Main cause of infertility in African women  is the result of genital infection, which may have been sexually transmitted, or caused by traditional practices, such as female genital mutilation or unsafe abortions and home deliveries in unhygienic circumstances. These infections, if left untreated often result in bilateral tubal occlusion.

Other causes of infertility include ovulatory dysfunction (approximately 20%), for example in poly cystoid ovary syndrome (PCOS), diabetes and or in severe obesity.

In a significant number of cases no cause for infertility can be diagnosed.