What causes infertility?

The most common reasons to have trouble conceiving are 1) ovulation problems (failure to release an egg each month) 2) ovarian reserve or egg quality issues (including age-related infertility) 3) sperm factors (aka male factor); and female anatomic factors such as: 4) endometriosis, 5) problems of the uterus (polyps, fibroids or scar tissue) or 6) problems of the fallopian tubes (blockage). There can also be combinations of the above. In our patient population, the single most common diagnosis is diminished ovarian reserve (DOR) caused by advanced reproductive age.