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Female infertility

Female infertility

Also known as Sterility and Barrenness


Female Infertility refers to the inability to conceive in spite of trying through unprotected intercorse for at least a year. 

Infertility in women is linked to advancing age, especially over 35 years, underlying medical conditions, interference with ovulation, damage of anomalies in the female reproductive system,or any hormonal imbalance.

Also, unhealthy habits like overconsumption of alcohol and smoking along with stressful and sedentary lives have increased infertility rates in recent years.

The best way to conceive is to create a cohesive healthy environment that can help you get pregnant faster. Eating a healthy well balanced diet, exercising regularly, getting sufficient sound sleep, and managing your stress can help you in this journey.

If you think you need treatment, you may consider talking to a fertility specialist or gynecologist. They can recommend the best fertility treatment option for you.

Key Facts

Usually seen in
  • Women above 35 years of age
Gender affected
  • Female reproductive system
Mimicking Conditions
  • Endometriosis
  • Androgen-producing ovarian tumors
  • Adrenal tumors
  • Nonclassic congenital adrenal hyperplasia
  • Cushing syndrome
  • Prolactinemia disorders
  • Thyroid disorders
  • Polycystic ovarian syndrome (PCOS)
Necessary health tests/imaging
  • Medications: Clomiphene, Gonadotropins, Letrozole, Bromocriptine, and Metformin.
  • Surgery: Laparoscopy and Tubal surgery
  • Assisted reproduction: Intrauterine insemination, IVF (in-vitro fertilization), GIFT (gamete intrafallopian transfer), and ZIFT (zygote intrafallopian transfer).
Specialists to consult
  • Endocrinologist
  • Gynecologist
  • IVF specialist

Symptoms Of Female Infertility


The main symptom of infertility is not being able to get pregnant. Symptoms can also depend on many health conditions that can make it difficult to conceive a child. Some of the symptoms include:

  • Abnormal, irregular, or no periods

  • Bleeding during menstruation is heavier or lighter than usual

  • Painful periods with back pain, pelvic pain, and cramping

  • Pain during intercourse

  • Other symptoms indicating hormonal imbalance, such as:

    • Acne and skin problems

    • Changes in sex drive and desire

    • Dark hair growth on face 

    • Thinning or loss of hair

    • Weight gain

Confused about irregular periods?  What is a Normal Period?
Read this article to answer the questions

Causes Of Female Infertility 

To understand the cause of infertility we should understand the steps in conception first and how any problem in each step can hamper your chances of getting pregnant. These include:

1. Sperm transport

The sperms need to travel through the female vagina and cervix to the site of fertilization for the pregnancy to occur. Any changes in the female environment due to hormonal imbalance can destroy the sperm, inhibiting fertilization.

2. Egg transport

This process starts during ovulation (release of an egg from one of the ovaries) where the egg is then picked up by the fallopian tubule where it travels to the uterus. Conditions such as pelvic infections and endometriosis can permanently impair the function of the fallopian tubes, leading to infertility.

3. Fertilization and embryo development

This is the most important step that consists of a union between the sperm and egg for the pregnancy to occur. Any impairments in the fallopian tubule can result in fertilization taking place in the tubules itself leading to ectopic pregnancy (pregnancy outside the uterus).

4. Implantation

It is a process in which the embryo attaches to the surface of the uterus and starts developing into a baby. Abnormalities in the uterus, hormonal or metabolic imbalances, infections, or immunological factors can lead to defective implantation, causing miscarriages.

The various factors that can cause infertility in females include:

1. Ovarian causes

  • Polycystic ovary syndrome (PCOS): It is a hormonal disorder in which ovaries produce large amounts of male sex hormones or androgens which interfere with the development and release of eggs. Some of these eggs develop into cysts, which are little sacs filled with liquid, hence the name, polycystic ovary syndrome. PCOS has been linked to infertility in women.

Learn from our experts more about PCOS, its symptoms, and lifestyle changes to manage it better.

  • Premature ovarian failure (POF): Refers to the loss of function of the ovaries before the age of 40. It is characterized by a decrease in the hormone estrogen, loss of female egg cells, and infertility.

  • Hyperprolactinemia: High levels of the hormone Prolactin, interferes with the normal production of other female hormones, like estrogen and progesterone. This can change or halt ovulation. It can also lead to irregular or missed periods. 

2. Tubal and peritoneal causes

  • Inflammatory diseases: Infection of one or more of the upper reproductive organs, including the uterus, fallopian tubes, and ovaries can cause inflammation and predispose to infertility issues.

