Good sexual and reproductive health is a state of complete physical, mental and social wellbeing in all matters relating to the reproductive system (UNFPA). This section addresses the reproductive health concerns of women to make them more aware of reproductive matters and to empower them to make informed decisions.



  • The couple has not conceived after 12 months of contraceptive-free intercourse if the female is under the age of 34.
  • The couple has not conceived after 6 months of contraceptive-free intercourse if the female is over the age of 35.
  • The female is incapable of carrying a pregnancy to term.

Women reach the peak of fertility in their early twenties. Couples in their twenties who are in good physical health and engage in regular sexual activity have about a 25% to 30% chance per month of conceiving.

Women in their thirties, particularly those over the age of thirty-five, have less than a 10% chance per month of becoming pregnant.


Infertility may be due to problems in the female, the male or a combination of both. In some cases, the cause is not known.


Common Female Factors
Following female factors may cause or contribute to infertility:

  • Damage to the Fallopian tubes following infection or surgery.
  • Uterine fibroids: These are benign tumors which grow from the muscle layers of the uterus.
  • Endometriosis: This condition is characterized by presence of tissue similar to the lining of the uterus elsewhere outside the uterus causing pain especially during periods and intercourse.
  • Hostile cervical mucus. This is a condition in which the cervical mucus creates a thick barrier that sperm cannot penetrate.
  • The production of sperm antibodies i.e. when a woman develops antibodies to her partner’s sperm.
  • Sexually Transmitted Diseases such as Chlamydia, Gonorrhea etc. are one of the most preventable causes of infertility.
  • If left untreated, STDs can cause up to 40% of women to develop pelvic inflammatory disease (PID). PID causes infertility by producing scarring of the fallopian tubes.
  • Tuberculosis can affect various body systems including the reproductive system in females as well as male infertility.
  • Hormonal Imbalances:


    • Altered levels of thyroid hormone (a chemical released into the blood circulation from a tiny organ in front of the neck called thethyroid gland).
    • Increased levels of prolactin hormone due to a brain tumor called prolactinoma. This condition is usually associated with galactorrhea (milk leaking from the breasts).
    • Increased levels of insulin.
    • Diabetes mellitus and Adrenal gland dysfunction.
  • State of being over or underweight.
  • Polycystic Ovarian Syndrome (PCOS), a condition characterized by development of multiple cysts in the ovaries due to failure of maturation and expulsion of eggs from them.
  • Inconsistent ovulation due to obesity, thyroid dysfunction, peri-pubertal (13 to 16 years) or peri-menopausal stage (40-45 years).
  • Psychological issues, such as anxiety resulting from a lack of emotional support, can lead to hormonal problems that affect a woman’s fertility



Pregnancy (conception/fertilization) most commonly occurs when a spermfertilises an egg by joining with it during sexual intercourse without contraception, (or assisted reproduction).

The fertilised egg moves down into the uterus and implants itself into the uterus lining where it begins to grow and develop into anembryo. The embryo grows into a foetus.

Conception only takes place at a particular time of the month in the female during her menstrual cycle.