Causes of Infertility



The causes of infertility can be traced back to either the male or the female or may remain unknown. The main causes of infertility in women are:

  • Problems with Ovulation: If there is a disorder with the ovaries and an egg is not released on a monthly basis, or not at all, conception cannot take place. Ovarian problems can be a result of premature ovarian failure, PCOS (Polycycstic Ovarian Syndrome), poor egg quality, Hyperprolactinemia, thyroid disorders, and diseases such as AIDS or cancer.
  • Disorders of the Uterus or Fallopian Tubes: Once the egg is released it has to travel from the uterus to the womb through the fallopian tubes. If there is something wrong at any point of this journey, natural conception may not be possible. The uterus or fallopian tubes can get affected or scarred due to previous surgery, fibroids, endometriosis, and previous tubal ligation. Fallopian tube blockage can also be caused by sexually transmitted diseases such as Chlamydia.
  • Certain medications such as NSAIDs, chemotherapy drugs, radiotherapy, and illegal drugs such as cocaine or marijuana can increase the risk of infertility in women.
  • Early menopause can affect some women before the age of 40. This marks the absence of menstruation making conception impossible.
  • Scar tissues of pelvic adhesions that bind the organs in the pelvic region can also affect fertility. This may be caused as a result of abdominal or pelvic surgery, appendicitis or a pelvic infection.
  • Certain types of cancers especially those that affect the female reproductive system often cause severe cases of infertility. Cancer treatments such as radiation therapy and chemotherapy can also affect a person’s ability to conceive.
  • Other medical conditions and diseases such as Cushing's disease, kidney failure, diabetes, amenorrhea or sickle cell disease can also cause infertility in women.

Causes of Infertility in Men Include:

  • Abnormal or low sperm production caused by genetic defects or infections are the main cause of male infertility. Problems such as low sperm count, no sperm, poor sperm motility, and abnormal shape of the sperm cause infertility. Testicular infections, surgery or testicular cancer can cause problems with the semen. Undescended testicles (either one or both) affect sperm production as well.
  • Varicocele is a varicose vein in the scrotum that can cause the sperm to overheat and impair fertility.
  • Problems with ejaculation where the delivery of the sperm is affected can affect fertility. Retrograde ejaculation, premature ejaculation, blockages of the testicle and painful intercourse can prevent the sperm from reaching the egg to achieve conception.
  • Environmental factors such as exposure to pesticides and toxins can also increase the risk of infertility. Similarly, exposure to high temperatures caused by the regular use of saunas and hot tubs can damage sperm production as well.
  • Radiation and chemotherapy for cancer treatments can severely reduce sperm production and increase the risk of male infertility.
  • Genetic defects – In some men, genetic defects could cause an abnormality in the testicles or sperm production as well as low testosterone levels.
  • Diseases such as mumps, hypogonadism, cystic fibrosis, diabetes, anemia, thyroid problems, and Cushing's syndrome can affect male fertility.
  • Certain medications and drugs can lower the sperm count and reduce sperm motility.

Risk factors of infertility refer to those conditions or circumstances that increase the likelihood of infertility, but they are not necessarily causes:

  • Age: Fertility levels start to decline as a natural part of the aging process.
  • Smoking and Alcohol: Regular smoking and drinking can significantly increase your chances of infertility.
  • Obesity
  • Eating disorders such as anorexia and bulimia
  • Following strict diets such as veganism that may not provide the necessary nutrients and vitamins essential for conception and a healthy pregnancy.
  • Too much exercise
  • Contracting a sexually transmitted disease
  • Exposure to chemicals and toxins
  • Stress

References
  1. W Weidner, G.M Colpi, T.B Hargreave, G.K Papp, J.M Pomerol, The EAU Working Group on Male Infertility, EAU Guidelines on Male Infertility, European Urology, Volume 42, Issue 4, October 2002, Pages 313-322, ISSN 0302-2838, 10.1016/S0302-283
  2. Petra De Sutter, Rational diagnosis and treatment in infertility, Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 20, Issue 5, October 2006, Pages 647-664, ISSN 1521-6934, 10.1016/j.bpobgyn.2006.04.005.
  3. Vicki Denson, Diagnosis and Management of Infertility, The Journal for Nurse Practitioners, Volume 2, Issue 6, June 2006, Pages 380-386, ISSN 1555-4155, 10.1016/j.nurpra.2006.03.019.