What are the most common causes of infertility?
In approx. 40% of the cases the cause is in the female partner. It is most commonly a low or very high supply of eggs, eggs’ failure to mature (anovulation) or ovarian obstruction. The same ratio – 40% – is constituted by the causes in the male partner. 20% of the infertility causes are a combination of both factors – male and female.
Cause in the male partner (andrological factor)
sperm quality is too low or their number does not correspond to the quantity needed to conceive physiologically.
This group also includes the so-called hidden andralogical factor. This factor affects patients with a standard sperm test result – meaning that the sperm look normal and exhibit normal behaviour in the microscope, but their quality “under the surface” is bad. This cause requires a detailed examination of the patient while consulting a urologist or sexologist.
Ovarian cause
the female partner’s age is the main factor influencing both the probability of natural pregnancy and the success of the treatment using IVF fertilisation. As the age of the female partner increases her egg supply decreases. This includes a substantial drop in their genetic quality – and an increasing risk of aneuploidy. It has been proven that this is the main reason why we see a rapid decrease of fertility in women when they reach the age of 33-35. It is not only the number of eggs which is decreasing but also their quality. Other ovarian causes include ovulation disorders connected e.g. with PCOS, autoimmune diseases, high levels of prolactin, irregularities in the function of the thyroid gland and the causes induced by the negative influence of the environment, or by genetic factors, which can be the cause of a result as serious as a total ovarian failure.
Tubar cause
(or rather more accurately named today the Tubo-peritoneal cause) – ovarian obstruction – in its unilateral (relative tubo-peritoneal factor) or bilateral (absolute tubo-peritoneal factor); post-inflammatory changes are the most common cause. Other properties of the Fallopian tube may be damaged as well – its motility, peristaltic, secretion, or the rarely seen congenital Fallopian tube abnormalities.
Uterine (womb) cause
congenital development abnormalities of the internal genitalia, myoma – especially those that deform the uterine cavity or protrude directly into the uterine cavity, fibroids inside the uterine cavity, which most commonly appear as a result of an extensive inflammation of the uterine cavity or repeated operations within the uterine cavity.
Infertility due to Endometriosis
when the presence of a single case or multiple cases of endometriosis (tissue similar to uterine mucous membrane) induces chronical inflammatory changes and has a direct negative influence on the fertilisation processes – the egg quality is lower, as is sperm mobility and the quality of the mucous membrane.
Immunologically determined infertility
a malfunction induced by the production of antibodies or the increased activity of the immunoactive cells against sperm, eggs or embryos. These states prevent the fertilisation itself, which is also true for hatching as well as the correct development of the embryo.
Idiopathic (unexplained) cause of infertility
when the cause cannot be determined by any examination method available (after excluding the hidden andralogical factor and immunologically determined infertility), this type of infertility constitutes about 10% out of all possible causes.
Reproduction age
(of not just the mother, but also the father) is one of the significant factors which the couples should take into consideration when planning their families.