Causes of infertility and what you need to know

Trying to get pregnant is often an exciting time for many couples as they start dreaming of their future family. However, as time passes and the negative pregnancy results keep happening, you can start to wonder whether something’s wrong.

If you are struggling to conceive naturally, you’re not alone. Did you know that infertility affects 1 in 7 couples in the UK?

For many people, infertility can be heartbreaking. It can make you feel hopeless. However, with TFP, there is hope. We provide treatments centred around our patients, helping to improve your chances of getting pregnant.

The definition of infertility and the different types

Infertility in heterosexual couples is defined as not being able to get pregnant despite having regular, unprotected sex. There are two types of infertility: primary and secondary. Primary infertility is when couples have been trying to conceive naturally for at least 12 months by having regular, unprotected sex. Secondary infertility is when a couple has previously had a natural conception but are no longer able to.

What causes female infertility?

While there are many causes of female infertility, the primary causes include:

• Ovulatory disorders

• Damage to the fallopian tubes or uterus

• Problems with the cervix

• Smoking

• Being overweight or underweight

• Sexually transmitted infections

• Excess consumption of alcohol

Let’s break down the common causes of infertility in women so that we all have a better understanding of what they mean.

Premature ovarian failure

Premature ovarian failure is the loss of ovarian function before the age of 40. If a woman has premature ovarian failure, her ovaries are no longer producing any eggs. The problem can be caused by genetic inheritance or as a result of chemotherapy.

Ovulation disorders

It is common for women with fertility problems to be experiencing ovulation disorders. If a woman ovulates infrequently or not at all, this is regarded as an ovulation disorder and is the cause of infertility in about 1 in 4 infertile couples. Without successful ovulation occurring in a woman’s body, the eggs are unable to be fertilised.

Polycystic ovarian syndrome

Difficulties with ovulation can also be caused by polycystic ovary syndrome (PCOS), and this is one of the most common causes of infertility in women. PCOS often causes abnormal hair growth on the face or body, acne, obesity, and insulin resistance. PCOS can significantly affect a woman’s fertility.

Hypothalamic dysfunction

There are two hormones produced by the pituitary gland in a woman’s body. The pituitary gland is responsible for stimulating ovulation every month. If a woman suffers from frequent physical and/or emotional stress, has disrupted hormones, or experiences a substantial change in her weight, her ovulation may be affected. The most common symptom of hypothalamic dysfunction is irregular or absent periods.

Damaged fallopian tubes

If a woman’s fallopian tubes are damaged, either from surgery or contracting a sexually transmitted infection, this can prevent the sperm from reaching the egg. Damaged fallopian tubes can also block the natural passage of the fertilised egg into the uterus.

Endometriosis

Many women struggle on a day-to-day basis with endometriosis (you can read Samara’s story here). This disorder can affect a woman’s ability to conceive naturally. Endometriosis occurs when tissue from the uterus implants itself in other locations around the body.

Endometriosis can range anywhere from minor to major and may need to be removed surgically. However, the surgical removal of endometriosis can cause scarring, which may block or damage the fallopian tubes, preventing the egg and sperm from uniting.

A woman’s age and infertility

A woman’s age can significantly affect her fertility. As a woman ages, her fertility rates begin to drop. So, the longer a woman waits to have children, the more she may reduce her chances of conceiving naturally. As a woman ages, her fertility may be affected in these ways:

• Higher chances of miscarriage

• A woman’s ovaries may become less able to release eggs

• A reduced number of eggs

• A higher likelihood of additional health problems

• A decline in the health of her eggs

When to see a doctor if you’re female

Many people who start trying for a family expect to get pregnant straight away. However, quick conceptions are rarely the case for most couples. You probably don’t need to see a doctor about infertility unless you have been trying to conceive naturally, through regular, unprotected sex, for at least one year. However, it is important to talk to your doctor if you’re a woman and you are experiencing any of the following:

• You’re 35 to 40 years old and have been trying to conceive naturally for six months or more

• Your periods are very painful

• You are over 40

• You menstruate irregularly or not at all

• You’ve had multiple miscarriages

• You have been diagnoses with endometriosis or pelvic inflammatory disease

• You have known fertility problems

• You have undergone treatment for cancer

How is female infertility diagnosed?