  • Endometriosis: It is a condition characterized by the growth of tissue resembling the lining of the uterus outside the uterus. This extra tissue and its surgical removal can cause scarring, blocking the fallopian tubes and making it difficult for the egg and sperm to meet.

3. Structural abnormalities

  • Uterine anomalies: The uterine malformations characterized by adhesions and/or fibrosis within the uterine cavity can lead to infertility.

  • Fallopian tube anomalies: Any obstruction in the tubules doesn’t let the ovum and the sperm converge, making fertilization unfeasible. 

  • Cervical anomalies: Cervical stenosis (narrowing or closing of the passageway through the cervix- the lower part of the uterus) might affect natural fertility by impeding the passage of semen into the uterus.

Risk Factors For Female Infertility

1. Age

Fertility declines with advancing age. The 20s and early 30s are usually the best time to conceive. It becomes difficult to conceive after the age of 35.

2. Being underweight or overweight

BMI (body mass index) plays an important role in fertility. Being significantly overweight or underweight can cause hormonal changes that can affect fertility rates. 

Trying to get rid of that stubborn fat?

3. Stress

Stress alone cannot cause infertility, but it can interfere with your ability to get pregnant. Research has shown that anxiety also can prolong the time needed to achieve pregnancy.

Stressed? Try these relaxation techniques to help you battle chronic stress.

4. Genetic factors

Gene mutations can cause female infertility and pregnancy disorders.

5. Environmental factors

These include exposure to pesticides, radiation, air pollution, heavy metals, and other chemicals that can disrupt the hormones leading to infertility.

6. Hormonal disorders

  • Thyroid conditions: Thyroid diseases are associated with an increased risk of prematurity or stillbirth and can affect fertility.

  • Diabetes: Studies show that diabetic women are at increased risk of infertility, delayed puberty, absence of periods, menstrual irregularities and possibly earlier menopause.

Don’t let diabetes slow you down. Up your diabetes care game with our products to meet all your diabetes care needs.

  • Others: Excess growth hormone and testosterone also increase the risk of female infertility.

7. Lifestyle

  • Diet: Food items with a high glycemic index (shows how your blood sugar (glucose) level changes after eating a specific food item) can cause infertility among women. Moreover, packaged, processed, and fried foods predispose to obesity and diabetes, both known risk factors for female infertility.

  • Smoking: In women, smoking can increase the risk of miscarriage and ectopic pregnancy (when fertilized egg implants and grows outside the uterus.)

Do you really know how much harm smoking can do? Read more about 5 ways how your body reacts to the smoke.

  • Excessive alcohol: Excessive alcohol intake can lower the fertility rate in women. According to the American Cancer Society, it is best not to drink alcohol. Women who choose to drink alcohol should limit their intake to no more than 1 drink a day.

Did you know?

Can drink caffeine cause infertility? Studies have found that women who drink large amounts of caffeine may take longer to become pregnant. High concentration of caffeine is also found in energy drinks. Know if energy drinks are really good for you.

9. Sexually transmitted disease (STD)

STDs are often associated with the risk of decreased fertility. Some of the identified STDs are syphilis, Chlamydia, gonorrhea, herpes simplex virus, human papillomavirus, HIV, etc.

Protect yourself from STDs with our wide range of contraceptives.

10. Chemotherapy

Studies have shown that ovarian function decreases with chemotherapy increasing the risk of infertility in women.

Diagnosis Of Female Infertility 

Infertility can be caused by multiple factors. Arriving at a correct diagnosis can help plan the treatment accurately focusing on treating the problem. The diagnosis mainly consists of the following:

1. History 

A detailed history must consist of the duration of infertility, menstrual history, gynecological history to include a history of sexually transmitted infections, and sexual history to include frequency and timing of intercourse. Social and lifestyle history along with the family history is also taken into account.

2. Physical examination

The physical exam includes vital signs and BMI, thyroid evaluation, the appearance of an abnormal vagina, pelvic masses or tenderness, and uterine enlargement or irregularity.

3. Laboratory tests

  • Post-coital test: This test analyzes cervical mucus within a few hours of sexual intercourse to inspect the interaction between sperm and cervical mucus. 

  • Antisperm antibody tests: This test detects if a woman’s immune system may produce proteins that attack sperm (anti-sperm antibodies). 

  • Clomiphene citrate challenge test (CCCT): It is a sensitive test that picks up a decreased ovarian reserve. It checks both FSH and estradiol levels between days 2 and 4 of the menstrual cycle.

