Fertility in Women
Fertility means the natural ability to become pregnant and have a baby. At Santasa, we help women understand their fertility clearly and guide them with the right treatment at the right time.
Understand Female Fertility in 30 Seconds
20s and Early 30s
Fertility slowly starts reducing after the early 30s and decreases faster after 35 years.
Eggs, Tubes, Sperm, Uterus & Hormones
All 5 physiological components must align together for pregnancy to happen.
PCOS/PMOS, Endometriosis & Tubes
Many conditions can be treated or managed when diagnosed early.
6–12 Months Rule
Seek evaluation after 12 months trying if under 35, or after 6 months if 35+.
Understanding Your Fertility
Fertility means the natural ability to become pregnant and have a baby. For pregnancy to happen, several things need to work together:
What Is the Most Fertile Age for Women?
A woman’s fertility is usually highest in her 20s and early 30s. Fertility slowly starts reducing after the early 30s and decreases faster after 35 years, mainly because both the number and quality of eggs reduce with age.
Why Does Fertility Decrease With Age?
Women are born with a fixed number of eggs. As age increases, the number of eggs becomes lower, and egg quality also reduces. This can lead to:
Ovarian reserve tests such as AMH and ultrasound follicle count can help doctors understand the likely egg reserve.
Factors That Can Affect Fertility
Fertility can be affected by many factors, including:
Common Causes of Infertility in Women
Hormonal Imbalance and PMOS / PCOS
PMOS, formerly known as PCOS, is a common hormone-related condition. It can cause irregular periods, delayed ovulation, acne, weight gain, excess facial hair, and difficulty conceiving. In many women, pregnancy is possible with lifestyle changes, ovulation medicines, IUI, or IVF depending on the situation. PCOS is linked to ovulation problems and may also have long-term metabolic effects, so proper evaluation is important.
Endometriosis
Endometriosis is a condition where tissue similar to the inner lining of the uterus grows outside the uterus. It may cause:
Endometriosis can affect fertility by causing inflammation, scar tissue, ovarian cysts, and problems with egg pickup by the fallopian tube.
Adenomyosis
Adenomyosis happens when the inner lining of the uterus grows into the muscle wall of the uterus. It may cause:
Treatment depends on age, symptoms, fertility goals, and whether IVF is being planned.
Decreased Ovarian Reserve
Decreased ovarian reserve means the number of eggs in the ovaries is lower than expected for age. It may happen because of:
Women with low ovarian reserve may need timely fertility planning, IVF, or fertility preservation depending on their situation.
Tubal Disease
The fallopian tubes help the egg and sperm meet. If the tubes are blocked or damaged, natural pregnancy may become difficult. Tubal damage may happen due to:
Depending on the condition of the tubes, treatment may include surgery or IVF.
What Is Hydrosalpinx?
Hydrosalpinx means a fallopian tube is blocked and filled with fluid. This fluid can sometimes flow back into the uterus and reduce the chances of pregnancy. It can also lower IVF success rates. In selected cases, removing or clipping the affected tube before IVF can improve pregnancy and live birth chances. ASRM notes that salpingectomy for hydrosalpinx can restore IVF pregnancy and live birth rates closer to those seen in women without hydrosalpinx.
Why Can Removing Hydrosalpinx Improve Fertility?
Your doctor will advise this only after checking your reports and fertility plan.
Endometrial Polyps
Endometrial polyps are small growths inside the uterus. They may cause:
Removing polyps through hysteroscopy can improve the uterine environment before natural conception, IUI, or IVF.
Fibroids
Fibroids are non-cancerous growths in the uterus. Not all fibroids affect fertility. Fibroids may reduce fertility when they:
Treatment depends on the size, location, symptoms, and pregnancy plan.
Defects in the Formation of the Uterus
Some women are born with differences in the shape of the uterus, such as a uterine septum. These may be linked with:
Many uterine cavity problems can be diagnosed with ultrasound, hysteroscopy, or hystero-laparoscopy and treated when needed.
High Prolactin
Prolactin is a hormone that helps with breast milk production. When prolactin is high outside pregnancy or breastfeeding, it can disturb ovulation and periods. Symptoms may include:
High prolactin is often treatable with medicines after proper evaluation.
Genetic Conditions Like Turner Syndrome
Some genetic conditions can affect ovarian function. Turner syndrome is one such condition where the ovaries may stop working early, leading to reduced fertility or infertility in many women. Early diagnosis can help with timely counselling, fertility preservation options, and safe pregnancy planning.
What Can You Do to Improve Fertility?
1. Track Your Periods and Ovulation
If your periods are irregular, very painful, very heavy, or absent, meet a fertility specialist early.
2. Maintain a Healthy Weight
Both excess weight and very low weight can affect ovulation and hormone balance.
3. Eat Well and Stay Active
A balanced diet, regular exercise, good sleep, and stress management support reproductive health.
4. Avoid Smoking and Limit Alcohol
Smoking can affect egg quality and ovarian reserve.
5. Treat Medical Conditions Early
Thyroid imbalance, high prolactin, diabetes, PCOS/PMOS, endometriosis, and infections should be evaluated and managed.
6. Do Not Delay Fertility Evaluation
Seek help if: 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; You have irregular periods, endometriosis, low AMH, previous surgery, blocked tubes, or repeated miscarriages.
7. Consider Fertility Preservation
Women who wish to delay pregnancy may consider egg freezing, especially if they are approaching their mid-30s or have conditions that may reduce ovarian reserve.
When Should You See a Fertility Specialist?
You should consider a fertility consultation if you have:
Santasa Fertility Care for Women
At Santasa, we believe fertility care should be clear, compassionate, and personalized. Our specialists help identify the reason for delayed conception and guide you with the most suitable options—from lifestyle correction and ovulation treatment to IUI, IVF, fertility surgery, and fertility preservation.
Frequently Asked Questions (FAQs) (29 Answers)
Specialist Medical Guidance
"Your fertility journey is personal. At Santasa, we walk with you at every step, combining rigorous reproductive science with compassionate care and hope."