Causes of infertility

Female infertility

Egg maturation issues

Various factors influence hormone production and distribution in both genders. Stress, medications, weight, thyroid disorders can all impact the body's delicate hormonal balance. This can then go on to impact fertility by causing the woman's menstrual cycle to flux. A result of this can be that egg maturation and subsequent ovulation may be inhibited or not take place at all, meaning no egg is available to be fertilised and become an embryo. 

Infertility due to an issue with the fallopian tubes

After ovulation, the egg travels through the fallopian tube. This is where the egg and sperm first have the opportunity to meet and fertilise.

If there is damage to the fallopian tube, as is there is in the cases of approximately a third of women, then infertility can occur. These delicate fallopian tubes can be damaged due to inflammation, previous ectopic pregnancies or adhesions after an operation. Another common cause of obstruction in the fallopian tubes is endometriosis, a chronic disease that causes uterus lining to occur outside of the uterus.

Myomas

Myomas are benign growths that can grow in the uterine wall or outside the uterus. Depending on their position and size, these harmless growths can impact fertility by blocking the area inside the uterus where the embryo usually implants, or can press and therefore obstruct the fallopian tube, prohibiting fertilisation. In addition, typical symptoms of myomas, such as intermenstrual bleeding and inflammation, can negatively impact fertilisation and embryo implantation.

Antibodies against sperm

Occasionally, sperm can be registered by the woman's body as undesirable foreign objects. Antibodies in the cervical mucus of the uterus can then start fighting the sperm which prevents fertilisation of the egg, called an immunological problem.

Examination methods at a glance:

• Ultrasound examination to examine reproductive organs.

• Blood sampling to determine hormone values.

• Basal temperature curve to define ovulation occurrence and timing.

• X-ray examination to detect fallopian tube blockages.

• Laparoscopy (abdominal examination) to examine the abdominal area and remove any small obstructions.

Male infertility

Dysfunctional sperm maturation

The most common problem with fertility in men is the insufficient production of motile sperm. Semen quality is considered 'normal' when the number of sperm cells is 20 million per millilitre of semen or over. Of these, at least 15% should be normally formed and 25% should have good forward mobility - meaning it can move forwards (and therefore towards the egg) properly. If this isn't achieved, then the man is considered to have reduced fertility. However, even if the sperm count is normal, it's still possible that another problem could prevent the sperm from reaching and penetrating the egg.

Dysfunction in sperm maturation can result from a mumps in childhood. Another common cause is varicose veins on the testes (varicocele).

Male infertility is increasing around the globe, and a number of lifestyle factors are thought to contribute. Hormonal problems, stress, environmental pollution, undescended testicles, tumours that have been operated on or genetic causes, such as chromosomal abnormality can also impact male fertility. Acute infections can also temporarily reduce sperm motility.

Dysfunctional sperm transport

In 4% of cases, sufficient sperm is formed – but these fail to reach the woman's egg during ejaculation because of blocked seminal ducts.

This situation is comparable to a blocked fallopian tube in a woman. It could be caused by prior sterilisation, undeveloped epididymis or adhesions in the epididymis, potentially as a result of infections.