Female Infertility: Causes, Diagnosis & Treatment

Female Infertility Consultation - Dr Sunita Arora

Fertility & Gynaecology

Female Infertility: – Causes, Diagnosis and Treatment in South Delhi

Trying to conceive without success can be emotionally exhausting. Many women feel confused, anxious or even guilty, yet infertility is a medical condition, not a personal failing. In most cases there is an identifiable factor, and with careful evaluation many couples find a clear way forward.

This page explains the common causes of female infertility, how a fertility specialist investigates them, and the treatment options available. It is general educational information. Every couple's situation is different, and the right plan can only be decided after a personal clinical assessment.

What Is Female Infertility?

Infertility is generally defined as not achieving pregnancy after 12 months of regular, unprotected intercourse. For women aged 35 and above, evaluation is usually advised after 6 months, and women over 40 or those with known risk factors should not wait that long. Infertility can be primary, when a woman has never conceived, or secondary, when she has conceived before but is now unable to do so.

Fertility depends on both partners. In a significant proportion of couples, a female factor, a male factor or both are involved, and in some couples no cause is found at all. For this reason, a complete evaluation usually includes the male partner as well.

When Should You See a Fertility Specialist?

Consider a consultation if any of the following apply:

You are under 35 and have not conceived after 12 months of trying.

You are 35 or older and have not conceived after 6 months, or you are over 40.

Your periods are very irregular, very infrequent or absent.

You have severe period pain, pelvic pain or a known diagnosis such as PCOS, endometriosis or fibroids.

You have had pelvic infection, pelvic or abdominal surgery, an ectopic pregnancy or repeated pregnancy loss.

Early Guidance: Seeking advice early does not commit you to treatment. It gives you clear information and avoids unnecessary delay.

Common Causes of Female Infertility

Conception requires a healthy egg to be released, a clear path for the egg and sperm to meet, a receptive uterus and a balanced hormonal environment. A problem at any of these steps can reduce fertility.

Ovulation Disorders

Irregular or absent ovulation is one of the most frequent causes. Polycystic ovary syndrome (PCOS or PCOD) is a leading reason, and thyroid disorders, raised prolactin levels, significant weight changes and excessive stress or exercise can also disturb ovulation. Irregular or missed periods are often the first sign.

Blocked or Damaged Fallopian Tubes

If the fallopian tubes are blocked or damaged, the egg and sperm cannot meet. Previous pelvic infection, pelvic inflammatory disease, past abdominal or pelvic surgery, genital tuberculosis or an earlier ectopic pregnancy can all affect the tubes.

Endometriosis

In endometriosis, tissue similar to the uterine lining grows outside the uterus. It may cause painful periods, pelvic pain or pain during intercourse, and can affect the ovaries, tubes and egg quality. Some women with endometriosis have few symptoms, so it is sometimes discovered only during a fertility work-up.

Uterine Factors

Fibroids, polyps, adhesions (scar tissue) or a uterine septum can interfere with implantation or the growth of an early pregnancy. These conditions are usually detected by ultrasound or hysteroscopy.

Age and Ovarian Reserve

Egg quantity and quality decline naturally with age, and the decline becomes more pronounced after the mid-30s. Reduced ovarian reserve can also occur earlier because of genetics, ovarian surgery, certain treatments or unknown reasons.

Unexplained Infertility

In some couples, standard tests show no clear abnormality. This does not mean there is no solution; treatment can still be offered, guided by age, duration of infertility and previous outcomes.

How Female Infertility Is Diagnosed

The aim of the evaluation is to find the cause or causes in an organised, step-by-step way, using only the tests that are relevant to you.

Step 01

1. Detailed History and Examination

The first visit includes questions about menstrual cycles, previous pregnancies, past infections or surgeries, medical conditions, medicines, lifestyle and how long you have been trying. A general and pelvic examination is performed where appropriate.

Step 02

2. Hormonal and Blood Tests

Depending on your history, tests may include thyroid function, prolactin, and reproductive hormones such as FSH, LH and estradiol. Anti-Mullerian hormone (AMH) is commonly used, along with ultrasound findings, to estimate ovarian reserve. Ovulation may also be confirmed through cycle tracking or follicular monitoring.

Step 03

3. Pelvic Ultrasound

An ultrasound examines the uterus and ovaries, looks for fibroids, polyps, cysts or features suggesting PCOS, and counts the small resting follicles in the ovaries (antral follicle count).

Step 04

4. Assessing the Fallopian Tubes and Uterine Cavity

Tubal patency may be checked with hysterosalpingography (HSG), a special X-ray test, or with ultrasound-based techniques. If needed, hysteroscopy allows the inside of the uterus to be viewed directly, and laparoscopy allows the pelvis to be examined and, in many cases, treated in the same procedure.

