Infertility is a condition that affects approximately 1 out of every 6 couples. An infertility diagnosis is given to a couple that has been unsuccessful in efforts to conceive over the course of one full year. Women who can conceive but are unable to stay pregnant are also referred as infertile. Female infertility alone accounts for approximately one-third of all infertility cases.

Pregnancy is a process that has many steps. Difficulty to conceive can happen if there is a problem at any of these stages:

Ovulation: A woman's body releases an egg from the ovaries.

The egg passes through the fallopian tube toward the uterus.

Fertilization: A sperm from the male meets the egg of the female to fertilize the egg.

Implantation: The fertilized egg attaches to the uterine wall (inside of the uterus).

The most common causes of female infertility include problems with ovulation – where there are no eggs produced to be fertilized. Ovulation problems may be caused by a hormonal imbalance, tumor or cyst, thyroid gland problems, excessive weight and stress.

One of the most common reasons of ovulation problems due to hormonal imbalance is Polycystic Ovarian Syndrome (PCOS). PCOS, as the name suggests causes multiple cysts, that surround the eggs in the ovary, leading to failure in normal functioning of the ovaries. It is not only associated with infertility, but can also cause miscarriages. Primary Ovarian Insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman's ovaries stop working normally before she is 40 - irregular periods and reduced fertility start before the age of 40. Sometimes it can start as early as in the teenage.

Damage to the fallopian tubes or uterus can be caused by Pelvic Inflammatory Disease, a previous infection, polyps in the uterus, Endometriosis or fibroids in the uterus, scar tissue or adhesions, chronic medical illness, a previous ectopic (tubal) pregnancy.

Abnormal cervical mucus can also cause infertility. Abnormal cervical mucus can prevent the sperm from reaching the egg or make it more difficult for the sperm to penetrate the egg. Thus, interfering with the process of fertilization of the egg.

Failure of implantation of the embryo (fertilized egg) can occur due to age of the eggs, intrauterine polyps, chromosomal issues or lifestyle factors like smoking and alcohol use, stress, extensive exercise, being overweight or underweight and poor diet.

How is female infertility diagnosed?

Potential female infertility is assessed as part of a thorough physical examination. The doctor will also ask for both partners' health and sexual histories. Sometimes this can find the problem. However, most of the time, the doctor will need to do more tests:

In women, the first step is to find out if she is ovulating each month. You may be asked by the doctor to track your ovulation at home or may be prescribed some blood tests to understand the same.

A blood test to check for infections like sexually transmitted diseases (STD) or a hormone problem, including your thyroid function may be prescribed by your doctor.

Pelvic examination through an ultrasound.

A sample of cervical mucus and tissue to determine if ovulation is occurring.

Hysterosalpingography (HSG), which is an x-ray used in conjunction with a colored liquid inserted into the fallopian tubes making it easier for the technician to check for blockage.

Laparoscopy – A laparoscope is inserted into the abdomen to view the condition of organs and to look for blockage, adhesions or scar tissue.

Hysteroscopy uses a tiny telescope with a fiber light to look for uterine abnormalities.