Female infertility is the inability to conceive after 12 months of regular, unprotected intercourse (or 6 months if over age 35). It can arise from ovulatory disorders, tubal blockages, uterine abnormalities, or hormonal imbalances that interfere with egg release, fertilization, or implantation.
-
Irregular or Absent Menstrual Cycles: Oligomenorrhea or amenorrhea
-
Anovulation Signs: No mid-cycle ovulation pain or temperature shift
-
Hormonal Imbalance: Excess facial hair, acne, or weight gain (PCOS)
-
Pelvic Pain: Endometriosis-related discomfort
-
History of Miscarriage: Recurrent early pregnancy loss
-
-
Ovulatory Disorders: PCOS, premature ovarian failure, thyroid dysfunction
-
Tubal Factors: Blocked or damaged fallopian tubes from infection or surgery
-
Uterine Abnormalities: Fibroids, polyps, congenital malformations
-
Endometriosis: Ectopic endometrial tissue causing adhesions
-
Age-Related Decline: Diminished ovarian reserve after age 35
-
-
Extreme Weight Fluctuations: Underweight or obesity disrupts ovulation
-
Chronic Stress: Alters hypothalamic signaling and menstrual regularity
-
Smoking & Alcohol: Impairs egg quality and uterine receptivity
-
Excessive Exercise: High-intensity training can suppress cycles
-
Medication Effects: Certain psychotropics or chemotherapy agents
-
-
Menstrual & Medical History: Cycle regularity, past pregnancies, surgeries
-
Ovulation Assessment: Mid-luteal progesterone level or basal body temperature charting
-
Hormonal Panels: FSH, LH, estradiol, AMH, prolactin, TSH to evaluate ovarian reserve and endocrine health
-
Ultrasound Imaging: Antral follicle count, uterine and tubal anatomy
-
Hysterosalpingography (HSG): X-ray dye study to check tubal patency
-
Laparoscopy / Hysteroscopy: Direct visualization for endometriosis, adhesions, polyps
-
-
Clomiphene Citrate (Clomid®): Oral ovulation inducer for 5 days starting cycle day 3–5
-
Letrozole (Femara®): Aromatase inhibitor promoting follicle growth, often first-line in PCOS
-
Gonadotropins (FSH, hMG): Injectable hormones for controlled ovarian stimulation
-
Metformin: Insulin-sensitizing agent in PCOS to restore regular cycles
-
Progesterone Support: Oral or vaginal progesterone (Duphaston®, micronized progesterone) to maintain luteal phase
-
Adjunctive Supplements: Folic acid, CoQ10, vitamin D, myo-inositol to improve egg quality
-
Surgical Interventions: Laparoscopic correction of endometriosis or tubal blockage
-
Assisted Reproduction: IUI or IVF when medical therapy alone is insufficient
-
Q1: How long does it take to conceive after starting Clomiphene?
A: Many achieve ovulation in the first 1–3 cycles; cumulative pregnancy rates exceed 60% after 6 cycles.
Q2: Are there side effects to ovulation-inducing drugs?
A: Clomiphene can cause hot flashes, mood swings, or multiple pregnancies; injectables risk ovarian hyperstimulation.
Q3: Can lifestyle changes improve fertility?
A: Yes—achieving a healthy BMI, balanced diet, stress reduction, and moderate exercise enhance treatment success.
Q4: When should I consider IVF?
A: After 3–6 failed ovulation-induction cycles or with severe tubal/uterine factors, IVF offers higher success rates.
Q5: Is age a limiting factor?
A: Egg quality and quantity decline after 35; earlier evaluation and treatment improve outcomes.