Medical Minute: Infertility Causes

As mothers, we understand the joy of having a child.  Imagine the pain of not being able to fulfill that dream.  Infertility affects about 12 percent of couples of childbearing age. This is not just a woman’s concern, men suffer the effects too and a problem with the male is often the sole cause, or a contributing cause, of infertility in about 50 percent of infertile couples. About one-third of infertile couples have more than one cause or factor related to their inability to conceive. About 20 percent of couples have no identifiable cause for their infertility after medical investigation.

What causes infertility?

Many different factors and problems can cause infertility, including problems in the female reproductive system, the male reproductive system, or a combination of the two. The following are some of the conditions or factors that are associated with infertility:

  • female factors
    • ovulation dysfunction
      With this condition, the woman’s reproductive system does not produce the proper amounts of hormones necessary to develop, mature, and release a healthy egg.
    • anatomical problems
      Abnormal development or function of the female anatomy can prevent the egg and the sperm from meeting. The most common anatomical problem is blockage of the fallopian tubes. Other anatomical problems may include the presence of pelvic scar tissue from previous surgeries or infections.
    • endometriosis
      Endometriosis is a condition in which the tissue that lines the uterus develops outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle by building up and breaking down, resulting in internal bleeding which can cause scar tissue to form and affect reproductive organ function.
    • birth defects
      Abnormal development and function of reproductive organs resulting from birth defects can affect fertility. One of the most common reproductive system birth defects occurs following a woman’s exposure to DES (diethylstilbestrol) taken by her mother during pregnancy. In years past, DES was given to women at risk for pregnancy loss. Fetal DES exposure often causes abnormal development of the uterus and cervix.
    • infection
      Pelvic inflammatory disease (PID) is caused by a type of bacteria such as gonorrhea and chlamydia. PID can affect the uterus, fallopian tubes, and/or the ovaries. It can lead to pelvic adhesions and scar tissue that develops between internal organs, causing ongoing pelvic pain and the possibility of an ectopic pregnancy (the fertilized egg becomes implanted outside the uterus).
    • immunological problems
      A problem with a woman’s immune system can lead to pregnancy loss. Antibodies (immune or protective proteins) in a woman’s system can fail to recognize a pregnancy, or there may be an abnormal immune response to the pregnancy. Women can also develop antisperm antibodies which attack and destroy sperm.
  • male factors
    • low or absent sperm production
      Without proper numbers of healthy sperm, the chance of fertilization is decreased.
    • abnormal sperm function
      Sperm must have proper motility and the ability to penetrate the egg.
    • varicocele
      This is a condition in which varicose veins develop around the testes. It is a very common cause of male factor infertility and is usually treatable and reversible with surgery.
    • lifestyle
      Use of recreational drugs (i.e., marijuana, cocaine), heavy alcohol use, cigarette smoking, certain medications, and excessive heat to the genital area (as in hot tubs) can affect sperm quality and function.
    • hormonal disorders
      Improper male hormone or endocrine function can affect sperm production and fertilization ability.
    • chromosomal defects
      Certain chromosomal abnormalities are associated with male infertility.
    • birth defects
      Abnormalities in a man’s reproductive system can occur during fetal development. Some birth defects are due to a man’s exposure to DES (diethylstilbestrol) taken by his mother during pregnancy.
    • immunological problems
      A man may have antisperm antibodies (immune or protective proteins) which attack and destroy sperm
Infertility can be brutal on a couple or a family as a whole, men and other siblings are not immune to the emotional roller coaster. It can become consuming and can cause depression and many experts advise trying to limit the amount of time you and your partner talk about your infertility. To prevent it from taking over, try to discuss it only during your cycle, let out all of your emotions, frustrations, fears and tears, then spend some quality time having fun together. Learning to manage your day to day can help minimize the emotional toll it can have on your family.
Stay tuned for our next series on diagnosis and treatment of infertility.

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