Top Four Common Causes of Female Infertility

In a recent interview, Dr Sulaiman Heylen – a reproductive medicine specialist and director of Cape Fertility in Cape Town – highlighted the top four common causes of infertility among women. In this article, we find what these top four common causes are and discover more about how each one and how it affects your chances of achieving a pregnancy.


Endometriosis, blocked fallopian tubes, ovulation problems and fibroids are the top four most common causes of infertility among women.


Below follows a brief overview of each one of these common causes of female infertility – and how each one affects your ability to conceive.


Endometriosis is a benign condition in which the lining of the uterus is growing where it is not supposed to be – outside of the uterus, often at the back of uterus or around the ovaries or on other organs.

Endometriosis is a very common disease and it can start at any age. Up to 10% of all women have this disease.

There are different stages of the disease, ranging from minimal to severe. Most women have minimal or mild endometriosis, characterised by superficial implants and mild adhesions. Moderate and severe endometriosis is characterised by chocolate cysts and more severe adhesions.

A very common symptom of endometriosis is infertility – endometriosis affects between 25 and 40% of women facing fertility challenges.

This is because endometriosis can cause inflammation and scar tissue. Endometriosis is an inflammatory disease, and the inflammation it causes can interfere with a woman’s ovulation.

Endometriosis can also cause anatomical abnormalities such as scarring that can reduce the chances of conceiving. For example, endometriosis adhesions may prevent the fallopian tubes from picking up the egg from the ovary during ovulation.

Endometriosis can also grow on the surface of the ovary as implants or invade the ovary and develop a blood-filled cyst called an endometrioma, or a “chocolate cyst” (so called because over time the blood they contain darken to a deep reddish-brown colour). These cysts may be as small as a pea or grow larger than a grapefruit.

You can read more about endometriosis here.

Blocked Fallopian Tubes

While “blocked” fallopian tubes is the condition most people have heard of, there are a number of other possible medical problems that can affect the fallopian tubes and their functioning, resulting in infertility.

Fallopian tubes are tiny, delicate tubes stretching from the uterus to the ovaries and have the primary role of transporting eggs or embryos from the ovaries to the uterus. Essentially, a fallopian tube is the pathway that allows the egg and the sperm to meet and for fertilisation to take place.

Fertilization normally happens in the fallopian tubes. Without functional fallopian tubes, an egg and the sperm won’t be able to meet – and natural conception is not possible.

In order for natural conception to take place, a fallopian tube needs to be open all along its length, it needs to be free to move around and the tube needs to have a normal structure inside and out.

Fallopian tubes may be blocked for a number of different reasons, they may be damaged or swollen, or there could be damage to the actual structure of the tube preventing it from moving around freely or from moving the egg or embryo successfully along the tube.

Given how tiny and delicate the fallopian tubes are, there are many common causes of damage to the fallopian tubes. The most common cause is sexually transmitted diseases (STDs) that many women are unaware of. Another common cause of damage to the fallopian tubes is endometriosis. Damage to the fallopian tubes can also be the result of surgery or internal infection.

Follow the link if you would like to read more about fallopian tubes.

Ovulation Problems

Ovulation problems are quite common in general, and they are also one of the top four common causes of infertility among women.

Ovulation problems are evident when periods become abnormal or irregular. This could mean that a woman’s periods become very short in duration, or very long – for example, instead of five days, the bleeding lasts for 10 days or two weeks or even longer. In other cases, a woman’s periods may be reduced to only one every second month, or even to just three or four periods per year. All of these irregularities are all typical symptoms of ovulation problems.

There are different causes of ovulation problems. The most common cause of ovulation problems is polycystic ovarian syndrome or PCOS. In fact, PCOS is responsible for ovulation problems in about 80% of cases.

However, there are also other causes of ovulation problems, such as early menopause, thyroid problems, a dysfunction of the pituitary gland, and even certain medications.

The good news is that all of these causes of ovulation problems can be treated successfully. In many of cases, treatment can help restore ovulation and advanced treatments such as IVF are not always required.

You can read more here about the causes of ovulation problems.


Fibroids are non-cancerous, benign growths of the muscle cells in the uterus. Fibroids can be microscopic in size or can grow to weigh many kilograms and fill the entire uterus. Tiny fibroids can easily be missed and can also recur even after treatment.

Fibroids are quite common in women during their 30s and 40s through menopause. As many as 1 in 5 women may have fibroids during their childbearing years, and half of all women have fibroids by age 50. Thankfully, fibroids often shrink and cause no symptoms in women who have gone through menopause.

However, a uterus with fibroids is not conducive to growth and development of an embryo. An embryo must implant in the endometrial layer and draw essential nutrients from it. For this to be possible, the uterine lining (endometrium) must be thick and vascular.

Fibroids can cause infertility. This is because they grow directly below the uterine lining, taking up space and limiting blood supply to an embryo, which can prevent pregnancy or cause miscarriages.

Fortunately, fibroids can be treated very effectively, removing this cause of infertility.

Do I Have One of These Causes of Infertility?

If you are facing challenges in achieving a pregnancy and you suspect that you have one of the top four causes of female infertility – endometriosis, blocked fallopian tubes, ovulation problems and fibroids – we would like to invite you to come and meet one of our specialists by clicking here

We offer all the most effective fertility treatments at Cape Fertility, including successful treatment for endometriosis, blocked fallopian tubes, ovulation problems and fibroids at our purpose-built clinic, with procedure rooms and a modern sophisticated laboratory adjacent to our Main Reception and Staff Offices in the Claremont Medical Village. Our four reproductive specialists all have impressive qualifications and extensive experience and enjoy the qualified support of a team of associated specialists, embryologists, IVF co-ordinators, theatre staff and an administration team.

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises, where we achieve some of the best success rates in the world, yet always strive for higher success rates to ensure even more of our patients can experience the joy of have their own baby.