Female fertility is wonderfully complex, encompassing several aspects of reproduction. A woman’s body provides the egg and a place for fertilisation to occur, in addition to carrying and nourishing a baby through pregnancy. Healthy female fertility relies on a number of factors working together, including regular ovulation, healthy eggs, open fallopian tubes, a receptive uterine environment, and the ability of an embryo to implant and develop.
For many women, fertility is closely linked to overall health and wellbeing. While fertility challenges are common, they can also be emotionally complex and deeply personal. Seeking answers early can provide reassurance, clarity, and access to treatment options that may help you achieve your family-building goals.
Whether you’re part of a couple having difficulty conceiving, a same-sex female couple planning a pregnancy with donor sperm, or a single woman exploring your fertility and reproductive options, speaking with a fertility specialist is often the first step towards understanding your fertility and planning for the future.
A variety of conditions can interfere with one or more of the structures or processes involved in female fertility, either making it more difficult to conceive or to sustain a healthy pregnancy. Comprehensive investigations with a fertility specialist can help identify potential causes of infertility in women and guide the most appropriate treatment options.
Female fertility naturally declines with age as both the number and quality of eggs decrease. While every woman’s fertility journey is different, fertility generally begins to decline in the early 30s, with a more significant reduction after age 35.
Though no treatment can prevent the deterioration in egg number and quality, freezing your eggs while you are still young and storing them for future use, or conceiving through assisted reproduction such as IVF with your own eggs or donor eggs, can still give you options for motherhood in older age.
Ovulation disorders are one of the most common causes of female infertility after age. If ovulation occurs irregularly or not at all, opportunities for conception become less frequent.
Conditions that may affect ovulation include polyendocrine metabolic ovarian syndrome (PMOS, formerly polycystic ovary syndrome or PCOS), significant weight changes, excessive exercise, and other hormonal imbalances. Depending on the cause, ovulation disorders affecting fertility can often be managed with lifestyle modifications, medication, or assisted reproductive technologies.
The uterine lining is known as the endometrium. Endometriosis occurs when endometrium-like tissue grows outside the uterus, such as behind the uterus or around the ovaries and fallopian tubes. This condition can cause inflammation, pelvic pain, and fertility challenges.
Many women with endometriosis are able to conceive naturally, while others may benefit from surgery to support natural conception, or fertility treatment such as IVF.
The fallopian tubes play a critical role in fertilisation by providing a space for your egg and your partner’s or donor’s sperm to meet. If one or both tubes are blocked or damaged, natural conception may become more difficult.
Tubal damage can occur as a result of previous infections, endometriosis, surgery, or other pelvic conditions. Treatment for fallopian tube problems can depend on the situation, but often will involve surgery to clear the obstruction or repair damaged tissue.
Certain conditions affecting the uterus such as fibroids, scarring, or congenital abnormalities can interfere with implantation or increase the risk of miscarriage.
Many uterine conditions can be diagnosed and treated with surgery, helping to improve the chances of a successful pregnancy.
A range of medical conditions may affect fertility, including thyroid disease, autoimmune disorders, diabetes, and genetic conditions. Previous pelvic surgery, chemotherapy, radiation therapy, or certain medications may also affect reproductive function.
Managing infertility caused by these situations can be complex. Options may involve optimising treatment for these conditions, finding alternative medications where appropriate, or taking steps to preserve your fertility before undergoing serious medical treatments.
Lifestyle factors such as smoking, obesity, excessive alcohol or caffeine intake, and exposure to environmental toxins can influence fertility and reproductive health in women.
Optimising your health before conception may improve your chances of pregnancy and support a healthy pregnancy journey.
Sometimes fertility investigations do not identify a specific reason why pregnancy has not occurred. This is known as unexplained infertility.
While receiving no clear diagnosis can be frustrating, many women with unexplained infertility go on to conceive naturally or with the assistance of fertility treatment.
Tests for female fertility can help to identify barriers to conception where they exist, guiding informed treatment planning.
Dr Erin will begin by discussing your medical history, menstrual cycles, lifestyle, and fertility goals. This may include questions about:
This information helps build a comprehensive picture of your reproductive health and guides any further investigations.
Blood tests can assess hormone levels involved in ovulation and reproductive function, including ovarian reserve and ovulation. They can also be used to identify conditions such as PMOS and thyroid disorders.
A pelvic ultrasound is commonly used to assess the uterus and ovaries. It is often recommended as part of investigations into conditions such as PMOS, fibroids, ovarian cysts, and uterine abnormalities.
Depending on your individual history and symptoms, Dr Erin may recommend further investigations such as:
Not every woman will require these tests, but they can provide valuable information in more complex cases.
Your health before conception plays an important role in fertility, pregnancy outcomes, and the health of your future child.
Preconception care focuses on optimising your physical and reproductive health before pregnancy.
You can support your fertility by:
Because egg quality and reproductive health are influenced by overall wellbeing, positive lifestyle changes can help create the best possible environment for conception and pregnancy.
If you are considering delaying pregnancy, fertility preservation through egg freezing may also be worth discussing with your fertility specialist.
Does having regular periods mean I am fertile?
Regular menstrual cycles are often a sign that you are ovulating, which is an important part of fertility. However, regular periods do not guarantee fertility. Other factors, such as egg quality, fallopian tube function, endometriosis, or conditions affecting the uterus, can also impact your ability to conceive. Fertility testing can provide a more complete picture of your reproductive health.
How does age affect female fertility?
Female fertility naturally declines with age as both the number and quality of eggs decrease over time. While many women conceive naturally in their 30s and 40s, the chances of pregnancy gradually reduce with age, particularly after 35. The risk of miscarriage and chromosomal abnormalities also increases as women get older. If you are considering delaying pregnancy, speaking with a fertility specialist can help you understand your options and fertility potential.
Why am I having trouble conceiving again even after I’ve already had a child?
Difficulty conceiving after previously having a child is known as secondary infertility and is relatively common. Fertility can change over time due to factors such as age, hormonal changes, medical conditions, or changes in your partner’s sperm quality. If you have been trying to conceive again without success, a fertility assessment can help identify any underlying issues and guide the most appropriate next steps.