What are the leading causes of infertility among women?
When we consider the various things that can go wrong on the female side of the fertility equation, of course it depends on what group of women we're talking about as to which cause will play the dominant role. Most women that come to see me are typically in their late 30s. Most of the women that I see tend to have some kind of ovulatory problem, or a problem with egg quality, because they're getting close to menopause. If you look at the population at large, by far and away the most common cause of infertility is some kind of tubal blockage: an infection in the fallopian tubes from a sexually transmitted disease, or from a prior pelvic surgery. This is one of the many reasons that we advocate the practice of safe sex, so that fertility later on in life is preserved. The second leading cause of infertility is lack of ovulation, and there is a condition called polycystic ovary syndrome, or PCOS, in which women do not ovulate and they need fertility medications to help their ovary release the egg. They can get pregnant after that fairly readily. Those are the basic factors: it's the ovulatory factor and the tubal factor, and in our case, sometimes the age factor: the early menopause also being part of the ovulatory side of the fertility equation.
