Sterility in women

Female infertility — causes and diagnosis

Female infertility is the inability to conceive after 12 months of regular unprotected intercourse. It affects about 10-15% of reproductive-age couples. Causes are diverse and require systematic diagnosis.

Most common causes of female infertility

• Ovulation disorders — PCOS, hypothalamic amenorrhea, premature ovarian insufficiency
• Tubal factor — fallopian tube damage or obstruction (due to PID, endometriosis, previous surgeries)
• Endometriosis — endometrial tissue outside the uterus interferes with ovulation, egg transport, and implantation
• Uterine factor — fibroids, polyps, Asherman syndrome, congenital anomalies
• Cervical factor — cervical canal stenosis, abnormal cervical mucus
• Age — ovarian reserve decreases after 35, drastically after 40
• Unexplained infertility — in 10-15% of couples, the cause cannot be identified

Diagnostic protocol

• Hormonal panel — FSH, LH, estradiol, AMH, prolactin, TSH (cycle day 3)
• Transvaginal ultrasound — antral follicle count (AFC), ovarian and uterine morphology
• Hysterosalpingography (HSG) — X-ray imaging of fallopian tube patency
• Hysteroscopy — direct visualization of the uterine cavity
• Laparoscopy — gold standard for tubal factor and endometriosis assessment
• Post-coital test — evaluation of sperm-cervical mucus interaction

Risk factors

• Age — the most important factor — fertility declines after 35
• Smoking — accelerates ovarian aging and reduces egg quality
• Body weight — both obesity and underweight disrupt ovulation
• Sexually transmitted infections — chlamydia and gonorrhea can damage fallopian tubes
• Stress — chronic stress affects hormonal balance

Individualized treatment approach

Based on diagnostic results, your gynecologist creates a treatment plan tailored to your specific situation — from hormonal stimulation, through surgical corrections, to assisted reproduction (IUI/IVF).