably, pregnancy becomes difficult. There are also chances where some women may go months without ovulating. And others may ovulate only at irregular intervals.

Signs of irregular ovulation can include:

  • You may have menstrual periods that are absent or unpredictable
  • You may face very heavy or very light bleeding
  • You may have cycles that are unusually long or short
  • You may not see any clear mid-cycle changes that usually suggest ovulation

For many of you, these irregularities are the first hint that something may not be working as it should.

The Leading Cause: Polycystic Ovary Syndrome (PCOS)

The most common reason for irregular ovulation, and thereby the leading cause of female infertility, is Polycystic Ovary Syndrome (PCOS).

PCOS is a hormonal condition that affects the way the ovaries function. Women with PCOS usually have higher levels of male hormones. They are called androgens. Now, these interfere with the growth and release of eggs. Instead of producing one mature egg each month, the ovaries may develop many small follicles that do not release an egg.

Common features of PCOS include:

  • Irregular or absent periods
  • Multiple small follicles in the ovaries seen on ultrasound
  • Hormonal symptoms such as acne, excess facial hair, or weight gain
  • Difficulty losing weight despite lifestyle efforts

Also, PCOS makes it harder to conceive and can also affect a woman’s health in the long term, increasing the risk of diabetes and metabolic concerns.

How Do You Know If You Have Irregular Ovulation?

You may notice that your cycles are not regular. But you may find it confusing as to what might be the reason behind that. Some signs that may point to ovulation issues are:

  • Notice if your menstrual cycles are shorter than 21 days or longer than 35 days
  • Check if you may have missing periods for several months in a row
  • See if you are facing trouble in predicting fertile days despite using tracking methods
  • See if you have no clear symptoms such as mild mid-cycle cramps or changes in discharge

Doctors may run blood tests to check hormone levels. They may perform ultrasounds to look at the ovaries and uterus or refer to other tests depending on symptoms. A proper diagnosis is important. This is because not every irregular cycle is caused by PCOS. Thyroid problems, high prolactin, or stress can also disrupt ovulation.

Other Causes of Female Infertility

Yes, PCOS and irregular ovulation are the main causes. But infertility in women can also come from other conditions:

  • Endometriosis: This happens when tissue that is similar to the uterine lining grows outside the uterus. It comes with pain and sometimes scarring, which may interfere with fertility.
  • Blocked or damaged fallopian tubes: This is usually the result of past infections, pelvic inflammatory disease, or surgery. If your tubes are blocked, it prevents the egg and sperm from meeting.
  • Age-related decline in egg quality: As you age, especially after you hit 35, the number and quality of eggs decrease. This is a natural process. But it does play a role in infertility.
  • Hormonal imbalances: If you have thyroid disorders, raised prolactin levels, or other hormonal disruptions, it can prevent regular ovulation.
  • Uterine abnormalities: Another reason is fibroids, polyps, or differences in the shape of the uterus. This can make it harder for an embryo to implant and grow.

Understanding the genuine cause is key for choosing the right treatment.

Can Infertility Due to Irregular Ovulation Be Treated?

The encouraging thing is that infertility caused by irregular ovulation is one of the most treatable forms of infertility. Even with PCOS or other ovulation-related issues, you can go on to conceive successfully with the right care.

Common treatment approaches:

  • Lifestyle changes: If you take care of your weight, have proper nutrition, and exercise regularly, it can restore more regular ovulation.
  • Medications to stimulate ovulation: Some drugs and medications prescribed by your doctor can encourage the ovaries to release eggs.
  • Hormone treatment: If you take proper treatment and correct your thyroid or prolactin imbalances, it can restore natural cycles.
  • Advanced fertility care: if simpler steps do not succeed, treatments such as IVF can bypass some of these challenges and improve the chance of pregnancy.

For women with PCOS, IVF can be especially effective when combined with protocols that lower the risk of ovarian hyperstimulation.

When Should You Seek Help?

It is natural to hope that conception will happen in time. But there are situations where it is best not to delay seeking medical advice:

  • If you have been trying for over a year without success (or over six months if you are above 35)
  • If your cycles are irregular or absent
  • If you have been diagnosed with PCOS, thyroid disease, or endometriosis
  • If you have a history of pelvic infections or surgeries

The earlier the evaluation, the sooner the right treatment can begin.

Your Path to Treatment and Care

Infertility is not the end of the road. It is a condition with causes that can be identified and treatments that can make a real difference. PCOS and other causes of irregular ovulation may delay pregnancy. But they are also among the most treatable forms of infertility.

If you are facing irregular cycles or difficulty conceiving, meeting a fertility specialist can get you answers and reassurance. Dr. Ila Gupta comes with more than 30 years of experience in reproductive medicine. She is known for her compassionate and patient-focused approach.

If you decide to visit, you will find complete support under one roof. Here, advanced laboratories use modern embryo freezing methods. Genetic testing is also available when needed. And counselling is always provided. Couples are supported immensely during treatment and throughout their journey to parenthood.

Parenthood is about reaching pregnancy with health, care, and peace of mind. With the right guidance, you can hold your baby soon. To take the next step, schedule a consultation with Dr. Ila Gupta at ilaguptaivf.com.

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