4. Imaging tests

  • Hysteroscopy: This test is a gold standard for assessing the uterine cavity. It allows direct visualization of the intrauterine pathology and provides an opportunity for immediate surgical correction.

  • Hysterosalpingography: It is one of the common tests which is used to examine the fallopian tubes and help in the detection of any blockage or damage of the fallopian tubes and uterine cavity. 

  • Laparoscopy: Just like the hysterosalpingogram, this test also helps to detect any abnormalities in the fallopian tubes. In this test, a small instrument known as a laparoscope is inserted into the body through a cut in the abdomen. The instrument helps to view and examine the female reproductive organs. In some cases, it can be used to remove the blockages, if any, found in the body.

  • Lower abdomen ultrasound: It is a procedure that uses high-frequency sound waves to scan the internal organs located in the lower abdomen of the body including the pelvic cavity and reproductive system.

  • Transvaginal ultrasound: It is an ultrasound test that helps the doctor look inside the uterus for abnormalities such as scarring, fibroids, or polyps. In this, a wand that is inserted into the vagina produces sound waves which give a clear picture of the reproductive organs including the ovaries and uterus.

  • Sonohysterograms: This is a special kind of ultrasound that uses sterile saline and air to observe the inner lining of the uterus. The pelvic organs are visualized through a transvaginal ultrasound. 

Book your tests now from the comfort of your home.

5. Endometrial biopsy

A sample of the cells lining the uterus (endometrium) after ovulation is evaluated for signs of inflammation and changes in the endometrium (due to ovulation). It is generally performed about 7 to 12 days after ovulation. 

Celebs affected

Farah Khan
The famous Indian choreographer and director, Farah Khan, opted for IVF in 2008. She has talked about the subject on several occasions. She gave birth to healthy triplets when she was 43.

Prevention Of Female Infertility

Harmful lifestyle choices have been found to have a lasting impact on health and are a major contributing factor to female infertility. Here are a few things you can do to prevent and manage infertility. These include:

1. Maintain a healthy weight

Maintaining a healthy weight lowers the chances of ovulation disorders. To do this, you can exercise regularly and eat a healthy well balanced wholesome diet.

Keep track of your weight with our widest range of weighing scales to choose from.

2. Say No to smoking

Tobacco not only harms your overall health, it adversely affects fertility as well. If you are planning to get pregnant, you should consider quitting smoking.

Get rid of this deadly habit with our smoking cessation products.

3. Avoid or limit the consumption of alcohol

Heavy drinking can increase the risk of ovulation disorders. While it is best not to drink alcohol,  women who choose to drink alcohol should limit their intake to no more than 1 drink a day.

4. Manage stress  

Everyone suffers from stress from time to time. But if there is continued stress, it can mess up your ovulation. Moreover, in a vicious cycle, infertility can inevitably cause stress and stress can hamper the results of infertility treatment. You can manage your stress effectively by working out, reading, and meditating amongst other stress-coping techniques.

5. Practice safe sex

Sexually transmitted infections can lead to infertility in both sexes. Such infections can spread through the reproductive system, causing damage, scarring, and inflammation in reproductive organs, leading to infertility.

Use the right protection to safeguard yourself and your partner from sexually transmitted infections. Check out our range of contraceptives.

6. Treat existing conditions

Identifying and controlling chronic diseases increases your chances of conception. Regular physical examinations (including Pap smears) help to detect early signs of infections or abnormalities.

Specialist To Visit


If you have tried conceiving for a year or six months or if you are 35 or above, you may consider going to the following doctors:

  • Gynaecologist

  • Endocrinologist

  • IVF specialist

 A gynecologist is a doctor who treats issues related to the female reproductive tract. An endocrinologist is a doctor who has special training in diagnosing and treating disorders of the glands and organs that make hormones. An IVF specialist is a doctor who specializes in treating infertility.


Consult India’s best doctors online to give you all the care and guidance you need in this journey.

Treatment Of Female Infertility 

Treatment of fertility problems needs an accurate diagnosis of the condition and a comprehensive and holistic approach. It consists of the following:


Fertility treatments are most commonly focused on infertility due to problems with ovulation. The most common medications used to treat infertility help stimulate ovulation. Some of them are:

Ordering medicines has never been easier!

Hormonal therapy

Hormone treatment is particularly suitable for women with impaired egg maturation or impaired no ovulation at all. It includes:

  • Gonadotropins

  • Human menopausal gonadotropin (HMG)

  • Follicle-stimulating hormone (FSH)

  • Luteinising hormone (LH)

  • Pergonal

  • Clomiphene citrate-human menopausal gonadotropin (CC-HMG) combination


If infertility is due to anomalies in the reproductive organs like the uterus or fallopian tubes, the following surgeries might be advised:

  • Laparoscopic surgery: It helps with problems with the uterus (womb) by removing endometrial polyps and fibroids (growths made of the uterine muscle). 

