Female infertility is usually diagnosed after a year of trying to conceive without success, or six months if you’re over 35. It’s far more common than most people realise: a 2023 World Health Organization report found that roughly 1 in 6 people of reproductive age worldwide experience infertility at some point in their lives, with South Asia among the regions showing higher prevalence.
This guide walks through the most common causes in women, what each one actually means for your body, and when it’s time to see a specialist rather than wait it out.
What Is Female Infertility?
Infertility doesn’t mean pregnancy is impossible – it means it hasn’t happened within the expected timeframe, and there’s usually an identifiable reason why. Most causes fall into a handful of categories: problems with ovulation, structural issues in the reproductive organs, hormonal conditions, or age-related changes in egg quality. Knowing which one applies to you is the first real step toward a treatment plan that actually works, instead of guessing.
Common causes of infertility in women
Ovulation disorders. For pregnancy to happen, an egg needs to be released regularly. When hormone levels shift – due to stress, sudden weight changes, or an underlying condition – ovulation can become irregular or stop altogether. This is one of the most common and most treatable causes of female infertility, often managed with medication that restores a regular cycle.
PCOS (Polycystic Ovary Syndrome) recently renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS) by global medical consensus published in The Lancet in May 2026 affects hormone levels in a way that disrupts ovulation, often causing irregular or absent periods, and remains one of the leading causes of infertility in women. Small cysts may form on the ovaries, but the bigger issue is the hormonal imbalance driving the irregular cycles in the first place.
Thyroid disorders. The thyroid regulates far more than metabolism. It directly influences ovulation and cycle regularity. Both an underactive and an overactive thyroid can throw this off, which is why a thyroid panel is one of the first things checked in a fertility workup.
Blocked or damaged fallopian tubes. The fallopian tubes are where the egg and sperm actually meet. If they’re blocked or scarred, usually from a past infection, surgery, or endometriosis, fertilisation simply can’t happen naturally, regardless of how healthy the eggs are.
Uterine conditions. Fibroids and polyps are growths inside the uterus that can physically interfere with an embryo’s ability to implant. They’re also a common cause of heavy periods or pelvic pain, which is often what brings women in for an evaluation in the first place.
Age-related decline in egg quality and quantity. Egg count and quality both decline with age, and the pace accelerates after 35. This is a biological reality, not a condition to be fixed, but it does change the timeline and the options worth considering sooner rather than later.
Unexplained infertility. In some cases, every test comes back normal and there’s still no pregnancy. This doesn’t mean nothing can be done – many women in this category go on to conceive with the right combination of monitoring and treatment, even without a single identified cause.
When should you see a fertility specialist?
Most causes above are manageable once identified – the real risk is waiting too long to find out which one applies to you. It’s worth booking a consultation if you:
● Have been trying to conceive for over a year (or six months if you’re over 35)
● Have irregular or missed periods
● Experience severe pain during periods or intercourse
● Have a history of pelvic infections or abdominal surgery
● Have been diagnosed with PCOS, thyroid issues, or endometriosis
● Have had more than one miscarriage
Next step
A fertility workup typically starts with a few targeted tests – hormone levels, an ultrasound, and a review of your cycle history rather than guesswork. The sooner the actual cause is identified, the more options stay on the table.
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