Shocking! 7 Serious Reasons Why Some Women Cannot Conceive.

Introduction

Infertility is a major concern affecting millions of women worldwide. According to the World Health Organization (WHO, 2023), about 1 in 6 couples globally experience infertility. While both men and women can have fertility challenges, studies show that female infertility accounts for nearly 50% of cases (American Society for Reproductive Medicine, 2023).

Many factors contribute to infertility, but some conditions are more serious than others. This article explores seven serious reasons why some women cannot conceive, backed by scientific research and statistics.

Relevant Statistics on Female Infertility

• Ovulatory disorders account for about 25% of female infertility cases.

• Polycystic Ovary Syndrome (PCOS) affects 8–13% of women of reproductive age and is the leading cause of ovulatory infertility.

• Tubal diseases of the fallopian tubes contribute to 25–35% of infertility cases (American Society for Reproductive Medicine, 2023).

• Endometriosis affects 10–15% of women of reproductive age and is found in up to 50% of women with infertility (Journal of Clinical Medicine, 2023).

• For every 100 fertile 30-year-old women trying to get pregnant in 1 cycle, 20 will be successful and the other 80 will have to try again. By age 40, a woman’s chance is less than 5% per cycle, so fewer than 5 out of every 100 women are expected to be successful each month.

7 Serious Reasons Why Some Women Cannot Conceive

1. Ovulatory Disorders

One of the most serious reasons why some women cannot conceive is ovulatory dysfunction, which occurs when a woman’s ovaries fail to release eggs regularly or at all. Without regular ovulation, conception is nearly impossible. Below are the most common causes of ovulatory disorders:

Common Causes of Ovulatory Disorders

1. Polycystic Ovary Syndrome (PCOS)

PCOS is the most common hormonal disorder affecting ovulation, responsible for about 70% of ovulation-related infertility cases. It occurs when the ovaries produce an excess amount of androgens (male hormones), disrupting the normal development and release of eggs. In order to deal with the hyperandrogenism that comes with PCOS, we recommend Evergreen Formular for Women. It is a supplement that contains Vitamin D among other very important nutrients. 

Symptoms of PCOS:

• Irregular or absent periods

• Excessive hair growth (hirsutism)

• Acne and oily skin

• Weight gain and difficulty losing weight

• Multiple small cysts on the ovaries (seen via ultrasound)

How PCOS Affects Fertility:

PCOS causes anovulation, meaning the ovaries do not release an egg regularly. It also disrupts hormone levels, affecting egg maturation and increasing the risk of miscarriage.

2. Premature Ovarian Failure (POF) / Primary Ovarian Insufficiency (POI)

Premature Ovarian Failure (POF), also known as Primary Ovarian Insufficiency (POI), occurs when the ovaries stop functioning properly before the age of 40. Women with POF experience a significant decline in egg production and estrogen levels, leading to infertility. It affects 1 in 100 women under 40.

Causes of Premature Ovarian Failure:

• Genetic disorders (e.g., Turner syndrome, Fragile X syndrome)

• Autoimmune diseases (the body mistakenly attacks ovarian tissue)

• Cancer treatments (chemotherapy and radiation damage the ovaries)

• Idiopathic causes (unknown reasons in some cases)

Symptoms of POF:

• Irregular or missed periods

• Hot flashes and night sweats

• Vaginal dryness

• Mood swings

• Infertility

How POF Affects Fertility:

Because POF leads to low estrogen and egg depletion, women with this condition struggle to conceive naturally. However, some still have occasional ovulation, making pregnancy possible with medical assistance.

3. Hypothalamic Dysfunction

The hypothalamus is a part of the brain that controls hormone release, including those responsible for ovulation. When the hypothalamus is not functioning properly, it fails to send signals to the ovaries, preventing the release of eggs.

Causes of Hypothalamic Dysfunction:

• Excessive stress – Physical or emotional stress disrupts hormone production.

• Extreme weight loss – Malnutrition reduces hormone levels needed for ovulation.

• Over-exercising – Intense workouts, especially in athletes, can stop menstruation.

• Chronic illnesses – Conditions like diabetes or thyroid disorders affect hormone balance.

Symptoms of Hypothalamic Dysfunction:

• Irregular or absent periods

• Low energy levels

• Weight fluctuations

• Reduced libido

• Cold intolerance (often linked to thyroid dysfunction)

How Hypothalamic Dysfunction Affects Fertility:

Since ovulation is controlled by signals from the hypothalamus, any disruption in this brain region prevents egg release and reduces pregnancy chances. If untreated, it can lead to long-term infertility.

Treatment:

• Medications like Clomiphene Citrate or Letrozole.

• Lifestyle changes, including weight management and a healthy diet.

• IVF for severe cases.