  • Tubal surgery: If the fallopian tubes are found to be blocked, scarred, or damaged, they can be repaired surgically.

Assisted reproduction

  • Intrauterine insemination: In this, many sperms that are washed and concentrated are placed in your uterus around the time of ovulation. It can help if you or your partner have a low sperm count, mild endometriosis, unexplained infertility, or issues with ejaculation or erection. 
  • IVF (in-vitro fertilization): During this process, mature eggs are taken and fertilized by sperm in a lab. The fertilized egg/eggs are then transferred to the uterus. This procedure is suggested if you have endometriosis, blockage in fallopian tubes, genetic disorder, or unexplained infertility.
  • GIFT (gamete intrafallopian transfer) and ZIFT (zygote intrafallopian transfer): In these procedures, the sperm and egg are collected and placed in the fallopian tube. In GIFT, both the sperm and egg are placed without fertilization. But in ZIFT, the sperm and egg are fertilized, and the embryo is placed in the fallopian tube.

Home-care For Infertility in Females

An amazing way to manage infertility is to have a healthy lifestyle. Here are a few home remedies that can help you:

1. Tweak your diet

We all know the importance of food and diet in fertility. Adding these foods can prove to be very beneficial while trying to conceive:

  • Pomegranate (Anaar): It is very useful in treating female infertility. Have at least one fresh pomegranate every day to keep your ovaries healthy.

Know more about other benefits of pomegranate.

  • Indian ginseng (Ashwagandha): Using this herb powder in milk balances hormones and reproductive organs.
  • Cinnamon (Dalchini): Studies suggest that cinnamon has been found to have a positive effect on hormones and improve menstrual cyclicity in women with PCOS.
  • Dates (Khajoor): Adding dates to your diet helps in reducing the risks of infertility.

2. Cut down on caffeine

Caffeine in small quantities does not affect female infertility. But you may consider cutting down on it if you are trying to conceive. If you have already conceived, then it is best to stay away from it altogether. 

3. Make no excuse to skip exercise

Exercise can positively influence fertility in women. Women who do regular, moderate exercise may get pregnant quicker than women who don't exercise at all.

Too lazy to go to the gym and sweat? Try our range of exercise equipment to help you get that daily dose of activity at home.

4. Take time to relax

Infertility comes with numerous tests and visits to the doctor. So it is not surprising that it can be stressful. It can mess up hormones in women as well. So take time to relax and unwind from time to time.

5. Add supplements

Micronutrients have essential roles in fertility, and inadequate levels can have an adverse impact on the ability to conceive. Taking folic acid, vitamin D, and omega-3 fatty acids can help improve fertility. 

Explore our widest range of vitamin and mineral supplements to meet all your needs.

Complications Of Female Infertility

Infertility and infertility treatments can lead to a few complications. Here are some of them:

1. Multiple pregnancies: One of the most common complications of infertility treatment is the chance of multiple pregnancies. Having twins, triplets, or more can put you at risk of premature labor and delivery.

2. Ovarian hyperstimulation syndrome (OHSS): It is an exaggerated response to hormones. Some fertility medicines can cause your OHSS in which the ovaries become swollen and painful.

3. Infections: Although rare, there are chances of getting an infection with reproductive surgery.

4. Psychological stress: Infertility procedures can increase degree of stress leading to depression and anxiety during the entire therapy procedure, due to lack of emotional and educational support. Infertility can sometimes lead to difficulties in marriages as well.

Alternative Therapies For Female Infertility 

Alternative options can act as an adjunct to the conventional treatment for infertility and help in your journey to conception. Some of these therapies include:

Relaxation techniques

Multiple relaxation techniques like meditation, deep breathing, guided imagery, and yoga, have been shown to reduce anxiety scores in women undergoing infertility treatment. Yoga, specifically, increases the quality of life and decreases negative feelings and thoughts that are associated with infertility. 

Understand other benefits of yoga that even doctors swear by! 


It works by putting tiny, delicate needles into particular body locations. Acupuncture may assist boost blood flow to the reproductive organs, stimulate hormones, control ovulation, and reduce stress, all of which may help in conceiving. However, it is better to consult your doctor before starting acupuncture therapy.

