Causes of Infertility

The most obvious and common indication of infertility is an inability to conceive. In women an abnormal menstrual cycle, one that is too long (35 days+) or too short (less than 21 days), can also indicate this.

Female infertility

There are many causes of female infertility. Ovulation disorders result in flaws in the regulation of reproductive hormones by the hypothalamus or the pituitary gland. If you are not ovulating or infrequently ovulating it is likely you have an ovulation disorder.

Damage to the Fallopian tubes (tubal infertility) includes when the tube becomes blocked or damaged, preventing the sperm from reaching the egg, or closing the passage to the uterus for the fertilised egg. It is caused by inflammation of the Fallopian tubes due to chlamydia or gonorrhoea, a previous ectopic pregnancy or previous abdominal or pelvic surgery.

Endometriosis is when tissue that usually grows in the uterus implants and grows in other places. This, along with surgical removal of the tissue, can cause scarring, impairing fertility.

Cervical Stenosis is cervical narrowing or blocking, caused by inherited malformation or damage to the cervix. The cervix can’t produce the best type of mucus for fertilisation, or a closed cervix prevents the sperm from getting to the egg.

Uterine causes include polyps or tumours in the uterus which impair fertility by blocking the Fallopian tubes or disrupting implantation. Unexplained infertility is when a cause cannot be found. It could be a combination of minor factors on both sides.

Male infertility

Infertility can also appear in males and can be due to low sperm count, mis-shapen or immobile sperm, or blockages which prevent sperm delivery. Symptoms may be caused by an underlying inherited disorder, hormonal imbalance or condition that blocks the passage of sperm.

Apart from an inability to conceive, symptoms or indications of infertility include problems with sexual function, pain, swelling or lump in the testicle area, decreased facial or body hair or having a lower than normal sperm count. There are a number of causes of male infertility, including Varicocele, which is swelling of the veins that drain the testicles. Infection in the form of Sexually Transmitted Infections, inflammation of the prostate and inflamed testicles due to mumps are also causes. This can interfere with sperm health or production. Ejaculation issues such as retrograde ejaculation, which is when semen enters the bladder during orgasm, can also result in infertility. There are also antibodies that attack sperm. These are immune system cells that try to eliminate sperm which are identified as ‘harmful.’ Tumours can also affect reproductive organs or the glands that release reproductive hormones e.g. the pituitary gland.

Sperm duct defects is where damage has occurred to the sperm ducts as a result of illness or injury. Other causes of male infertility include undescended testicles, hormone imbalances, chromosome defects, sexual intercourse problems, celiac disease and certain medications. A number of environmental, health and lifestyle factors can also affect fertility.

If you or your partner suspect you may be infertile the first step is to talk to your GP. Your GP will investigate this through the use of minimally invasive procedures. From there further investigations might be recommended.

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