2. Blocked Fallopian Tubes

One of the serious reasons why some women cannot conceive is blocked fallopian tubes. The fallopian tubes play a crucial role in reproduction by allowing the sperm to meet the egg for fertilization and transporting the fertilized egg to the uterus for implantation. If these tubes are blocked, conception becomes impossible.

How Common is Tubal Factor Infertility?

According to the American Society for Reproductive Medicine (2023), tubal disease of the fallopian tubes account for 25–35% of female infertility cases. This means that more than 1 in 4 cases of female infertility are due to issues with the fallopian tubes.

Common Causes of Blocked Fallopian Tubes

Several medical conditions and past surgical procedures can lead to tubal blockages. The most common causes include:

1. Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs, often caused by untreated sexually transmitted infections (STIs) such as chlamydia and gonorrhea. These infections cause inflammation and scarring in the fallopian tubes, leading to blockages.

How PID Affects Fertility:

• Scarring and adhesions can completely block the tubes.

• In some cases, the tubes remain partially open, increasing the risk of ectopic pregnancy (pregnancy outside the uterus).

• Early treatment of STIs can prevent PID-related infertility.

Statistics:

• 1 in 8 women with a history of PID will experience tubal infertility.

• Women with multiple episodes of PID have a 75% higher risk of blocked fallopian tubes 

2. Endometriosis

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, often affecting the fallopian tubes. This abnormal tissue causes inflammation, scarring, and adhesions, leading to blocked tubes.

How Endometriosis Affects Fertility:

• Scar tissue formation can block the fallopian tubes entirely.

• Even if the tubes are not fully blocked, inflammation can damage eggs and sperm, reducing fertility.

• Up to 50% of women with endometriosis struggle with infertility.

3. Previous Abdominal or Pelvic Surgeries

Women who have undergone surgeries in the pelvic region, including C-sections, fibroid removal, or surgeries for ovarian cysts, may develop scar tissue (adhesions) around the fallopian tubes, leading to blockages.

How Surgery Affects Fertility:

• Scar tissue from surgery can cause the fallopian tubes to stick to surrounding organs.

• Some surgical procedures may accidentally damage the fallopian tubes.

• Women who have undergone multiple C-sections or fibroid surgeries are at a higher risk of tubal blockages.

Diagnosis of Blocked Fallopian Tubes

Since blocked tubes do not always cause symptoms, many women only discover the issue when they have trouble conceiving. Several tests can confirm a blockage:

1. Hysterosalpingography (HSG):
   • A special X-ray using contrast dye to check if the tubes are open.

   • A blocked tube will not allow dye to pass through.

2. Sonohysterography (Saline Infusion Sonogram):
   • Uses ultrasound with saline solution to assess tubal function.

3. Laparoscopy:
   • A minimally invasive surgery where a camera is inserted through a small incision to directly view the fallopian tubes.

   • If blockage is found, minor surgical correction can be done immediately.

Treatment:

• Hysterosalpingography (HSG) to diagnose blockages.

• Surgery to remove blockages.

• IVF to bypass the fallopian tubes.

3. Uterine Abnormalities

Structural problems in the uterus are one of the serious reasons why some women cannot conceive. The uterus plays a vital role in pregnancy by providing the environment for implantation and fetal development. If the uterus has abnormalities, it may prevent implantation or increase the risk of miscarriage.

How Common Are Uterine Abnormalities in Infertility?

• Up to 19% of women with recurrent pregnancy loss have structural abnormalities in the uterus.

• Fibroids affect up to 80% of women by age 50, making them one of the most common causes of uterine-related infertility.

Common Causes of Uterine Abnormalities

Several conditions can lead to an abnormal uterus, affecting fertility and pregnancy outcomes. The most common causes include:

1. Fibroids (Uterine Leiomyomas)

Fibroids are non-cancerous growths in the uterus that can affect fertility by blocking the fallopian tubes, distorting the uterine cavity, or affecting blood flow to a developing embryo.

How Fibroids Affect Fertility:

• Submucosal fibroids (inside the uterine lining) can prevent implantation.

• Large fibroids can block the fallopian tubes, preventing sperm from reaching the egg.

• Fibroids can cause heavy bleeding and pain, making pregnancy more challenging.

2. Congenital Uterine Anomalies

Some women are born with uterine abnormalities that affect their ability to conceive or carry a pregnancy to term. These conditions include:

• Septate Uterus: A fibrous wall divides the uterus, preventing implantation or causing miscarriage.

• Bicornuate Uterus: The uterus is heart-shaped instead of pear-shaped, leading to recurrent miscarriages.

• Unicornuate Uterus: Only half of the uterus develops, reducing space for a pregnancy.

Statistics:

• 2–4% of women have congenital uterine anomalies (American Society for Reproductive Medicine, 2023).

