What are the Common Causes of Infertility?

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Many people grow up looking forward to the day they can have children. However, many people find that they’re unable to have children no matter how hard they try. If you are having difficulty getting pregnant, the good news is that treatment is often available, meaning you can still have the family of your dreams. However, before you can treat infertility, you first need to know what is causing it, and there are several potential causes.

There are numerous potential causes of infertility, and each can be treated in different ways, if at all. Below are some of the most common causes of all.

Ejaculation Disorders (Men)

Some men have ejaculation disorders that can make it impossible for them to impregnate their partners. For example, some men may not be able to ejaculate at all, while others can suffer from premature ejaculation, making it hard to have sex. Such disorders are usually down to physiological or psychological conditions or a combination of both. They can be treated in some cases with drugs or therapy.

A similar condition is erectile dysfunction syndrome (EDS), which means a man is unable to get erect, making sex difficult. However, medication is available that will help treat EDS in most cases.

Endometriosis

The endometrium is a thin layer of material that lines the uterus. In some people, this lining can begin growing in places like the ovaries, where it can cause damage. This can result in infertility if the damage is bad enough.

Unfortunately, there is no known cure for endometriosis. However, treatments are available that will help reduce the severity of the symptoms and perhaps even improve the patient’s fertility.

Fibroids

Fibroids, also known as leiomyomas or myomas, are growths found in and around the uterus. They are non-cancerous but can grow to the extent they cause problems. Such problems include:

  • Pain
  • Heavy or painful periods
  • Constipation
  • Frequent urination
  • Pain during sex

In many cases, fibroids are harmless, and treatment is not necessary. However, fibroids can be treated with the help of medication that causes them to shrink. The patient can also be given medication to help relieve them of symptoms caused by the condition.

Hypogonadism (Men)

Testosterone is produced in the testicles and is involved in the sperm-making process. Hypogonadism is a condition where the testes don’t make enough testosterone. This, in turn, means the patient will have a low sperm count and a low sex drive.

Hypogonadism is often caused by medicines and drugs, tumours, and a range of other factors. The condition can usually be treated with hormone replacement therapy (HRT), which helps to make up for the missing testosterone.

Medicine and Drugs

Some medications and drugs are also known to contribute to infertility, particularly anabolic steroids, sulfasalazine, and chemotherapy. Infertility can also be caused by some herbal remedies, while some recreational drugs can also be responsible.

The patient will often regain their fertility once they stop using the drug that was causing a problem. If you suspect a medication is causing fertility issues, it’s best to speak with your doctor to see which alternatives are available.

Pelvic Inflammatory Disease

Female genitalia and urinary tract are prone to infections, and the infections can cause considerable problems, including infertility. The fallopian tubes, ovaries, and womb can all become infected, potentially causing irreparable damage. In some cases, pelvic inflammatory disease will cause severe scarring to the fallopian tubes, preventing the egg from travelling through.

Symptoms include:

  • Pain when urinating
  • Discoloured and malodorous vaginal discharge vaginal discharge
  • Heavy or painful periods
  • Bleeding after sex and in between periods
  • Fever
  • Nausea

Treatment for pelvic inflammatory disease typically involves using antibiotics to help kill the infection. Most people with the condition will regain full fertility, but fertility loss is permanent in some cases.

Surgical Scarring

Surgery will sometimes leave scars on the fallopian tubes, potentially restricting the ovum’s passage through. Infertility from surgical scarring is often permanent, depending on the severity of the damage.

Unexplained

The factors behind whether or not somebody falls pregnant can be complex, making it difficult to pinpoint the exact cause of infertility. In some cases, everything will appear to be fine on tests, leaving doctors scratching their heads as to how to fix the issue. Unexplained infertility is also relatively common, with around 1 in 4 infertility cases in the UK, and we see a similar pattern throughout the rest of the world.

Without knowing the cause of unexplained cases, we can’t know how to cure them. However, IVF treatments will help in some cases.

Cervical Mucus Problems

The cervix is lined with a thin mucus layer that helps sperm swim through the cervix until it finds the egg. When women are not ovulating, this mucus is thick and prevents sperm from swimming through. Hormonal changes during ovulation should cause the mucus to become thinner, allowing the sperm through.

However, the mucus doesn’t always become thinner, meaning the sperm can’t find their way through. Other potential problems include acidic mucus, inflammatory cells that can kill sperm, and antibodies that can attack and kill sperm.

There are numerous potential causes of cervical mucus problems, which means there are also numerous potential treatments. In some cases, the patient is asked to try making lifestyle and diet changes, and even consider changing to a sperm-friendly lubricant, while some medication is also available that can help regulate the mucus.

Summary

There are other potential causes of infertility, but those above are some of the more common. Some will be relatively easy to treat, while some might require extensive treatments or be untreatable. The good news is that being unable to treat the cause of infertility does not necessarily mean pregnancy is not possible, thanks to advanced infertility treatment options such as IVF.

Regardless, it is always best to speak with a qualified doctor should you suspect something is wrong. In many cases, it might simply be a case of changing your diet. However, at other times, the condition can be more serious and potentially a threat to more than just your fertility, making regular check-ups a good idea.

Picture of Dr. Tanut Jerachotechueantaveechai

Dr. Tanut Jerachotechueantaveechai

Medical Director, Bangkok Central Clinic IVF & Wellness Dr. Tanut Jerachotechueantaveechai is a specialist in Obstetrics, Gynecology, and Reproductive Medicine, having graduated with first-class honors from Siriraj Hospital in 2010. Dr. Tanut has experience working at Maharaj Nakorn Chiang Mai, Lanna, Chiang Mai Ram, and Phyathai Sriracha hospitals. He previously served as a Medical Director at First Fertility PGS Center Bangkok, and was a special reproductive technology lecturer at Mahidol University. He provides a tailor-made treatment approach, working closely with couples to support their family-planning goals, and achieved an average success rate of 72.5% in 2019. He continuously updates his medical knowledge through international workshops and congresses across Asia-Pacific, Europe, and Australia.