Infertility causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[3]
Overview
A wide range of physical and emotional factors can cause infertility. Infertility may be due to problems in the woman, man, or both.
Causes
Causes In Either Sex
Factors that can cause male as well as female infertility are:
- Genetic
- General factors
- Diabetes mellitus, thyroid disorders, adrenal disease
- Hypothalamic-pituitary factors:
Causes Specific to Female
- Female infertility may be caused by:
- Autoimmune disorders, such as antiphospholipid syndrome (APS)
- Cancer or tumor
- Clotting disorders
- Diabetes
- Drug Side Effect- Cyclophosphamide, Norgestimate and Ethinyl estradiol
- Growths (such as fibroids or polyps) in the uterus and cervix
- Birth defects that affect the reproductive tract
- Excessive exercising
- Eating disorders or poor nutrition
- Use of certain medications, including chemotherapy drugs
- Drinking too much alcohol
- Obesity
- Older age
- Ovarian cysts and polycystic ovary syndrome (PCOS)
- Pelvic infection or pelvic inflammatory disease (PID)
- Scarring from sexually transmitted infection or endometriosis
- Thyroid disease
- Too little or too much hormones
Causes Specific to Male
- Male infertility can be caused by:
- Environmental pollutants
- Being in high heat for prolonged periods
- Birth defects
- Heavy use of alcohol, marijuana or cocaine
- Too little or too much hormones
- Impotence
- Infection
- Older age
- Cancer treatments, including chemotherapy and radiation
- Scarring from sexually transmitted diseases, injury, or surgery
- Retrograde ejaculation
- Smoking
- Use of certain drugs, such as cimetidine, spironolactone, and nitrofurantoin
- Other drugs- Cyclophosphamide, Sulfasalazine, Valganciclovir
- In healthy couples under age 30 who have sex regularly, the chance of getting pregnant is about 25 - 30% per month.
- A woman's peak fertility occurs in her early 20s.
- After age 35 (and especially 40), the chances that a woman can get pregnant drops considerably.
Combined infertility
- In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these conditions.
- In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.
Unexplained infertility
- In about 15% of cases the infertility investigation will show no abnormalities. In these cases abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails.
- It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization.