10 Things to Know About Female Infertility

Infertility is a deeply personal and challenging journey for many women. If you’re struggling to conceive or just want to understand more about reproductive health, you’re not alone. 

Millions of women face fertility issues, but knowledge is power. By learning about the causes, treatment options, and lifestyle factors that can affect fertility, you can take informed steps toward your goals.

What is female infertility?

Female infertility is defined as the inability to conceive after 12 months of regular, unprotected sex (or six months if you’re over 35). It can be caused by a variety of factors, including ovulation disorders, blocked fallopian tubes, hormonal imbalances, and underlying medical conditions. It’s important to remember that help is available, and many women go on to conceive with medical assistance or lifestyle changes.

1. It’s far from uncommon

Female infertility is more common than many people realize. In the United States, about 11% of women have fertility problems. While infertility can feel isolating, these numbers show that many women share similar challenges. Thankfully, advances in reproductive medicine offer hope and support for those facing fertility struggles.

2. Age plays a big role

One of the most significant factors affecting female fertility is age. Women are born with a finite number of eggs, and as they age, both the quantity and quality of those eggs decline. Fertility decreases gradually in the early thirties and more significantly after 35. This doesn’t mean pregnancy is impossible later in life, but it may require additional fertility treatments. 

3. Ovulation issues are a common cause

Many cases of female infertility stem from ovulatory disorders. Conditions like polycystic ovary syndrome (PCOS) or premature ovarian failure (also known as primary ovarian insufficiency), can disrupt the hormonal balance needed for regular ovulation. If you have irregular or absent periods, or they're extremely painful, it may be a sign of an ovulation issue. Fortunately, medications that stimulate ovulation or lifestyle changes can help regulate your cycle and improve fertility.

4. Untreated STIs can affect fertility

Ironically, using protection can safeguard your chances of having a baby later on. Untreated sexually transmitted infections (STIs) like chlamydia and gonorrhea can lead to pelvic inflammatory disease (PID), which can leave scar tissue in the fallopian tubes and increase the risk of infertility. 

Regular STI screenings and early treatment are crucial to maintaining reproductive health. Practicing safe sex and seeking prompt medical care for any infections can help prevent complications that may impact fertility.

5. The vaginal microbiome plays a role

Researchers are still exploring the extent to which the vaginal microbiome affects fertility, but we know that it plays a crucial role in reproductive health. 

A balanced microbiome, dominated by beneficial Lactobacillus bacteria, helps maintain an optimal pH level and prevents infections that can lead to inflammation or conditions like bacterial vaginosis (BV). 

Disruptions in this balance can impact fertility by increasing the risk of infections, altering cervical mucus quality, and even affecting implantation.

Evvy’s Vaginal Health Test can identify imbalances in the vaginal microbiome and provides key fertility insights. So, whether you’re at the start of your fertility journey or are undergoing infertility treatments, testing your microbiome could unlock extra information about your chances of conceiving.

6. Lifestyle factors matter

Your overall health plays a big role in fertility. Diet, weight, stress levels, and alcohol consumption can all impact reproductive function and be potential risk factors for infertility. Maintaining a healthy weight is especially important — being significantly underweight or overweight can disrupt hormone levels and ovulation. Eating a balanced diet rich in whole foods, managing stress, and avoiding excessive alcohol or smoking can all support better fertility outcomes.

7. There are many treatment options

If you’ve been trying to conceive without success, fertility treatments can offer hope. Depending on the cause of infertility, options may include medications to stimulate ovulation, or assisted reproductive technologies (ART) such as intrauterine insemination (IUI), or in vitro fertilization (IVF). In some cases, surgery may be needed to address structural issues like blocked fallopian tubes or fibroids. Consulting a fertility specialist can help you determine the best course of action based on your unique situation.

8. Infertility isn’t just a female issue

While this article focuses on female infertility, it’s important to note that infertility can affect the male partner, too. In about 40-50% of cases, male infertility plays a role. If you’re struggling to conceive, both partners should undergo testing to identify any potential issues. A fertility specialist can assess sperm health, hormone levels, and reproductive function in both individuals to create a comprehensive treatment plan.

9. Getting professional help early can make a difference

If you suspect you have fertility issues, don’t wait too long to seek help. A fertility specialist can run tests to evaluate your ovarian reserve, hormone levels, and reproductive health. The earlier you identify potential challenges, the more options you’ll have for treatment. Even if you’re not ready to start a family, understanding your fertility health can help you make informed decisions for the future.

10. You have options

If traditional conception isn’t possible or fertility treatments aren’t successful, there are still many ways to build a family. Adoption, surrogacy, and donor eggs or embryos are options that many people consider. While the journey may not always be what you expected, there are still many paths to parenthood.

How to prevent female infertility

Protecting fertility involves a combination of smart lifestyle habits and proactive healthcare. While these tips can support reproductive health and reduce certain risks, it’s important to understand that infertility isn’t always preventable. Sometimes, it occurs for unexplained reasons — and even when a medical cause is known, it’s never your fault.

