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Dr. George Ioannidis
CONSULTANT OBSTETRICIAN & GYNAECOLOGIST
FERTILITY AND IVF SPECIALIST

Director GONIMOTIS Reproductive Centre
v. Scientific Director Institute of LIFE MHTERA Hospital IVF Unit

Dr. Alexandra Georgakopoulou
CONSULTANT OBSTETRICIAN & GYNAECOLOGIST
FETAL MEDICINE SPECIALIST

Scientific Director GONIMOTIS Ultrasound Centre
Scientific Collaborator MHTERA Hospital Fetal Medicine Unit.

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Home  /  Fertility  /  Causes of infertility

Fertility

Causes of infertility

According to official data from Great Britain and the US,

in 30% of infertile couples, the cause of infertility is due to a factor related to sperm,

in another 30% of infertile couples, the cause of infertility lies within the female reproductive system, such as tubal disease or endometriosis,

while another 30% of all infertile couples will present a combination of female and male infertility factors.

In the remaining 10% of infertile couples no infertility factor is detected and this is referred to as unexplained infertility.

 

Cumulative couple fertility

If the woman has a minor infertility problem and her partner has a minor problem, these two problems per se may not be a serious cause of infertility. This means that both the woman and the man are fertile, but their combination results in the inability to achieve pregnancy (cumulative effect). We are talking about the cumulative fertility of the couple.

 

The woman’s age is the most important factor

The age of the woman is the most important factor that affects the likelihood of a couple to conceive. So it is recommended that you seek help after 6 months of attempts if you are over 35 years of age and after 12 months of trying to conceive if you are under 35 years of age. We also encourage all couples when the woman is over 40 to seek specialist advice from the gynecologist as soon as possible.

 

Other causes of female infertility

  • injury or obstruction of the fallopian tubes: usually resulting from inflammation of the fallopian tube (salpingitis) due to chlamydia,
  • endometriosis: a fairly common condition especially in women over 30 who have not had children yet , in which cells from the endometrium (the inside of the uterus) grow elsewhere in the body, usually around the uterus, the ovaries, the fallopian tubes,
  • polycystic ovary syndrome (PCOS): one in 10 women of childbearing potential suffers from PBO. The symptoms of the syndrome include irregular period or even amenorrhea, increased hair growth, acne, obesity and difficulty in conceiving,
  • uterine fibroids: these are benign tumors in the uterine wall and are quite common in women 30-40 years of age. They can affect fertility if they are located within the uterine cavity, preventing proper implantation of the fertilized egg,
  • pelvic adhesions: scar tissue formed after pelvic inflammation, appendicitis, or abdominal or pelvic surgery. This scar tissue formation can impede fertility,
  • disorders of ovulation: which can prevent the ovaries from producing and releasing eggs,
  • increased prolactin (hyperprolactinemia): prolactin is the hormone that stimulates the production of breast milk. High levels in women who are not pregnant or breast-feeding may inhibit ovulation,
  • premature menopause: this is a premature exhaustion of the follicles before the age of 40. Although the cause is often unknown, certain conditions associated with premature menopause include diseases of the immune system, radiation or chemotherapy and smoking.
  • thyroid disease: high (hyperthyroidism) or low (hypothyroidism) production of thyroid hormones can disrupt the cycle, inhibit ovulation and cause infertility,
  • medicines: transient infertility can occur with the use of certain drugs, which is restored when the drug is discontinued,
  • cancer treatment: certain forms of cancer, particularly of the female reproductive system, seriously impair female fertility. The same applies to both radiation and chemotherapy,
  • other medical conditions: medical conditions associated with delayed puberty or amenorrhoea, such as Cushing’s disease, sickle cell anemia, renal disease and diabetes mellitus may affect female fertility.

 

Causes of male infertility

  • abnormal production or function of the semen: is due to various problems such as cryptorchidism, genetic diseases, inflammation (e.g. chlamydia) or childhood mumps history,
  • problems with sperm delivery: is due to conditions such as retrograde ejaculation, to sexual problems such as premature ejaculation or painful sexual intercourse and to genetic diseases such as cystic fibrosis,
  • testicular injuries or testicular twisting: for example in sporting activities,
  • excessive exposure to environmental factors: pesticides and other chemicals, frequent exposure to heat, such as a sauna or hot tub, can affect sperm production and reduce the amount of sperm,
  • lifestyle issues: poor diet, obesity, and the use of alcohol and tobacco may affect sperm production,
  • cancer therapies: both radiation and chemotherapy affect sperm production, sometimes severely.