Infertility is defined as the inability to get pregnant after one year of regular sexual intercourse without birth control, according to ACOG. Sometimes it’s easy to identify the causes of infertility, and other times it’s much harder.
Here are some of the most common causes of infertility, according to experts:
Not Ovulating or an Ovulation Disorder
In order to achieve a pregnancy, a person has to ovulate, which is defined as the time when the ovary releases an egg. If a person is not releasing an egg, there’s no way to achieve pregnancy.
“A common ovulation disorder is a hormone imbalance called polycystic ovarian syndrome (PCOS). This is a hormonal imbalance that women can be born with, and it tends to run in families,” explains Jennifer Makarov, M.D., a reproductive endocrinology and fertility specialist at New Hope Fertility. It is very common, she notes, and can cause ovulation to be irregular, which decreases your fertility.
Other causes of ovulation issues can include being overweight, underweight, having a hormonal disorder such as thyroid abnormalities or hyperprolactinemia and excessive physical and emotional stress.
Sometimes, infertility issues are related to the uterus. “Any structural abnormalities within the uterus itself may distort the uterine cavity,” says Dr. Sun. “Examples include fibroids [noncancerous growths in the uterus] and uterine septum [a condition where the uterus gets an extra wedge of tissue and runs down the middle of the uterus].”
Tubal Factor Infertility
Tubal factor infertility is when a person has damage in their fallopian tubes. “Examples can include a history of pelvic inflammatory disease, smoking or ectopic pregnancy,” says Dr. Sun.
Male Factor Infertility
Infertility is not exclusive to women. In fact, 40% to 50% of infertility cases are considered to be male factor. “The top cause of male infertility is problems with sperm,” explains Amy Roskin, M.D., board-certified OB-GYN and chief medical officer of Seven Starling, a women’s health digital platform. “This could be a low number of sperm or problems with how they move. Lifestyle factors like alcohol consumption and smoking can negatively impact fertility.”
Age is another big cause of fertility issues. According to ACOG, for healthy couples in their twenties or early thirties, the chances that a woman will become pregnant is about 25% to 30% in a menstrual cycle, and that percentage starts to decline in a woman’s thirties and more rapidly by age 37.
By 40, a woman’s chances of getting pregnant drop to less than 10% each menstrual cycle.