Here are ten expert-backed steps that can help support fertility:

1. Get regular STI testing and treatment: Untreated infections like chlamydia and gonorrhea can damage the reproductive tract and lead to infertility. Regular screening is key, especially if you have new or multiple partners.
2. Monitor your vaginal microbiome health: A balanced vaginal microbiome helps prevent infections and inflammation that may affect fertility. Supporting this delicate ecosystem can reduce the risk of conditions like bacterial vaginosis and help maintain reproductive wellness. Consider taking probiotics, avoid douching, and choose pH-friendly products when possible. Tools like Evvy’s Vaginal Health Test with Fertility Insights can help you better understand your microbiome and take informed steps to support your fertility journey.
3. Address chronic vaginal infections early: Recurrent BV can cause inflammation and complications. Early treatment reduces long-term risks, so don’t ignore symptoms.
4. Manage stress and get enough sleep: High stress and poor sleep can disrupt ovulation. Practice relaxation techniques, aim for 7–9 hours of quality sleep, and seek support when needed.
5. Eat a fertility-supportive diet: Focus on whole grains, leafy greens, fiber, folate-rich foods, and antioxidants. A Mediterranean-style diet supports hormonal balance and ovulatory health. 
6. Exercise moderately and maintain a healthy weight: Both underweight individuals and those with obesity can experience fertility issues. Aim for consistent, moderate activity.
7. Limit alcohol, avoid smoking, and recreational drugs: These substances are linked to reduced egg quality and hormonal disruption. Limit caffeine and reduce exposure to environmental toxins when possible.
8. Take a daily folic acid supplement: Folic acid not only prevents birth defects but may improve fertility outcomes.
9. Stay current on reproductive health screenings: Regular pelvic exams, Pap smears, and hormone panels can catch issues early. 
10. Talk to a doctor early if cycles are irregular or if you have a family history of infertility: Early evaluation helps address concerns before they become obstacles. Don’t wait—fertility naturally declines with age, especially after 35.

FAQ

What are the female causes of infertility?

Female infertility can be influenced by a variety of factors that affect different parts of the reproductive system. For instance, ovulation disorders like PCOS or issues with the hypothalamus can make it tough to release eggs, which is essential for conception. Hormonal imbalances, often linked to thyroid problems or high prolactin levels, can also disrupt ovulation and menstrual cycles. There are also structural factors to consider, such as blocked fallopian tubes from conditions like pelvic inflammatory disease (PID) or endometriosis, which can interfere with fertilization or the implantation of an embryo. Uterine issues, like fibroids or polyps, might make it challenging for an embryo to settle in and grow. Studies have also found a link between the vaginal microbiome and fertility outcomes. Don’t forget that age plays a role too — as women get older, both the quality and quantity of eggs can decrease, affecting fertility. Lifestyle choices, including weight, exercise habits, smoking, and stress levels, can also impact reproductive health. In many cases, the cause is unknown, a diagnosis called unexplained infertility.

What decreases the chances of getting pregnant?

Several factors can decrease the chances of getting pregnant, including age, hormonal imbalances, underlying medical conditions, and lifestyle choices. As women age, fertility naturally declines, with egg quantity and quality decreasing significantly after 35. Hormonal disorders such as PCOS or thyroid dysfunction can disrupt ovulation, making conception more difficult. Structural issues like blocked fallopian tubes, uterine fibroids, or endometriosis can also interfere with fertilization or implantation. Lifestyle factors play a major role as well. Being significantly underweight or overweight can impact hormone levels and ovulation. High stress levels may affect the menstrual cycle and reduce libido, making conception less likely. Smoking, excessive alcohol consumption, and drug use can lower fertility by harming egg quality and disrupting reproductive hormones

Can you be infertile after having a baby?

Yes, it's possible to experience infertility even after having a baby. This is called secondary infertility, which means you can't conceive or have another successful pregnancy after already giving birth. This situation can be surprising and emotionally tough, especially if your first pregnancy was easy. Secondary infertility can happen for various reasons. These include age-related changes in egg quality, hormonal issues, complications from past pregnancies or deliveries, blocked fallopian tubes, endometriosis, or problems with male fertility. Changes in lifestyle, new medical issues, or weight changes since the last pregnancy can also affect fertility. Sometimes, there's no clear cause. Remember, facing infertility after having one or more children doesn't mean something is wrong with you. Fertility can change over time, and it's not your fault. If you've been trying to get pregnant again for six to 12 months without success (especially if you're over 35), it may be helpful to see a fertility specialist for evaluation and support.

Can you overcome infertility?

Many women overcome infertility, and there’s a lot of hope, depending on the underlying cause, age, and treatment options available. Thanks to advances in reproductive medicine, individuals and couples facing challenges have more chances to conceive than ever before. Treatments for female infertility can include lifestyle changes, medications to help stimulate ovulation, surgeries to fix any anatomical issues, or assisted reproductive technologies like IUI or IVF. For some, addressing hormonal imbalances or managing conditions like PCOS or endometriosis can work wonders for restoring fertility. Others might find that using donor eggs, embryos, or surrogacy is the perfect path to parenthood. It’s important to know that success rates can vary based on individual circumstances, but getting evaluated early and receiving personalized care can often lead to better outcomes. It’s also essential to remember that not all infertility can be resolved, and some people may not conceive even with medical help. That can be really tough emotionally, but it’s important to lean on support from healthcare providers, counselors, and fertility support communities. 

Does hot water affect female fertility?

There’s no scientific evidence that hot water affects a woman's ability to conceive. However, hot water can have an impact on male fertility. When men are exposed to high temperatures for a long time, like taking frequent hot baths, soaking in hot tubs, or even using a laptop on their lap, it can raise the temperature of the testes. Since sperm production does best at a slightly cooler temperature than the body’s core, too much heat can temporarily lower sperm count and motility. These effects are usually reversible if the heat exposure is minimized. If a man is looking to conceive, it’s a good idea to limit time in hot baths and saunas, and to wear looser clothing.