Infertility affects many women worldwide, and doctors diagnose it after 12 months of trying to conceive a baby. Since both partners contribute to conception, the cause may involve the man, the woman, or both. Here are three major causes of infertility and when to seek an evaluation:
Hormonal Imbalances
Ovulation depends on a precise balance of hormones like estrogen and progesterone. When these hormones fall out of balance, the ovaries may not release an egg each month, leading to infertility. Without ovulation, no egg reaches the fallopian tube, and pregnancy will not occur that cycle.
Polycystic ovary syndrome (PCOS) may raise androgen levels, and it disrupts regular ovulation. If your periods are less frequent each year, PCOS may play a role. Thyroid disorders and high prolactin levels also interfere with ovulation cycles. Watch for these key signs that there is an issue:
- Irregular or absent periods
- Excess facial or body hair
- Chronic acne into adulthood
- Unexplained weight gain or fatigue
- Milky nipple discharge when not breastfeeding
Men experience hormonal problems too. When testosterone runs low, the testes produce fewer healthy sperm. A simple blood test identifies typical hormone problems, and many respond to medication. Early diagnosis and tailored treatment can restore hormone balance and improve fertility outcomes.
High or Low Body Weight
When fat tissue produces estrogen, body weight directly affects reproductive hormones. Excess weight may raise estrogen and insulin levels, and these changes stop ovulation. Obesity may also lower sperm quality and testosterone in men. Doctors can flag these factors:
- A high BMI
- A low BMI
- A rapid weight gain or loss
Low body weight sends a different signal, and the brain may slow its release of reproductive hormones. Intense exercise and restrictive diets have the same effect. If your weight sits in either range, a registered dietitian may help you set realistic goals. Balancing weight within a healthy range can improve hormone levels and increase the chances of conception.
Excessive Abdominal Surgeries
Abdominal and pelvic surgeries leave scar tissue behind. Doctors call these bands adhesions, and they may bind organs together. When adhesions form around the fallopian tubes, they block the path between egg and sperm.
Your risk rises with each surgery, especially if an infection or ruptured appendix occurred. Procedures on the ovaries also reduce egg supply. Repeated cyst or endometriosis removal may damage healthy ovarian tissue, and that loss is permanent.
Adhesions typically don’t cause symptoms, so many people do not know they have them. If you have had two or more abdominal surgeries, tell your fertility doctor. An HSG X-ray or laparoscopy checks your tubes for blockages.
Get Evaluated for Infertility
Many causes of infertility have clear, testable explanations, so book an evaluation after 12 months of trying, and shorten that wait after middle age. If you have irregular periods or past abdominal surgeries, schedule a visit sooner. Before you go, write down your cycle dates, weight changes, and past surgeries. Bring this list to your appointment; your doctor will review it, and both partners will likely complete basic testing.
