Female Infertility


Female infertility can have several causes.  They are, in descending order:

  1. Tubal issues
  2. Ovulation problems
  3. Older age
  4. Uterine abnormalities
  5. Endometriosis
  6. Genetic problems



The Fallopian tubes are canal-like structures that extend from the right and left sides of the uterus to the ovaries in the shape of fingers. These tubes are the conception site for the egg to be fertilized by the sperm. The fertilized egg (embryo) moves through the tube to the uterus for implantation.  The tubes must be working perfectly for conception to occur.

What are the causes and symptoms of blocked fallopian tubes?

Conditions that lead to blocked fallopian tubes may occur as a result of pelvic infections, intra-abdominal surgeries or endometriosis.


Many women are not aware that they have blocked tubes until they try to get pregnant and have trouble doing so.

How is a blocked fallopian tube diagnosed?

The most commonly used method to diagnose blocked fallopian tubes is hysterosalpingography (HSG). HSG is a type of X-ray used to examine the inside of fallopian tubes by using an opaque substance introduced by your doctor into your uterus and fallopian tubes through a special cannula. With this X-ray method, we can find congenital or acquired problems in the uterine cavity and get information about the structure and integrity of the tubes.

Bilateral tubal obstruction in HSG

In addition, the integrity of the tubes can be checked by laparoscopic surgery.

Can a woman with blocked tubes become pregnant?

The tubal microsurgery for blocked tubes has given way to in-vitro fertilization (IVF) today. If blocking fluid is detected in the HSG, we recommend that this damaged tube should be removed by laparoscopic surgery before IVF treatment.

Bilateral hydrosaphinx in HSG


The normal length of the menstrual cycle in women of reproductive age is between 21 and 35 days. Cycle lengths outside this range are generally considered abnormal.  Polycystic ovary syndrome (PCOS) and some hormonal disorders (thyroid diseases, high prolactin levels, early menopause, etc.) are the most common causes of ovulation disorders.



Female age is one of the most important factors in fertility. Fertility starts to decline after the age of 35 and this decline gets faster after 40 years old. At this age, the ovarian reserve decreases. On top of this, the quality and genetic health of the egg cells deteriorate.

If pregnancy is not achieved despite unprotected and regular sexual intercourse for 6 months in women over the age of 35, and for 3 months in women over the age of 40, this is when we start to consider infertility treatment.

Advanced maternal age


Uterine factor infertility is one of the most common reasons for difficulty in getting pregnant. There are 2 major groups of uterine abnormalities:

  1. Congenital defects, known as Mullerian anomalies: There are several different forms of anomalies ranging from the absence of a uterus to the formation of a half uterus or a double uterus, to a uterus divided by a septum. All types affect the reproductive tract to varying degrees. These anomalies can both prevent pregnancy and cause recurrent miscarriages. Some of the congenital anomalies can be corrected by surgery.
  2. Acquired problems: Fibroids, polyps, and adhesions caused by intrauterine procedures or by infections may be the cause of infertility. These problems can also be treated by surgery.

Submucous myoma

Endometrial polyp


The presence of intrauterine tissue (endometrium) in any organ or tissue other than the uterus is called ‘Endometriosis’. Endometriosis often involves the ovaries and the membranes surrounding the abdominal organs. It can also cause ‘Endometrioma’ (chocolate cyst) in the ovary. Therefore, endometriosis can prevent pregnancy by causing both ovulation disorder and blockage in the tubes.



Numerical or structural abnormalities in the chromosomes, and hereditary genetic diseases both in men and women can be causes of infertility or recurrent miscarriage.

Human chromosome