Causes of infertility

What can I do if I think I have a fertility problem? 

If it turns out that you do have a fertility problem, you have every reason to feel optimistic about the outcome - IVF science has advanced very rapidly in recent years and CARE Fertility has been at the forefront of these developments, helping to pioneer ever more effective treatments and widening the range of people who can be helped.

When you’re ready, we will be with you every step of the way,  providing you with the information and support you need. We’ll give you clear guidance on what we need to do together to achieve the best possible chance of successful treatment for you. 

 

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What causes infertility?

There are many reasons for infertility :

Female fertility problems

Ovulation

Problems with ovulation are one of the most common causes of fertility issues for women. Poor egg quality, failure to ovulate through hormonal deficiency or imbalance, irregular ovulation and Polycystic Ovary Syndrome (PCOS) are commonly encountered problems. They are often related to age especially since egg quality is known to deteriorate quite dramatically from late thirties onward. Premature ovarian failure, when the ovaries stop working before age 40, is another reason for female infertility.
After a full assessment, treatment can include IVF, ovulation induction or IVF with donor eggs.

Womb and Fallopian tubes

Your Fallopian tubes which carry eggs from your ovaries to the womb can be blocked or damaged preventing any chance of eggs meeting sperm. The reasons include:

• scar tissue
• endometriosis
• pelvic inflammatory disease
• adhesions from an operation
• damaged tube ends
• pelvic or cervical surgery
• submucosal fibroids

If you've previously been sterilised and had the procedure reversed, remember that it will not necessarily mean that you will become fertile again.
Treatment is usually by IVF, however sometimes if the problem is a blockage, and it is very localised, then it can be possible to clear it by keyhole surgery.

Professor Charles Kingsland discusses miscarriage

Miscarriage

So many people go through the heartbreak of losing a baby.  In the first 12 weeks the commonest cause of a miscarriage is an abnormality in the embryo. Over 12 weeks there is a higher likelihood that that loss of pregnancy may be due to a maternal factor -  it could be that the uterus isn't working very well or the neck of the womb, the cervix, opens too early or there's an abnormality in the pelvis. It is very unlikely that a woman will miscarry three times in a row but if she does we need to think about the possibility of there being an underlying immunological factor whereby the embryo is just not implanting properly or the body itself is rejecting a normal pregnancy or in fact is mis-reading the embryo signals and that's when we need to undertake some sophisticated investigations which look at the possibility of there being an underlying immunological abnormality

Medication

The drugs involved with chemotherapy can sometimes cause ovarian failure which, sadly, can be permanent.
Advances in egg freezing of course now mean that if you have to undertake a course of chemotherapy you can take the precaution of freezing eggs in advance of your treatment.

Overall health

Being overweight, being seriously underweight, smoking, and drinking too much alcohol can all have a negative impact on your fertility.

Male fertility problems

Sperm

The most common cause of infertility in men involves abnormal or insufficient sperm. Problems can arise when either not enough sperm is being produced, or the sperm is of poor quality. In this case we mean that the motility can be low, which affects the sperm's ability to ‘swim’ as vigorously as it needs to, or the sperm can be abnormally shaped. A normal sample will show 20 million sperm per millilitre at least half of which will be active.
Problems with sperm can be difficult to solve, however some success has been achieved with fertility drugs, particularly in increasing volume. Intra-Cytoplasmic Sperm Injection (ICSI) can also help when there is a sperm issue.

Blocked tubes

Either the tubes which store and carry your sperm from your testicles, or the vas deferens which lead from them and carry sperm immediately prior to ejaculation can be blocked. If everything else is healthy then a simple procedure to retrieve sperm may be the recommended way forward.

Testicles

The testicles produce and store your sperm. Clearly, if they are damaged it will affect the quality and quantity of the sperm you produce. The damage could be caused by a wide number of events such as an infection, or testicular cancer or a testicular operation. If this is the case, it may still be possible to retrieve sperm surgically.

Medication

Sulfasalazine used to treat rheumatoid arthritis and Crohn's disease can decrease your sperm count, however the effects are only temporary and you should return to normal after your course of treatment. Long term use and abuse of anabolic steroids will reduce the number of sperm you produce and affect their motility. The drugs involved with chemotherapy can severely reduce your production of sperm, however advances in sperm freezing now mean that if you have to undertake a course of chemotherapy you can take the precaution of freezing sperm in advance of your treatment.