Female Infertility: Causes and Treatments


Chris Iliades, MD

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Fertility treatment in women depends on the cause. There are many causes and many options for treatment. You and your doctor will need to work together to figure out what's causing your infertility and then what will be the best way to treat it.

Conditions Affecting Female Fertility

Conditions affecting female infertility include problems with ovulation, egg delivery, and implantation.

The most common cause of infertility in women is a problem with ovulation. To get pregnant, you must be able to ovulate, which means release of a mature egg from an ovary, and have the egg travel to your womb (uterus). If a male sperm fertilizes your egg, it must be able to attach to your uterus and grow (implantation).

Ovulation: The most common ovulation problem that leads to infertility is polycystic ovary syndrome, or PCOS. This is an imbalance in the hormones that control ovulation. Another common cause is premature ovarian insufficiency, or POI. Your ovaries stop making eggs before age 40.

Physical and emotional stress also can cause problems with ovulation. These causes are called functional hypothalamic amenorrhea (FHA). FHA causes absence of your periods.

Egg delivery: A blocked fallopian tube can cause infertility by blocking egg delivery to your uterus. Your fallopian tubes carry your eggs from your ovaries to your uterus. Scarring is a common cause of a blocked fallopian tube. Scarring can result from an infection, a ruptured appendix, endometriosis or surgery. Endometriosis is growth of uterine tissue outside your uterus.

Implantation: A common cause of infertility related to implantation is the presence of uterine fibroids. These are noncancerous tumors that grow in your uterus. They can prevent successful implantation of a fertilized egg.

Treatments for Female Infertility

Treatment options for infertility include medications, surgery, intrauterine insemination (IUI), and assisted reproductive technology (ART). You may need a combination of treatments.


Medication options include:

  • Clomiphene citrate (Clomid). This is an oral medication. It makes your body produce more hormones that cause ovulation. This may be the first medication you take if an ovulation problem is causing your infertility.

  • Human menopausal gonadotropin (hMG) and follicle-stimulating hormone (FSH). These hormone medications stimulate your ovaries to produce eggs. You would get these drugs by injection.

  • Gonadotropin-releasing hormone (Gn-RH). This type of hormone medication helps regulate your ovulation cycle. It can be given as an injection or a nasal spray.

  • Metformin (Glucophage). This oral medication is sometimes used with clomiphene. It lowers male hormones that may block ovulation. You may have these male hormones if you have a type of diabetes or PCOS.

  • Bromocriptine (Parlodel). This medicine may help you ovulate if you make too much of a hormone called prolactin. Prolactin is the hormone that stimulates breast milk production. This is an oral medication.


You may need surgery to treat problems with your fallopian tube or your uterus. Surgery options for infertility include procedures to correct or remove scarred or blocked fallopian tubes, endometriosis and uterine fibroids.


IUI is artificial insemination. This procedure may be helpful if the cause of your infertility is not known. During the procedure, your doctor will place sperm into your uterus. The sperm is specially prepared for this purpose. Women who undergo IUI often also take ovulation medications.


With ART, both eggs and sperm are specially prepared outside your body and inserted into your uterus. This is in vitro fertilization. Your eggs may be removed, prepared and then replaced. Or, the eggs or sperm may come from a donor. You may need to take ovulation medications along with this procedure. ART is especially useful if your fallopian tubes are blocked or if your partner is not producing enough sperm.

Along with your treatment, lifestyle changes may also help you get pregnant. Lifestyle changes that can increase your chances of pregnancy include:

  • Not smoking

  • Maintaining a healthy weight

  • Avoiding alcohol

  • Reducing physical and emotional stress

  • Eating a healthy diet

If you have fertility problems, the most important thing to understand is you have options for conceiving a child. Learning more about your options and discussing each one with your doctor will help you make the right choice for you. You can search Healthgrades.com for fertility doctors in your area.