3. Asherman’s Syndrome (Uterine Scarring)

Asherman’s Syndrome is a condition where scar tissue (adhesions) forms inside the uterus, often due to:

• Previous uterine surgeries (D&C, fibroid removal, C-section).

• Severe pelvic infections that damage the uterine lining.

How Asherman’s Syndrome Affects Fertility:

• The scar tissue prevents implantation, leading to infertility.

• It can cause irregular or absent periods, making it hard to track ovulation.

• Even if conception occurs, the risk of miscarriage is high due to a damaged uterine lining.

Diagnosis of Uterine Abnormalities

Since many uterine abnormalities do not cause symptoms, they are often discovered after multiple failed pregnancies or unsuccessful attempts to conceive. Doctors use the following tests for diagnosis:

1. Transvaginal Ultrasound:
   • Detects fibroids and uterine shape abnormalities.

2. Hysterosalpingography (HSG):
   • Uses dye and X-ray to check for blockages or irregularities.

3. MRI or Hysteroscopy:
   • Provides a detailed image of the uterus to assess scarring, fibroids, or anomalies.
     

Treatment:

• Surgical removal of fibroids or uterine septum.

• Hormonal therapy to regulate the menstrual cycle.

4. Endometriosis

Endometriosis is one of the serious reasons why some women cannot conceive. It is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, leading to inflammation, scarring, and adhesions. This abnormal tissue growth can interfere with ovulation, block the fallopian tubes, or damage the uterus, making conception difficult.

How Common Is Endometriosis?

• 10–15% of women of reproductive age have endometriosis (Journal of Clinical Medicine, 2023).

• Up to 50% of women with infertility are diagnosed with endometriosis.

• In some cases, endometriosis is found in 71-87% of women with chronic pelvic pain.

Symptoms of Endometriosis

The symptoms of endometriosis vary from mild to severe, and some women may not experience any noticeable signs. The most common symptoms include:

1. Painful Periods (Dysmenorrhea):
   • Severe cramps that may start before and extend after menstruation.

   • Pain may radiate to the lower back and legs.

2. Pain During Intercourse (Dyspareunia):
   • Deep, sharp pain during or after sex due to endometrial implants in the pelvic region.

3. Heavy Menstrual Bleeding (Menorrhagia):
   • Prolonged or excessive bleeding during periods.

   • Some women also experience spotting between cycles.

4. Chronic Pelvic Pain:
   • Persistent pain that worsens during menstruation.

   • Can be misdiagnosed as irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID).

5. Bowel and Bladder Issues:
   • Painful urination or bowel movements, especially during menstruation.

   • Bloating, diarrhea, or constipation.

How Endometriosis Affects Fertility

Endometriosis affects fertility in several ways:

1. Blocked Fallopian Tubes:
   • Scar tissue from endometrial implants can block the tubes, preventing sperm from reaching the egg.

2. Inflammation and Immune System Response:
   • Endometriosis causes chronic inflammation, which may create a hostile environment for embryos.

3. Hormonal Imbalance:
   • The condition disrupts hormone levels, affecting ovulation and egg quality.

4. Implantation Issues:
   • If endometrial tissue grows inside the uterus in the wrong areas, it can prevent successful implantation.

Diagnosis of Endometriosis

Since endometriosis shares symptoms with other conditions like fibroids, PID, and IBS, it often takes years to diagnose.

Doctors use the following methods to confirm the condition:

• Pelvic Exam:
  • Checks for tender nodules or masses.

• Ultrasound or MRI:
  • Helps identify endometriomas (ovarian cysts caused by endometriosis).

• Laparoscopy (Gold Standard):
  • A minimally invasive surgery that provides a definitive diagnosis by visually identifying endometrial implants.

Treatment:

• Hormonal therapy to suppress endometrial growth.

• Laparoscopic surgery to remove excess tissue.

• IVF for severe cases.

5. Age-Related Infertility

Age is one of the most serious reasons why some women cannot conceive. A woman’s fertility declines with age, with a 50% lower chance of conception per cycle after 35 (CDC, 2023).

Why Does Age Affect Fertility?

• Egg quality declines over time.

• Hormonal imbalances become more common.

• Increased risk of miscarriage and genetic disorders.

Treatment:

• Fertility preservation (egg freezing) in younger years.

• Hormonal therapy to support egg health.

• IVF with donor eggs if necessary.

6. Autoimmune Disorders

Autoimmune diseases, such as lupus, Hashimoto’s thyroiditis, and rheumatoid arthritis, can attack reproductive organs, making it difficult to conceive. Up to 20% of women with unexplained infertility have an autoimmune condition.

