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Common causes of female infertility

When a couple has difficulty conceiving a child, there are many potential causes, both male and female. Female infertility can be related to several different factors, including issues with ovulation in the ovaries, low egg reserve, anatomy and endocrine systems, says Pavna Brahma, M.D., a reproductive endocrinologist at Piedmont Atlanta Hospital.

Click here to learn more about male infertility.

Irregular cycles

“Having irregular cycles and not ovulating regularly definitely makes it a challenge to conceive,” says Dr. Brahma.

Low egg reserve

“This is related to the number of eggs in a woman’s personal egg bank,” she says.

As the reserve diminishes, so does a woman’s chances of becoming pregnancy and of responding the medication.


“The uterus needs to be healthy,” she says. “Having fibroids, polyps or other structures in areas within the cavity where an embryo would try to implant can definitely cause trouble.”

Fallopian tube health is also crucial for achieving pregnancy because fertilization occurs in the tubes.

“If there’s occlusion or a swollen tube, all of those factors can make it harder to conceive,” she explains.

Endocrine systems

Endocrine systems affect a woman’s metabolism as well as her ability to conceive. The function of the endocrine system is critical. This system includes the thyroid, hypothalamus, pituitary gland and adrenal gland.

Caring for the whole couple

“When patients come to see me, we meet and do an initial history and physical,” she says. “After that, we spend about a month in a period cycle doing some testing.”

The month of testing typically includes:

  • Hormones blood test
  • Ovary reserve blood test
  • Anatomy tests
  • Hysterosalpingogram, an X-ray exam that examines the inside of the uterus and fallopian tubes, as well as the surrounding area
  • Semen analysis from male partner to rule out male factor infertility

“We do a series of testing and our goal is to find a diagnosis,” says Dr. Brahma. “Once we find a diagnosis, we can build our treatment plan around our specific findings.”

Undergoing testing and treatment for infertility can be a challenging process emotionally and physically.

“When you come to see a reproductive specialist, we work as a team,” she says. “We are a team of people dedicated to bringing you closer to your goal. We’ve truly dedicated our lives to figuring out the best diagnoses and treatments. In today’s world, in vitro fertilization and other treatments have higher success rates than they ever have. We bring [patients] that hope and positivity.”

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