If your doctor suspects you may be struggling with infertility, you will be assessed as part of a thorough physical exam. Your doctor may use one or more of the following fertility tests or exams to evaluate your fertility:

• A pelvic exam and breast exam

• A urine or blood test to check for any infections

• A sample of cervical mucus and tissue to determine if ovulation is occurring

• HSG, an X-ray used in conjunction with a coloured liquid inserted into the fallopian tubes, making it easier for the technician to check for blockages

• Ultrasound, either vaginally or abdominally, to look at the uterus and ovaries

• Hysteroscopy, which uses a tiny telescope with a fibre light to look for uterine abnormalities

• Sonohystogram, which combines an ultrasound and saline injected into the uterus to look for abnormalities or problems

Further advice: It is also helpful to track your ovulation through fertility trackers or by keeping a log of your menstrual cycle and any other hormonal changes. This will help your healthcare provider gain a better understanding of your fertility status.

How is female infertility treated?

Female infertility can be treated through medication, surgery, artificial insemination, or assisted reproductive technology. The causes of infertility in women will vary, and so do the treatments.

Our experts at TFP will work to recommend the best treatment option for you. Female infertility is most commonly treated in the following ways:

• Taking medications to help stimulate ovulation

• Taking hormones to address a hormonal imbalance, endometriosis or short menstrual cycles

• Using supplements to enhance female fertility

• Taking antibiotics to remove an infection

• Undergoing minor surgery to remove any blockages or scar tissues from the fallopian tubes, pelvic area or uterus

Can female infertility be prevented?

Many women worried about female infertility are concerned about how to prevent it from happening to them. However, there isn’t usually much that can be done to prevent female infertility caused by genetic problems or illness. However, there are preventative measures you can take if you do not have genetic problems or illness:

• Have annual check-ups with your doctor if you are sexually active

• Avoid illicit drugs

• Take steps to prevent sexually transmitted diseases

• Avoid heavy or frequent alcohol use

• Adopt good hygiene and health practices

Causes of male infertility

As we’ve already mentioned, infertility isn’t just something women may struggle with; it is also present in men. The most common causes of infertility in men include:

Abnormal sperm

It is common for men with fertility problems to have abnormal sperm product or function due to undescended testicles, health problems, such as infections or diabetes, and genetic defects. Enlarged veins in the testicles can also affect sperm quality, causing couples to struggle with conceiving naturally.

Overexposure to environmental factors

It is common for men with infertility to have experienced overexposure to certain environmental factors, such as pesticides, chemicals and radiation. Frequent exposure to hot temperatures can also affect sperm production.

Problems with the delivery of sperm

Some men struggle with problems such as premature ejaculation, certain genetic diseases, a blockage in the testicle or injury to the reproductive organs. All of this can cause problems with the delivery of sperm.

Damage caused by cancer and its treatments

If a man has had cancer and undergone various treatments for it, such as chemotherapy or radiation, it is possible that sperm production has been affected. This can cause problems with infertility.

When to see your doctor if you’re male

Men should seek support from their doctor early if they struggle with any of the following:

• Low sperm count

• Low sperm motility

• A history of testicular, prostate or sexual problems

• Testicles that are small in size

• Varicocele (swelling of the scrotum)

• You have undergone treatment for cancer

• You know of relatives who have infertility problems

Our consultants at TFP will carry out all the necessary tests and assessments to help understand the cause of the problem. At TFP, we prioritise supporting our patients throughout the testing process, helping you get the results you need.

How doctors test for male infertility

If a man suspects he has fertility problems, his doctor will carry out a thorough assessment. The doctor will assess his medical history and sexual habits and carry out a physical examination. One or more of the following procedures may also be carried out:

• Semen analysis

• Blood test

• Ultrasound

• Chlamydia test

Unexplained infertility in men and women

Sometimes, the cause of infertility in couples cannot be found.

Understandably, for many people, this diagnosis can be upsetting, and it can be difficult to know what the next steps are. However, at TFP we can help.

It is important to remember that, for those experiencing infertility, there are now more fertility treatment options available than ever before. Since 1987 when the first baby was born through IVF, over 5 million people have been born through IVF conceptions. Success rates are constantly improving, and we can help increasing numbers of people have the families they’ve always dreamed of.