Autoimmune conditions are another serious reason why some women cannot conceive. These conditions occur when the immune system mistakenly attacks healthy cells in the body. In the context of fertility, autoimmune disorders can disrupt normal reproductive processes, leading to difficulty in conceiving or maintaining a pregnancy.

1. Antiphospholipid Syndrome (APS)

Antiphospholipid Syndrome (APS) is an autoimmune disorder that significantly impacts fertility. Women with APS produce antibodies that target the phospholipids (fatty substances) in the blood, which can lead to increased clotting and interfere with normal blood flow. This condition is closely linked to recurrent miscarriages and pregnancy complications.

• Miscarriage risk: APS increases the risk of miscarriage during the first and second trimesters, particularly due to blood clots that block the placenta from receiving adequate oxygen and nutrients.

• Preterm birth and preeclampsia: Women with APS are also at an increased risk of preterm birth, preeclampsia, and intrauterine growth restriction (IUGR).

• Statistics: APS is estimated to affect 2-5% of women with recurrent miscarriages (American College of Obstetricians and Gynecologists, 2023).

Treatment for APS

• Blood-thinning medications: Women with APS often require blood thinners like heparin or aspirin to improve blood flow to the placenta and reduce the risk of miscarriage.

• Close monitoring during pregnancy: Frequent ultrasounds and blood tests may be needed to monitor the baby’s growth and the mother’s health during pregnancy.

2. Thyroid Disorders

Thyroid disorders, such as hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid), can have a profound effect on fertility. The thyroid gland regulates important hormones that control metabolism, ovulation, and implantation.

• Hypothyroidism: When the thyroid doesn’t produce enough hormones, it can interfere with the release of eggs (ovulation) and hormonal balance required for successful implantation of the fertilized egg. Women with untreated hypothyroidism often experience irregular menstrual cycles and may find it difficult to conceive.

• Hyperthyroidism: An overactive thyroid can also affect ovulation and increase the risk of miscarriage, premature labor, and low birth weight.

• Statistics: Studies show that women with thyroid disorders are 5 times more likely to experience fertility problems (Endocrine Society, 2023).

Treatment for Thyroid Disorders

• Thyroid hormone replacement therapy is used for hypothyroidism, and antithyroid medications or radioactive iodine therapy is used for hyperthyroidism.

• Fertility treatments may be necessary to assist with conception, especially when thyroid disorders are not well-controlled.

How Autoimmune Conditions Affect Fertility

Autoimmune conditions like APS and thyroid disorders can affect fertility in several ways:

1. Hormonal Imbalance:
   • In thyroid disorders, hormonal imbalance disrupts ovulation, making it difficult for a woman to conceive.

2. Increased Risk of Miscarriage:
   • Conditions like APS increase the risk of miscarriage due to clotting that affects the placenta and fetus.

3. Inflammation and Immune Response:
   • Many autoimmune diseases trigger inflammation that affects the reproductive organs, impairing the ability to conceive.

Treatment:

• Immunosuppressive medications for severe cases.

• Lifestyle changes to manage inflammation.

• Fertility treatments to improve chances of conception.

7. Unexplained Infertility

In some cases, doctors cannot pinpoint a cause of infertility. This is known as unexplained infertility, and it accounts for 10–15% of infertility cases 

Possible Causes:

• Subtle hormonal imbalances

• Poor egg or sperm quality

• Unknown genetic factors

Treatment:

• Lifestyle improvements (diet, stress reduction, exercise).

• Medications to improve egg release.

• Assisted reproductive techniques like IVF or IUI.

Conclusion

Infertility is a complex issue with multiple causes. Among the serious reasons why some women cannot conceive, ovulatory disorders, blocked fallopian tubes, uterine abnormalities, endometriosis, age-related infertility, autoimmune disorders, and unexplained infertility are the most significant. Fortunately, modern medicine provides solutions, from medication and surgery to advanced reproductive technologies like IVF. Women facing fertility challenges should consult a specialist to explore their options.

FAQs

1. What is the most common reason why some women cannot conceive?

The most common reason is ovulatory disorders, mainly caused by PCOS, which affects 8–13% of women of reproductive age.

2. Can age-related infertility be reversed?

No, but treatments like IVF and egg freezing can help improve pregnancy chances.

3. How do I know if my fallopian tubes are blocked?

An HSG test (hysterosalpingography) can confirm blockages.

4. Can autoimmune diseases cause infertility?

Yes. Autoimmune disorders like lupus and Hashimoto’s thyroiditis can attack reproductive organs.

5. What is the best treatment for endometriosis-related infertility?

Surgery to remove endometriosis tissue, followed by IVF, is often recommended.

6. How common is unexplained infertility?

It affects 10–15% of infertile couples.

7. When should I see a fertility doctor?

If you’re under 35 and trying for a year or over 35 and trying for six months, you should see a specialist.