Causes of infertility | GAMETA - Infertility Treatment Clinic

Causes of infertility

Infertility is becoming an increasingly common problem – in Poland it already affects almost one in five couples trying to have a child. The reasons for infertility lie equally with both women and men. In fact, fertility issues between men and women account for approximately 40% each of couples whose attempts to have a child are unsuccessful. The remaining cases are referred to as idiopathic infertility, i.e. infertility of unknown origin, the cause of which cannot be traced.

Female infertility – the causes

One in three cases of infertility in women is due to hormonal disorders. Abnormal sex hormone management disrupts the functioning of the reproductive system, which can manifest itself through:

impaired or absent ovulation,
premature menopause,
inability of the egg to rupture, which prevents fertilisation by the sperm,
growth of an empty follicle,
the abnormal release of an egg from a follicle.

Hormonal changes can be caused by disorders of the glands responsible for the production of hormones and for carrying out normal hormone management in the body. These include:

adrenal glands, whose overactivity leads to polycystic ovary syndrome,
the pituitary gland, which produces lutropin responsible for the normal ovulation cycle,
the thyroid gland, whose under-activity increases the risk of miscarriage and over-activity disrupts ovulatory cycles.

However, hormonal disorders are not the only causes of female infertility. Problems with falling pregnant can be caused by a number of lesions, inflammatory conditions or the effects of invasive procedures performed in the abdominal area. What else can cause infertility?

Endometriosis – which is a disorder that causes the cells of the endometrium not to leave the body, but to enter it, causing nodules, cysts, bleeding, inflammation and adhesions that lead to infertility.
Uterine myomas – affect women of all ages. They can cause painful periods with heavy bleeding. Some myomas can enter the vagina causing severe uterine contractions. These conditions lead to infertility and miscarriages.
Fallopian tube abnormalities – obstructed Fallopian tubes prevent the transport of egg cells to the uterus, as well as the fertilisation of the egg by the sperm. Obstruction may be caused by postoperative adhesions, polyps, myomas or inflammation.
Uterine abnormalities – e.g. bicornuate, septate, bowed. These abnormalities can interfere with pregnancy and, if fertilisation occurs, cause miscarriage.
Hostility of cervical mucus – this is when the mucus fights and neutralises the sperm.

Age plays a very important role, as a woman’s fertility decreases year by year, with a significant decline occurring after the age of 35. This is mainly associated with a decrease in the number and quality of ova and an increase in the risk of miscarriage.

Male infertility – the causes

Semen testing is crucial in assessing male fertility. In the case of male infertility, the most common causes of problems are sperm abnormalities, such as a low sperm count, abnormal sperm motility, and sperm morphology. Semen testing alone does not directly determine the cause of infertility, but poor results do confirm the presence of a fertility problem. Male fertility problems are much easier to diagnose and treat than female infertility. A change in lifestyle is often all that is needed to increase the number of progressive sperm cells – a change in diet, quitting smoking, limiting alcohol, reducing weight, being more physically active, reducing stress, and wearing looser underwear.

More serious problems sometimes require invasive procedures. What can cause male infertility?

Injuries or congenital defects of the testicles – mechanical trauma to the testicles or changes due to disease (e.g. epididymitis or prostate lesions) can cause abnormal testicular function, which manifests through insufficient production of progressive sperm. Infertility can also be caused by an abnormal position of the testicles, such as outside the scrotal sac.
Varicocele – dilated blood vessels cause excessive warming of the testicles, so this condition contributes to the constant deterioration of sperm quality.
Infections – bacterial or fungal infections also have a negative effect on the number and quality of sperm produced by the testicles.
Autoimmune disorders – the immune system may then treat sperm as foreign bodies and produce antibodies to fight them off.
Improper hormonal balance – as with women, male infertility can be caused by a malfunction of the organs or glands that produce sex hormones.
Surgeries of the inguinal hernia or of the perineal and abdominal area – as a result of such a procedure, it may happen that, due to an obstruction of the genital tract, ejaculation becomes impossible or the man has to deal with a so-called reflux ejaculation, as a result of which the semen does not escape to the outside, but returns to the inside of the body.

Idiopathic infertility

Idiopathic infertility is referred to when doctors have found none of the known causes of infertility in both partners trying for a child. The causes of idiopathic infertility are still unknown. There are hypotheses that it can be caused by: