According to the American Society for Reproductive Medicine (ASRM), age, smoking, sexually transmitted infections, and being overweight or underweight can all affect fertility.

The chances of a couple to successfully conceive at an advanced age depend on many factors, including the general health of a woman and the fertility of the male partner.

Nicotine and other harmful chemicals in cigarettes interfere with the body's ability to create estrogen, a hormone that regulates folliculogenesis and ovulation.

They often display few, if any visible symptoms, with the risk of failing to seek proper treatment in time to prevent decreased fertility.

[15] A study in the US indicated that approximately 20% of infertile women had a past or current eating disorder, which is five times higher than the general lifetime prevalence rate.

[16] A review from 2010 concluded that overweight and obese subfertile women have a reduced probability of successful fertility treatment and their pregnancies are associated with more complications and higher costs.

Chemotherapies with high risk of infertility include procarbazine and other alkylating drugs such as cyclophosphamide, ifosfamide, busulfan, melphalan, chlorambucil and chlormethine.

[19] On the other hand, therapies with low risk of gonadotoxicity include plant derivatives such as vincristine and vinblastine, antibiotics such as bleomycin and dactinomycin and antimetabolites such as methotrexate, mercaptopurine and 5-fluorouracil.

[19] Female infertility by chemotherapy appears to be secondary to premature ovarian failure by loss of primordial follicles.

[20] This loss is not necessarily a direct effect of the chemotherapeutic agents, but could be due to an increased rate of growth initiation to replace damaged developing follicles.

[21] Women may choose between several methods of fertility preservation prior to chemotherapy, including cryopreservation of ovarian tissue, oocytes or embryos.

Factors contributing to the formation of antisperm antibodies in women are disturbance of normal immunoregulatory mechanisms, infection, violation of the integrity of the mucous membranes, rape and unprotected oral or anal sex.

Also, there are additional conditions involving female infertility which are believed to be genetic but where no single gene has been found to be responsible, notably Mayer-Rokitansky-Küstner-Hauser Syndrome (MRKH).

[35] Finally, an unknown number of genetic mutations cause a state of subfertility, which in addition to other factors such as environmental ones may manifest as frank infertility.

Autosomal 46,XY, male-to-female sex reversal (phenotypically perfect females) 402C → G mutations associated with human granulosa cell tumours •2 of these 3 criteria: 1) Anovulation/oligovulation 2) Hyperandrogenism 3) PCO Ultrasound •Must be excluded: o Congenital Suprarenal hyperplasia o Androgen producer tumors o Hyperprolactinemia Some of PCOS's consequences are: •Higher incidence of spontaneous miscarriage.

•Higher risk of developing diabetes mellitus type 2 - Ultrasound: antral follicle count (AFC) >6AF - Hormones: FSH, E2, AMH •Permeability Hysterosalpingography (HSG) Ultrasoud + Hysterosonosalpingography (HSSG) Chlamydia serology Laparoscopy: methylene blue •Tubal examination (endoscopy): laparoscopy, faloscopy, fertiloscopy Previously, a bicornuate uterus was thought to be associated with infertility,[49] but recent studies have not confirmed such an association.

[53] Human genetic variants that likely cause dysregulation of critical meiotic processes have been identified in 14 female infertility associated genes.

The practice is primarily focused on helping their women to conceive and to correct any issues related to recurring pregnancy loss.

NICE guidelines state that: "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner.

[67][68] In the Makua tradition, pregnancy and birth are considered major life events for a woman, with the ceremonies of nthaa'ra and ntha'ara no mwana, which can only be attended by women who have been pregnant and have had a baby.

[63][65][66] This can be prevalent in some societies, including Cameroon,[63][66] Nigeria,[63] Mozambique,[67] Egypt,[65] Botswana,[70] and Bangladesh,[66] among many more where polygamy is more common and more socially acceptable.

[78] In some cultures, including Botswana [70] and Nigeria,[63] women can select a woman with whom she allows her husband to sleep with in hopes of conceiving a child.

The increase of sexual partners can potentially result with the spread of disease including HIV/AIDS, and can actually contribute to future generations of infertility.

The devaluation of a wife due to her inability to conceive can lead to domestic abuse and emotional trauma such as victim blaming.

[71] Many infertile women tend to cope with immense stress and social stigma behind their condition, which can lead to considerable mental distress.

[72] The long-term stress involved in attempting to conceive a child and the social pressures behind giving birth can lead to emotional distress that may manifest as mental disease.

[74] There can be considerable social shaming that can lead to intense feelings of sadness and frustration that potentially contribute to depression and suicide.

The range of psychological issues pertaining to infertility in women is vast and can include inferiority complex, stress with interpersonal relationships, and possibly major depression and or anxiety.

The psychological support is fundamental to limit the possibility to drop-out from infertility treatment and reduce the distress level which is strongly associated with lower pregnancy rates.

In addition some medications (in particular clomifene citrate) used in the treatment have several side effects which may be an important risk factor for the development of depression.