Female infertility

Common causes of female reproductive issues

A naturally conceived pregnancy requires ovulation, normal tubes and uterus as well as healthy sperm.

There are many common health factors that can affect a woman’s ability to ovulate, conceive, or carry a pregnancy to term such as being overweight, being underweight, having hormonal imbalances or autoimmune disorders, taking medications, and a range of other possible health factors. There are some inhibitors to your fertility that cannot be overcome naturally and those problems may be due to physical, hormonal or lifestyle factors

Impact of age

The eggs in the ovaries are made before a woman is born. Women are born with approximately 2 million eggs. That supply decreases to about 400,000 by the time a woman reaches her first period. The number of eggs steadily declines until, by the age of about 44, there are few or no eggs remaining in the ovaries. This explains why the biological clock is a reality for women.


Endometriosis is one of the most common conditions affecting women in their reproductive years. Endometriosis occurs when endometrial cells, usually found only in the womb, migrate to other areas of the pelvic cavity such as the fallopian tubes or the ovaries. This endometrial tissue can appear as spots or patches called implants or as cysts on the ovaries and can affect surrounding tissue, causing adhesions or scar tissue.

A woman’s ability to conceive might be impacted by endometriosis causing a blockage in the fallopian tubes. It could also interfere with the ovulation function or diminish optimal conditions for the travelling egg/oocyte. The only real way to diagnose endometriosis is by surgery or laparoscopy. Laparoscopy allows direct visualization and ideally biopsy of areas suspected of having endometriosis.

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) causes symptoms in up to 20% of women of reproductive age. In fact, it is the single biggest inhibitor of female fertility. PCOS can interfere with hormones that regulate reproduction and the ovulation process. PCOS is easily recognised through clinical assessment, hormonal analysis and ovarian ultrasound. PCOS does not necessarily mean difficulty in becoming pregnant, and is often treatable with a combination of medication and lifestyle changes. At Rotunda IVF, we can give you best guidance and advice in tackling the treatment of PCOS.

Ovulation problems

The process of Ovulation is complex. There are a number of barriers to conception that you can encounter along the way. Diagnosing an ovulation problem is straightforward. It requires blood tests and, in some cases, an ultrasound scan. Many women respond to medication that boosts the ovulation process, meaning IVF is not always required.

Blocked Fallopian Tubes

Fallopian tubes must be free and clear for a successful pregnancy. Blockage of the fallopian or reproductive tubes account for 20-25% of fertility problems experienced by women. The most common causes are chronic infection, endometriosis or swelling of the tubes by secretion (hydrosalpinx). Using X-Ray, laparoscopy, or a simple procedure called a HSG (hysterosalpingogram), we can easily identify whether tubal blockage is a problem. If confirmed, you will either be referred to a Rotunda IVF consultant who specialises in tubal surgery or you will be referred for IVF treatment.


Sometimes, the root cause of infertility can be psychological rather than physiological. It is not uncommon for a person to lose interest in sex due to stress or lifestyle factors. Some women even experience pain during sexual intercourse. At Rotunda IVF, we are well used to working with patients with sexual difficulties. It takes commitment and openness to address these issues and resolving those problems can be wonderfully rewarding. Our counselling team is a great resource, with a wealth of experience and training to help guide couples through this time.

When to seek help?

If you suspect that you have one of these conditions, or if you have been trying to conceive for more than 12 months (or 6 months if you are over the age of 35), then consider booking an appointment with one of our specialists.