Top 10 Causes of Infertility in Women

The fallopian tubes are a crucial part of the female reproductive system, approximately 10cm long, connecting the uterus to the ovaries. They consist of four sections: interstitial, isthmic, ampullary, and fimbrial. Each section plays a distinct role in fertilization. The normal function of the fallopian tubes is vital for conception, as they transport the egg from the ovaries to the uterus and serve as the only path for sperm to reach the egg for fertilization. The tubes also provide an optimal environment for the fertilized egg to divide and implant in the uterus. However, if the fallopian tubes become blocked due to infection or disease, they lose all functionality, leading to infertility. Blocked fallopian tubes are a leading cause of infertility, accounting for over 30% of cases. The most common cause of this condition is pelvic inflammatory disease (PID), which causes scarring in the fallopian tubes, leading to blockages. In rural areas, tubal blockage is often caused by Mycoplasma tuberculosis, while bacterial infections like gonorrhea, chlamydia, and staphylococcus can also contribute to the condition. In some cases, abnormal placement of endometrial tissue in the fallopian tubes can also cause blockages. The most frequent risk factor for this condition is a history of abortion, especially in younger women undergoing their first pregnancy. Symptoms include fatigue, lower abdominal pain, irregular menstrual cycles, and increased vaginal discharge.

After the age of 30, a woman’s fertility begins to decline. This explains why many couples struggle to conceive and face more reproductive challenges. By age 40, a woman’s fertility continues to decrease as ovulation becomes less frequent, and some menstrual cycles may even pass without egg release. Eventually, around ages 45 to 55, menopause occurs, marking the end of a woman’s reproductive years. A woman is born with about 400,000 eggs, but by 38, only around 25,000 eggs remain. However, these eggs are often aging and may have genetic abnormalities. When younger, a woman’s body selects the healthiest eggs to develop and release regularly. Thus, a 40-year-old woman will have a higher rate of genetically abnormal eggs compared to a 30-year-old woman. The number of eggs naturally declines over time, following a predetermined pattern. At 20 weeks of gestation, a female fetus has around 6 to 7 million eggs, which reduces to 1 to 2 million at birth, about 300,000 to 500,000 at puberty, and around 250,000 by age 37. By 51, only about 1,000 eggs remain. Throughout a woman’s reproductive life, only around 400 to 500 eggs will be used in reproduction, with the rest naturally dying off. As a woman ages, her ovarian reserve decreases, and this depletion leads to menopause, typically around age 51. Along with the decrease in egg quantity, egg quality also declines. Egg quality remains stable until around 30, then declines sharply after 35.

Studies show that a woman's fertility significantly drops up to 10 years before menopause, and in many cases, it starts to decline even earlier, from 15 to 20 years before menopause. According to scientific studies, age is one of the leading causes of female infertility. After 30, a woman’s chances of pregnancy significantly decrease. After 35, pregnancy becomes very rare, and babies born to older mothers are at higher risk of neurological disorders such as Down syndrome, cerebral palsy, and birth defects. Therefore, women should consider discontinuing birth control before turning 30.

Obesity and being overweight are not only concerns for women due to aesthetic reasons but also major factors contributing to infertility. This is because excessive body weight and fat impair ovarian function, leading to infertility. Specifically, obesity reduces ovarian function, decreases libido, disrupts menstrual cycles, causes excessive sweating, fatigue, and dry skin, all of which increase the risk of infertility. It is also a primary cause of several medical conditions. Therefore, treating obesity as a contributing factor to infertility in both men and women requires a focused approach. The disruption of hormonal balance caused by obesity makes it a dangerous factor in infertility. Additionally, individuals with obesity-induced infertility are more likely to experience ovarian infections, reduced egg and embryo viability.

These are the reasons why obese women may have difficulty conceiving. They may also face many complications during pregnancy, such as diabetes and preterm birth. According to Dr. Abhay Agrawal from the Asian Heart Institute, ovarian dysfunction is the main factor leading to infertility in obese women. Abnormal levels of hormones like androgen, estrogen, and progesterone can disrupt menstrual cycles. Ideal levels of these hormones are crucial for conception and pregnancy. The accumulation of fat in the ovaries also disrupts fetal development and can result in miscarriage. As a result, obesity is not only an aesthetic concern but also a major cause of infertility after marriage. According to studies from medical professionals at a U.S. medical university, obese girls over the age of 18 are more likely to develop polycystic ovary syndrome (PCOS), hormonal imbalances, and face difficulties with fertility later in life.

It's not only men, but smoking women also experience significant negative effects on their reproductive health. Smoking has been shown to degrade or even damage eggs in the ovaries. It increases the risk of early menopause, both of which reduce fertility. According to a study published by the British Medical Association, the chances of conception decrease by 40% in women who smoke compared to those who don't. The more cigarettes a woman smokes, the lower her chances of conception. Women who don't smoke tend to have a longer reproductive lifespan compared to those who do. Additionally, smoking can delay the process of conception, making natural pregnancy more difficult. Smoking alters the levels of various hormones, including estrogen, which disrupts ovulation and throws menstrual cycles out of balance, reducing fertility.

