The Most Common Causes of Infertility
When supporting my patients on their fertility journey, one of the most important steps is identifying the underlying cause of their struggles. Infertility can have many contributing factors, and while the list below is not exhaustive, it highlights some of the most common reasons conception may be more challenging. Understanding these factors is the first step toward creating a personalized plan to support your fertility.
Ovulation Disorders Causing Infertility
Ovulation issues are one of the most significant roadblocks to getting pregnant and among the most common fertility challenges I see in practice. Several hormonal conditions can affect ovulation, including:
Hypothalamic amenorrhea
Primary ovarian insufficiency (POI)
High prolactin levels (hyperprolactinemia)
These conditions can make ovulation unpredictable or stop it altogether. Each has distinct signs and symptoms, which help us determine the most likely cause, as well as comprehensive lab work.
Structural Causes of Infertility
Screening for structural barriers to pregnancy is an essential part of the fertility assessment. The fallopian tubes must be open and functioning properly, and the uterus must be free from abnormalities such as fibroids, polyps, or scar tissue that could affect implantation.
Investigating structural causes typically involves imaging tests, including:
Hysterosalpingogram (HSG) or Sonohysterogram (SHG): Ensures the fallopian tubes are open.
Ultrasound: Examines the uterus for structural concerns.
Since Naturopathic Doctors cannot perform these imaging tests, this step is usually completed through a fertility clinic.
Autoimmune Causes of Infertility
Certain autoimmune conditions have been linked to decreased fertility. The most common I see in my fertility patients is Hashimoto’s hypothyroidism, which has been associated with both reduced fertility and an increased risk of miscarriage. Other autoimmune conditions that may impact fertility include:
Celiac disease: Linked to chronic inflammation and nutrient deficiencies that may reduce fertility.
Antiphospholipid syndrome: A rare disorder affecting blood clotting, which can interfere with implantation and increase miscarriage risk.
While autoimmune disorders often come with a range of physical symptoms, it’s possible to have elevated autoimmune markers without noticeable signs. This is why screening for these conditions is particularly important for those with unexplained infertility or recurrent pregnancy loss.
Endometriosis
Endometriosis is a common but often overlooked cause of infertility. This condition occurs when tissue similar to the uterine lining grows outside the uterus, leading to:
Chronic inflammation and scarring
Blocked fallopian tubes
Reduced egg quality
Immune system dysfunction
Many women with endometriosis experience painful periods, digestive issues, or chronic pelvic pain. However, silent endometriosis—a form with few or no symptoms—can still impact fertility.
Diagnosis can be complex and may require specialized ultrasounds or laparoscopic surgery. If endometriosis is suspected, referral to a specialist is often the best next step.
Infection-Related Causes of Infertility
Certain infections can impact fertility by causing inflammation, scarring, or altering the vaginal and uterine environment. Some key infection-related causes include:
Pelvic Inflammatory Disease (PID): Often caused by untreated sexually transmitted infections (STIs) like chlamydia or gonorrhea, leading to scar tissue formation and blocked fallopian tubes.
Chronic or recurrent vaginal infections: Conditions such as bacterial vaginosis can disrupt the uterine microbiome, making implantation more difficult and increasing the risk of miscarriage.
Screening for infections may involve blood work, vaginal swabs, vaginal microbiome testing, or, in some cases, uterine biopsies.
Looking for more fertility support?
Understanding how to optimize your fertility, reduce miscarriage risk and support yourself for the healthiest pregnancy and postpartum period is incredibly important. Naturopathic medicine has many tools that can support you along your fertility journey. If you're searching for more guidance, in-depth testing and an understanding of how you can optimize your fertility through naturopathic medicine, you can book an appointment with me here.
