Female infertility, defined as the inability to conceive after a year or more of regular unprotected intercourse, affects approximately one in ten women of childbearing age globally. This reproductive health condition is a complex issue involving numerous potential factors, which are often intertwined and multifaceted. Despite advancements in reproductive medicine, understanding the underlying causes of infertility remains a crucial part of formulating effective treatment strategies. 

-Ovulatory Disorders

Ovulatory disorders account for about 25% of all female infertility cases, making them one of the most common causes. These disorders occur when a woman either ovulates irregularly or does not ovulate at all. They primarily originate from hormonal imbalances that disrupt the normal menstrual cycle. Conditions such as Polycystic Ovary Syndrome (PCOS), Premature Ovarian Insufficiency (POI), and Hypothalamic Dysfunction exemplify hormonal issues leading to ovulatory disorders.

PCOS is a hormonal disorder characterized by an excess of male hormones, irregular periods, and polycystic ovaries. This imbalance can disrupt ovulation, leading to infertility. POI is a condition where the ovaries cease to function normally before the age of 40, leading to diminished fertility due to a reduced number of viable eggs. Hypothalamic dysfunction involves the disruption of the pituitary gland's regulation of hormones, critical for ovulation.

-Structural Abnormalities: Tubal Damage and Uterine or Cervical Abnormalities

Structural abnormalities, specifically involving the fallopian tubes, uterus, and cervix, can also lead to female infertility. Damage to the fallopian tubes can prevent sperm from reaching the egg or block the fertilized egg's path to the uterus. Tubal damage can result from pelvic inflammatory disease, previous surgeries, or ectopic pregnancy.

Uterine or cervical abnormalities, such as polyps or fibroids (benign growths), may hinder implantation or increase the risk of miscarriage. In certain cases, women may have congenital abnormalities, like a septate uterus, that affect fertility.

-Endometriosis

Endometriosis is another prevalent cause of female infertility. It involves the growth of endometrial tissue (the tissue lining the uterus) outside the uterus, such as on the ovaries or fallopian tubes. This abnormal tissue growth can lead to pelvic inflammation, scarring, and adhesions, which can block the fallopian tubes or disrupt implantation. Endometriosis is also associated with lower egg quality and diminished ovarian reserve.

-Age-related Infertility

Age is a significant determinant of female fertility. As women age, both the quality and quantity of their eggs decline, leading to diminished fertility. This decline is gradual in the early and mid-thirties but accelerates after the age of 35. Age-related infertility can also be attributed to an increased risk of health conditions that can interfere with fertility, such as uterine fibroids and endometriosis.

-Unexplained Infertility

In about 10 to 20% of cases, infertility remains unexplained, meaning that standard testing cannot identify any specific cause. This could be due to subtle issues with egg quality or fertilization that current testing methods cannot detect, or a combination of minor factors in both partners leading to infertility