Smoking not only hinders conception but also affects the development of the baby. Tobacco smoke causes hormonal imbalances in women, damages healthy DNA, impairs ovulation, and leads to infertility. Smoking increases the levels of epinephrine and vasopressin hormones, which elevate blood pressure and heart rate. These hormones stimulate the fallopian tubes, causing embryos to reach the uterus too early. As a result, implantation of the embryo in the uterine lining does not occur, leading to spontaneous miscarriage. In some smokers, the movement of the embryo through the fallopian tube is slowed, which can result in an ectopic pregnancy. Women who smoke have a 2.2 to 4 times higher incidence of ectopic pregnancy and a 1.5 to 3.2 times higher risk of miscarriage compared to non-smokers. Smoking causes an estimated 19,000 to 141,000 miscarriages annually in women. Moreover, smoking directly damages or even destroys eggs, weakening the immune system and causing infections in the fallopian tubes, which heightens infertility. Smoking alters the levels of estrogen and follicle-stimulating hormones, disrupting normal ovulation, which is a leading cause of infertility. Not only does smoking reduce fertility, but it also makes fertility treatments less effective, with lower success rates in in vitro fertilization. Even for women who conceive through IVF, there is an increased likelihood of miscarriage.

Caffeine is known as a stimulant. Scientific studies have proven that caffeine can cause rapid heart rate, nausea, anxiety, and even depression. Recently, research has shown that consuming caffeine can make it more difficult for women to conceive. Caffeine enters the bloodstream and crosses the placenta. Being a stimulant, it can cause the baby’s heart rate and metabolism to increase. Excessive caffeine intake can also affect fetal development and increase the risk of miscarriage.

According to a study by the University of Nevada, caffeine in coffee is a direct cause of hindering the movement of eggs, reducing libido, and impairing fertility. Caffeine is not only a substance that should be limited for pregnant women but also for those trying to conceive. Consuming 200mg of caffeine per day can increase estrogen levels in the body, leading to reproductive disorders and infertility. Caffeine interferes with the absorption of nutrients necessary for fertility, which affects ovulation cycles and reduces the chances of conception. While caffeine is also a diuretic, excessive intake can lead to the elimination of nutrients essential for pregnancy. Experts recommend that the average woman should consume no more than 100-200 mg of caffeine daily.

Researchers have found that excessive alcohol consumption can lead to infertility. For women, drinking 3 glasses of alcohol per day (with 40% alcohol content) or consuming large amounts of alcohol within a week often makes it harder to conceive. This is especially detrimental for women who are planning to have children. In today's society, gender equality is increasingly valued, and alcohol consumption among women in Vietnam is on the rise, becoming a normal part of social life. If you're one of those individuals, or if you have a habit of drinking, it’s recommended to opt for wine as it benefits the heart, promotes blood circulation, and improves skin health. However, if your job forces you to drink heavily (such as working in hospitality, as a brand ambassador, or engaging in business meetings), it's important to learn how to drink responsibly to avoid getting drunk. Heavy drinking can negatively affect reproductive health. Additionally, habitual urinary retention can lead to infertility in women. This happens because the reproductive organs are located right behind the bladder in the pelvic area, and holding in urine can cause the bladder to swell, pressing against the uterus. Over time, this can cause the uterus to tilt backward, making it harder for conception to occur.

Therefore, when drinking at parties or social events, it’s best to avoid holding your urine. Don’t hold it in to show off your alcohol tolerance, thinking that you can drink more. Urinating regularly helps expel alcohol from the body, preventing you from getting too drunk. Additionally, you should consume detoxifying drinks or avoid foods that make you feel drunk quickly or cause dehydration, to reduce the strain on your liver and help you stay sober longer. However, unlike men, alcohol and alcoholic beverages are among the unexpected causes of infertility in women. Drinking one glass of alcohol daily can cause irregular ovulation, disrupt menstrual cycles, and increase the risk of infertility. Women who are pregnant and consume alcohol excessively are at risk of preterm birth, weak babies, and pale skin.

Frequent irritability and anger are common psychological traits that anyone can experience. However, consistently feeling angry or upset is detrimental to both physical and mental health. Women who face multiple pressures from family, work, friendships, or relationships often struggle with conception. Negative emotions and constant stress can diminish sexual desire, hinder the production of female hormones, slow down ovulation, and cause menstrual irregularities. When stressed, the body releases a substance called “catecholamine,” which affects the central nervous system, reduces detoxification, and lowers oxygen levels in the blood. This stress can also strain blood vessels in the brain. As a result, frequent anger or frustration can lead to various health issues such as liver damage, brain cell degeneration, oxygen deprivation in the heart, lung damage, and immune system deterioration. Experts also recognize that emotional instability, including irritability, can contribute to hormonal imbalances in women, which may lead to menstrual problems and infertility. While infertility in women is typically linked to causes like abortion, pelvic infections, or polycystic ovary syndrome, frequent anger can be a significant contributing factor. Additionally, women who are constantly angry are more likely to experience depression and high stress levels. Prolonged emotional turmoil, such as shock or deep emotional wounds, can result in irregular periods, painful menstruation, or missed periods. All these factors impact a woman’s reproductive health. Infertility often accompanies menstrual irregularities. Clearly, constant anger is harmful to health, especially reproductive health. Therefore, it's crucial to find ways to relieve stress, embrace joy, and let go of trivial frustrations to maintain good health, a positive attitude, and an optimistic outlook. Women should focus on keeping their emotions balanced, staying positive, and avoiding unnecessary negativity. Additionally, it’s important to avoid excessive consumption of foods like meat, fish, chocolate, and sugary treats, as they can elevate catecholamine levels, leading to irritability and negative emotions. For women trying to conceive, the first step is to free themselves from stress and negative thoughts, adopt a joyful attitude, and create a positive mindset for faster conception.

