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Problems with ovulation (egg production) account for most infertility in women. Ovulation is the monthly release of an egg. In some cases, the woman never releases eggs, while in others the woman does not release eggs during some cycles. Without ovulation, eggs are not available to be fertilized. Signs of problems with ovulation include irregular menstrual or no menstrual periods.

Ovulation disorders may be due to:

  • Premature ovarian failure – the woman’s ovaries stop working before she is 40.
  • Polycystic ovary syndrome (PCOS) – the woman’s ovaries function abnormally. She also has abnormally high levels of androgen. About 5 percent to 10 percent of women of reproductive age are affected to some degree.
  • Hyperprolactinemia – if prolactin levels are high and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
  • Poor egg quality – eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is the higher the risk.

Infertility in women may be caused by other health issues including:

  • Overactive thyroid gland
  • Underactive thyroid gland
  • Chronic conditions, such as AIDS or cancer
  • Sexually transmitted infections (STIs), such as chlamydia

Other issues can also lead to infertility in women. If the fallopian tubes are blocked, the egg and sperm cannot meet and fertilization will not occur. Blocked tubes may result from previous pelvic infections, endometriosis or surgery for an ectopic (tubal) pregnancy.

Certain lifestyle factors including stress or diet may also affect a woman’s hormonal balance. Much less often, a hormonal imbalance from medical conditions may cause the failure to ovulate.

Here are some lifestyle factors that have been linked to infertility:

  • Smoking – smoking significantly increases the risk of infertility in both men and women. Smoking may also undermine the effects of fertility treatment. Even when a woman gets pregnant, if she smokes she has a greater risk of miscarriage.
  • Being overweight – in industrialized countries obesity and a sedentary lifestyle are often found to be the principal causes of female infertility. An overweight man has a higher risk of having abnormal sperm.
  • Eating disorders – women who become seriously underweight as a result of an eating disorder may have fertility problems.
  • Being vegan – if you are a strict vegan you must make sure your intake of iron, folic acid, zinc and vitamin B-12 are adequate, otherwise your fertility may become affected.
  • Over-exercising – a woman who exercises for more than seven hours each week may have ovulation problems.
  • Not exercising – leading a sedentary lifestyle is sometimes linked to lower fertility in both men and women.
  • Exposure to some chemicals – some pesticides, herbicides, metals (lead) and solvents have been linked to fertility problems in both men and women.
  • Mental stress – studies indicate that female ovulation and sperm production may be affected by mental stress.

Aging is an extremely important factor in female infertility. The ability of a woman’s ovaries to produce good genetic quality eggs declines with age, especially after age 35. One third of couples where the woman is over 35 will have difficulty in conceiving.

By the time she reaches menopause, when her monthly periods cease, a woman can no longer produce eggs or become pregnant. However, many women choose to use eggs from younger women to conceive and carry a pregnancy themselves. This is an excellent option for many couples as it offers some significant advantages over adoption.