print this page

Infertility Causes

ALTInfertility causes are commonly classified by the organ system affected. For example, infertility caused by tubal factor results when there are conditions that interfere with the eggs’ successful transport through the fallopian tubes from the ovaries to the uterus.  Other infertility causes include uterine factor, cervical factor, ovarian factor, ovulatory disorders, endometriosis, unexplained infertility, and male infertility.

The infertility causes listed below are linked to pages with complete descriptions and treatment options.

 

Cervical Factor Polycystic Ovarian Syndrome (PCOS)
Endometriosis Poor Endometrial Development
Male Factor Infertility Tubal Disease
Ovarian Factor Unexplained Infertility
Ovulatory Factor Uterine Disease

 

 Cervical Factor

Cervical factor infertility can occur following surgical procedures performed on the cervix for dysplasia.  Following these procedures (conization, LEEP), a portion of the cervix that produces mucous is removed with the abnormal cells, and scarring of the cervix may result.  In addition, infections involving the cervix may change cervical mucus, so they should be treated.   Infertility causes related to cervical factor are often treated using intrauterine insemination (IUI) because it bypasses the cervical mucus.

Read more about Cervical Factor

 

 Endometriosis

Endometriosis is a common cause of infertility. Endometrial cells, which rapidly divide and grow, may move from the uterus thru the Fallopian tubes and exit, attaching to organs such as the uterus or ovaries, creating damage. Endometrial implants have been found throughout the body. Endometriosis is much more common in patients with infertility, and can impair fertility even when there is mild disease. All of the mechanisms by which endometriosis affects fertility are still unknown.

Read more about  Endometriosis

 

 Male Factor Infertility - Male infertility is much more common than once believed being present in up to half of all infertile couples.  The semen analysis is a mandatory fertility test which must be done prior to female treatment. Causes of male infertility include environmental, immune, a varicocele, and others.  Effective treatments include IVF with ICSI or in some cases, the use of a sperm donor.

Read more about Male Factor Infertility

 

 Ovarian Factor - Ovarian factor relates to the viability of the eggs within the ovaries.  Low ovarian reserve, usually evidenced by abnormally high FSH levels, means that the eggs are declining in quantity and perhaps also in quality, and will not fertilize and develop as readily as normal eggs. When ovarian failure occurs, the eggs have almost completely disappeared. The best reproductive option for women with ovarian failure is to use donor eggs.

Read more about all ovulation irregularities

 

 Ovulatory Factor - Each month, ovulation of an egg(s) occurs after recruitment and development of healthy follicles (each containing an egg) on the ovaries. The ovulatory cycle is controlled by the hypothalamus, a structure in the brain that produces a hormone called GnRH (gonadotropin-hormone releasing hormone).  The hypothalamus instructs the pituitary gland in the brain to increase or decrease production of FSH and LH. Estrogen produced by the ovary feeds back to affect FSH levels, which ultimately results in ovulation.   Conditions affecting the levels of reproductive hormones can lead to anovulation (no ovulation) or oligoovulation (irregular ovulation). Two of these conditions are PCOS and hyperprolactinemia.

Read more about all ovulation irregularities

 

 Polycystic Ovarian Syndrome (PCOS) - Polycystic ovarian syndrome was described about a century ago by doctors Stein and Leventhal. PCOS is a common cause of female infertility and usually presents with symptoms of obesity, and extra hair growth, especially on the face, neck and abdomen. We now know that PCOS affects a wide range of women of all weights and is typically defined by elevated androgen hormones (male hormones), the presence of irregular menstrual cycles, extra hair growth, and ovaries covered with cysts seen on ultrasound.

Read more about PCOS

Read more about all ovulation irregularities

 

 Poor Endometrial Development - Progesterone and estrogen are needed for the endometrium to thicken and become more vascular to support the implantation of an embryo.  When the endometrium fails to develop, it is sometimes due low levels of progesterone or estrogen.  This condition is often treated with additional progesterone administered to support endometrial development.

 

 Tubal Disease 

The fallopian tubes “carry” the eggs from the ovaries to the uterus, with fertilization occurring along the way.  Sometimes the tubes become partially or fully obstructed due to conditions such as endometriosis. Endometrial implants can attach to, penetrate and scar the fallopian tubes, making egg transport difficult or impossible.

Tubal health is determined using the hysterosalpingogram test (HSG).  Radiopaque dye is injected into the uterus and its flow through the uterus and tubes is monitored via sequential x-rays. Tubal obstructions show up as a concentration of dye behind the blockage.

Some women have their tubes “tied” (tuballigation) as a birth control method, and later decide to have children and seek tubal reversal surgery. The decision is usually due to changes in life situations such as divorce and remarriage.  While the tubes can sometimes be reconnected surgically and IVF is often effective, tubal ligation should be considered a permanent means of birth control.

 

 Unexplained Infertility - Sometimes no cause for a couple's infertility can be identified. Treatment depends upon many factors such as female age, previous treatment history, etc.

Read more about unexplained infertility

 

 Uterine Disease - The uterus must be normally shaped and free of obstructions to support a developing fetus.  Large fibroids or polyps can make implantation and fetal development difficult. Some women are born with a uterine structural abnormality such as a bicornuate uterus (two horned).  A bicornuate uterus does not cause infertility but it does increase the chances of miscarriage and can cause problems during pregnancy. Pelvic inflammatory disease, usually caused by infection, can also damage the uterus.

Read more about uterine disease 

 

Visit the infertility treatments section of our site to reads the latest treatments recommended for the conditions discussed above. Also, be sure and visit the staff section which details the extensive experience of our infertility specialists.