Female hormones are crucial in maintaining a woman’s physiological function and reproductive health. Studies have shown that hormonal imbalances are one of the leading causes of reproductive dysfunction in women. Additionally, a decline in hormones can lead to various unforeseen health consequences for women. A drop in estrogen levels, which is one of the most important female hormones produced by the ovaries, typically occurs between the ages of 30 to 40 and can significantly affect a woman's health, appearance, and sexual function. Estrogen plays a vital role in determining features like breast size, waist shape, and smooth skin. Hormonal imbalances can lead to fatigue, mood swings, anxiety, and even depression. If a woman experiences any of these symptoms, especially if she notices an irregular menstrual cycle, it's crucial not to ignore them. Early detection and intervention are key to successful treatment. Some signs of hormonal imbalance include unusual emotional states, fatigue, and persistent stress. This stress can result from an imbalance in the female hormones, particularly estrogen, which is responsible for the production of serotonin, a neurotransmitter that regulates mood. When estrogen levels fluctuate, it can lower serotonin production, leading to long-lasting negative emotions. The menstrual cycle is also closely linked to hormonal balance, and any irregularities—such as changes in cycle length, the amount of menstrual flow, or clotting—are often signs of hormonal imbalances.

Hormonal imbalances also affect the ovaries and uterus, causing further irregularities. This can lead to issues like vaginal dryness, which makes it difficult to produce the natural lubrication needed for comfort and protection. When the vaginal environment becomes too dry, it becomes more susceptible to infections, including pelvic inflammatory disease, cervicitis, and other reproductive health issues. Because hormones are crucial in regulating many functions within a woman’s reproductive system, it's vital to seek medical attention if you experience any of these symptoms. Timely diagnosis and treatment can prevent long-term health problems.

The vaginal area is highly sensitive and vulnerable, requiring proper care to prevent infections. If left unchecked, these infections can lead to serious conditions like endometriosis, fibroids, and even infertility. Early detection of infections is crucial for timely treatment, which can prevent further complications. In some cases, pain during bowel movements might indicate a more severe issue, such as endometriosis, which worsens during menstruation. If untreated, this can increase the risk of infertility. Additionally, unusual vaginal discharge, such as a grayish-white color with a foul odor, could signal a bacterial infection. Other signs include itching, irritation, and abnormal discharge consistency, which may indicate cervicitis or other gynecological conditions. It's important to seek medical advice if these symptoms occur. Young girls starting their menstrual cycles should also be mindful of their genital hygiene as the reproductive system begins functioning.

Vaginal infections can be difficult to treat and can spread rapidly, potentially causing life-threatening reproductive health issues like ovarian, fallopian tube infections, and other gynecological disorders. Dr. Nguyen Thi Huynh Mai, a seasoned obstetrician and gynecologist, points out that the causes of vaginal infections are diverse, including unsafe sexual practices, excessive use of stimulants, and cross-contamination. If left untreated, these infections can seriously affect reproductive health. Therefore, women should promptly visit a gynecologist for any unusual symptoms to ensure timely and effective treatment. Before treatment, a thorough examination and necessary tests are essential to identify the root cause of the infection. Identifying the cause enables doctors to provide the most effective treatment, ensuring the best possible outcomes for patients.

With the rise of machinery and industrial development, humans are increasingly exposed to harmful chemicals. Pesticides and lead-contaminated cosmetics are among the top culprits contributing to infertility. Research shows that phthalates, a chemical found in plastics and products with artificial fragrances, are toxic substances that can cause infertility. These chemicals are present in vinyl products, shower curtains, synthetic leather, as well as in scented items like perfumes, candles, air fresheners, cleaning agents, tissue papers, fabric softeners, shampoos, soaps, hairsprays, deodorants, moisturizers, and other personal care products. Pollution from nitrates and nitrogen in water supplies, originating from agricultural fertilizers, has also been linked to reproductive issues, cancer, and miscarriage.

According to the Rodale Institute, water runoff from farms using chemical fertilizers often contains nitrate levels that exceed the safe drinking water limits, especially when compared to organic farming systems. To reduce the nitrate levels in drinking water, a certified home water filtration system is recommended. Additionally, encouraging local farmers to adopt organic farming practices can help minimize the use of harmful chemicals and fertilizers that contaminate water sources, ultimately reducing infertility rates among women.