Causes Of Infertility In Males & Females

Infertility is condition which is defined as the ability to not get pregnant in spite of having frequent, unprotected sex with your partner for at least a year for most couples. This might be caused due to health issues in either the male or the female or due to a combination of other factors that prevent pregnancy.

In this article we will be discussing about the various factors which affect fertility in both males and females and the tests conducted in hospitals and clinics to diagnose the same.

Causes of infertility

In males –

  • Abnormal sperm production or function – can be due to undescended testicles, genetic defects, diabetes and infections like chlamydia, gonorrhea, mumps or HIV. Enlargement of veins in the testes also affect the quality of sperms.
  • Problems delivering the sperm – caused due to sexual problems like premature ejaculation, genetic disorders like cystic fibrosis, structural problems like blockage in the testicles or injury or damage of the reproductive organs.
  • Overexposure to some environmental factors – these include pesticides, harmful chemicals and radiations. Excess smoking, consumption of alcohol, marijuana and anabolic steroids as well as medication for bacterial infections and high blood pressure also affect sperm production. Frequent raise in body temperature due to exposure to external heat can also affect the quality and production of sperms.
  • Damage due to cancer and its treatment – radiation and chemotherapy used in cancer treatment can impair sperm production.

In females –

  • Ovulation disorders – Include hormonal disorders like polycystic ovarian syndrome (PCOS), hyperprolactinemia (excess prolactin production), hyperthyroidism or hypothyroidism. Excess exercise, eating disorders and tumors can also affect ovulation.
  • Abnormalities in the uterus or cervix – polyps in the uterus, and uterine fibroids can block the fallopian tubes and prevent a fertilized egg from implanting in the uterus causing infertility.
  • Damage/Blockage in the fallopian tube – Inflammation in the fallopian tube due to pelvic inflammatory disease caused by sexually transmitted infections, endometriosis or adhesions can result in infertility.
  • Endometriosis – The deposition of endometrial tissue occurs outside the uterus in the surface of other organs in the pelvic cavity which can affect the function of the ovaries, fallopian tubes and the uterus thereby causing infertility.
  • Primary ovarian insufficiency – also called early menopause occurs when the ovaries stop releasing eggs before the age of 40. Exact causes are unknown for this syndrome but experts suggest some immune system diseases, genetic disorders like Turner syndrome or fragile X syndrome and cancer treatment as possible causes.
  • Pelvic adhesions – caused by deposition of bands of scar tissue after pelvic infection, any prior surgeries, or endometriosis can hinder fertility.
  • Cancer and its treatment – Cancers of the reproductive system and the associated radiation and chemotherapy can damage the reproductive organs and associated hormones and cause infertility.

Diagnosing infertility

In males –

  • Semen analysis – The test checks for the sperm count and mobility to determine problems with the sperms. Sometimes, sperms are extracted from the testicles through a needle biopsy for testing.
  • Blood test – These check for the levels of hormones such as testosterone and thyroid in the blood. Genetic testing of the blood can be performed to rule out chromosomal aberrations.
  • Scrotal ultrasound – Ultrasound of the scrotum helps identify blockage in blood vessels surrounding the scrotum as well as other testicular problems.

In females –

  • Pelvic exam – A physical examination of the pelvis along with a pap smear test (test the cells of the cervix for cervical cancer) is performed to check for abnormalities in structure and to check for signs of any infection.
  • Blood test – Checks for levels of gonadotrophic hormones as well as of thyroid hormone.
  • Transvaginal ultrasound (TVS) – Ultrasound is performed of the internal structure of the female reproductive system by inserting the ultrasound stick though the vaginal opening.
  • Hysteroscopy – A thin tube containing a lighted camera is inserted through the vagina to check the internal structure of the uterus.
  • Saline sono-hysterogram (SIS) – TVS is performed by filling the uterus with sterile saline water to have a better view of the uterus.
  • Hysterosalpingogram (HSG) – This test checks for blockages in the fallopian tubes by capturing it under X-ray under the influence of an injectable dye.
  • Laparoscopy – This is an invasive procedure in which the pelvis is examined with the help of a laparoscope containing a small camera through an abdominal incision to check for endometriosis, uterine fibroids and scar tissue.

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