Step 05

5. Evaluation of the Male Partner

A semen analysis is a simple, important test and is usually advised at the beginning of the work-up, so that treatment is planned for the couple as a whole.

Treatment Options for Female Infertility

Treatment is chosen according to the cause, your age, ovarian reserve, how long you have been trying and your preferences. Not every woman needs advanced treatment, and a more complex procedure is not always a better one.

Lifestyle and Medical Optimisation

Healthy weight, balanced nutrition, regular activity, stopping tobacco, limiting alcohol and managing stress can support ovulation and overall fertility. Treating thyroid disorders, raised prolactin or other medical conditions is an important first step for many women.

Ovulation Induction

For women with irregular ovulation, such as in PCOS, oral medicines or injectable hormones may be used to stimulate ovulation, with ultrasound monitoring to guide dosing and timing and to reduce risks.

Intrauterine Insemination (IUI)

In IUI, prepared sperm is placed in the uterus around the time of ovulation. It may be considered for selected couples, for example in mild male factor, unexplained infertility or when ovulation is induced and the tubes are open.

Surgical Treatment

Where a structural problem is identified, minimally invasive surgery may help. Hysteroscopy can be used to remove polyps or septa and divide adhesions, while laparoscopy may be used for endometriosis, ovarian cysts, adhesions or fibroids when clinically appropriate. Surgery is recommended only when it is likely to benefit fertility.

Advanced Care

In Vitro Fertilisation (IVF)

IVF may be advised for blocked tubes, reduced ovarian reserve, endometriosis, male factor infertility, unexplained infertility that has not responded to simpler treatment, or after other treatments have not worked. Eggs are collected, fertilised in the laboratory and the resulting embryo is transferred to the uterus.

Outcomes vary from person to person, and no treatment can guarantee pregnancy.

Your First Visit

What to Expect at Your Consultation

Your first appointment is a conversation as much as an examination. You will be able to discuss your concerns, share your reports, and understand which tests are needed and why. After the initial assessment, you will be given a clear explanation of the likely causes, the options available, and the expected timeline, so that you can make informed decisions at your own pace.

Please bring previous reports, prescriptions and details of any earlier treatment, and, if possible, attend together with your partner.

Specialist Expertise

Consult Dr. Sunita Arora for Fertility Care in South Delhi

Dr. Sunita Arora is an obstetrician, gynaecologist and fertility specialist with more than 23 years of experience. She holds an MBBS from Lady Hardinge Medical College, New Delhi, and an MD in Obstetrics and Gynaecology from UCMS and GTB Hospital, and she is a Fellow of the Indian College of Obstetricians and Gynaecologists (FICOG) and a Fellow of the International College of Surgeons (FICS). She completed a fellowship in Reproductive Medicine at D.Y. Patil University, Mumbai, and received IVF training at RMA, Mount Sinai, New York.

Her areas of interest include infertility, IUI, IVF and endoscopic surgery.

Patients value a personalised, transparent approach in which each step of evaluation and treatment is explained in plain language.

Clinic Locations

Consult in South Delhi

She consults at Safdarjung Enclave and is also associated with Fortis La Femme, Greater Kailash II, which makes care accessible to women across South Delhi.

Safdarjung Enclave

Dr Sunita Arora Fertility and Gynae Clinic

Greater Kailash II

Fortis La Femme, South Delhi

Accessible to women across South Delhi, including Greater Kailash, Green Park, Hauz Khas and surrounding areas.

Frequently Asked Questions

Find answers to common questions about female infertility causes, evaluation tests, and treatment options.

Most couples are advised to seek evaluation after 12 months of trying. If the woman is 35 or older, a consultation after 6 months is reasonable, and women over 40, or those with irregular periods, known pelvic conditions or previous pelvic surgery, should seek advice sooner.

Yes. Irregular periods often indicate irregular or absent ovulation, which can reduce fertility. The cause, such as PCOS or a thyroid problem, can usually be identified and treated after evaluation.

Blood tests and ultrasound are generally well tolerated. HSG can cause cramping for a short time, and your doctor will explain what to expect and how to prepare. Hysteroscopy and laparoscopy are done with appropriate anaesthesia or sedation.

No. Many women conceive after treating an underlying condition, ovulation induction or IUI. IVF is recommended when it is the most suitable option for your specific circumstances.

Stress can affect menstrual cycles and wellbeing, but it is rarely the only cause. If you have been trying for some time, a medical evaluation is the best way to look for treatable factors.

Yes, in most cases. A semen analysis is simple and gives valuable information, allowing a more accurate and efficient plan for both partners.

Female Infertility: Causes, Diagnosis and Treatment in South Delhi