Living With Female Infertility 

Infertility treatment can take a physical and emotional toll on you. Living with it can be difficult as it can cause feelings of hopelessness and frustration in you and your partner. Here are a few aspects of infertility and infertility treatment that can help you out.

Psychological impact

Infertility can cause anger, depression, and anxiety. Women with infertility have a number of psychological commonalities like fear of complications during pregnancy, delivery, or maternity. Moreover, the negative thoughts of fear of losing your life or the child during delivery, or fear of failing as a mother are some of the underlying causes of stress that can hamper your chances of being pregnant. 

Addressing these psychological problems is the basis of good overall health and increases the chances of conception. The following points can help you out:

  • Learn stress-coping techniques

  • Have realistic expectations from every phase of treatment

  • Talk to your partner about every aspect of your physical and mental health

  • Opt for infertility counseling by a qualified medical health practitioner 

  • Take professional help for psychological issues

Psycho-Social impact

This includes low self-esteem, poor quality of life, and social isolation which is associated with infertility treatment. Also, comparisons between women undergoing repeated IVF cycles and first-time participants may lead to an increase in depressive symptoms. As you navigate through things, you have to make sure:

  • That you do not rely on only one option

  • Know the other alternatives

  • Learn ways to manage stress and anxiety

  • Communicate your fears and apprehensions with your partner

  • Keep your doctors updated about your mental and physical conditions

Psycho Economical impact

Treatment of infertility can have an economic impact on the couple's lives. Hence, it is important to keep in mind the financial aspect as well. The tips that can help you are :

  • Talk to your partner about all the expenses and chart out a proper financial plan

  • Select a treatment that fits your budget and expectations

  • Know if there is any insurance coverage

Are you tired of hearing all that you need to do to get pregnant? Here are all the myths debunked for you. 

Frequently Asked Questions


  1. Walker MH, Tobler KJ. Female Infertility. [Updated 2022 May 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.External Link
  2. Kaiser UB. Hyperprolactinemia and infertility: new insights. J Clin Invest. 2012 Oct;122(10):3467-8.External Link
  3. Moghadam et al. Epidemiology of Female Infertility; A Review of Literature. Biosci., Biotech. Res. Asia, Vol. 10(2), 559-567 (2013)External Link
  4. Olooto , Wasiu Eniola et al J. A review of Female Infertility; important etiological factors and management. Microbiol. Biotech. Res., 2012, 2 (3):379-385.External Link
  5. Rossi BV, Abusief M, Missmer SA. Modifiable Risk Factors and Infertility: What are the Connections? Am J Lifestyle Med. 2014;10(4):220-231.External Link
  6. Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues Clin Neurosci. 2018 Mar;20(1):41-47.External Link
  7. James JE. Maternal caffeine consumption and pregnancy outcomes: a narrative review with implications for advice to mothers and mothers-to-be. BMJ Evid Based Med. 2021;26(3):114-115.External Link
  8. Olooto, Wasiu Eniola et al J. Microbiol. Biotech. Res., 2012, 2 (3):379-385.External Link
  9. Deadmond A, Koch CA, Parry JP. Ovarian Reserve Testing. [Updated 2022 Dec 21]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.External Link
  10. Fertility treatment for females. National Institute of Child Health And Human Development. Jan 2017.External Link
  11. What is Assisted Reproductive Technology? Assisted reproductive Technology (ART). Centre for Disease Control And Prevention. Oct 2019.External Link
  12. Dou L, Zheng Y, Li L, Gui X, Chen Y, Yu M, Guo Y. The effect of cinnamon on polycystic ovary syndrome in a mouse model. Reprod Biol Endocrinol. 2018 Oct 19;16(1):99.External Link
  13. Schaefer E, Nock D. The Impact of Preconceptional Multiple-Micronutrient Supplementation on Female Fertility. Clin Med Insights Women's Health. 2019 Apr 23;12:1179562X19843868.External Link
  14. Ried K, Stuart K. Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: a systematic review. Complement Ther Med. 2011;19(6):319-331.External Link
  15. Katole A, Saoji AV. Prevalence of Primary Infertility and its Associated Risk Factors in Urban Population of Central India: A Community-Based Cross-Sectional Study. Indian J Community Med. 2019 Oct-Dec;44(4):337-341.External Link
  16. Sharma A, Shrivastava D (October 15, 2022) Psychological Problems Related to Infertility. Cureus 14(10): e30320.External Link
  18. Kumar P et al. Psychological aspects of infertility. BJMP 2010;3(3):a336External Link
  19. Infertility. National Health Portal. Aug 2016.External Link
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