Infertility

What causes infertility?

In female

• Age: The number and quality of eggs diminish with age.

• Problems with ovulation such as polycystic ovary syndrome (PCOS) where no eggs are released (anovulatory).

• Damaged or blocked tubes hence preventing the sperm and egg from meeting.

• Endometriosis: A condition which can cause pelvic pain or painful periods, and may cause distortion to the female anatomy in severe cases. This can affect the fallopian tube function or may cause a hostile environment that may interfere with fertilisation. It can also affect ovarian reserves (egg count) in severe cases.

• Fibroids and polyps that can distort the cavity of the womb and impair implantation.

• Premature ovarian failure such that eggs are no longer released. This can occur naturally or as a result of chemotherapy, radiotherapy or even previous ovarian surgeries.

In males

• Low sperm count or poor sperm motility which may have a genetic cause. This will mean fewer sperm getting to the fallopian tubes to meet the egg.

• Absent or no sperm: This may result from obstruction in the sperm ducts (vas deferens), the tube that delivers the sperm from the testis to the penis, or due to impaired sperm production in the testis.

• Erectile dysfunction, retrograde ejaculation resulting in failure of delivery of sperm in the vagina.

Note: Up to 25% of couples have no identifiable cause for subfertility. This is known as unexplained subfertility.

What are the risk factors for infertility?

There are many factors that can increase the risk of infertility in both men and women.

• Age plays one of the most significant factors for fertility. Female fertility begins to decline after age 34 and decreases sharply after 40, while male fertility also diminishes with age.
  

• Lifestyle choices such as smoking, excessive alcohol consumption and being either underweight or overweight can negatively affect fertility in both sexes.
  
  
• Women with certain medical conditions like polycystic ovary syndrome (PCOS), endometriosis or a history of pelvic inflammatory disease (PID) may have a higher risk of infertility.
   
• Previous reproductive surgeries or treatments such as chemotherapy and radiotherapy can also impact fertility.
  
  
• In men, certain infections including mumps can cause inflammation in the testicles, leading to reduced sperm production.
   
• Exposure to environmental toxins such as pesticides or industrial chemicals can further reduce sperm quality.
  
  
• Additionally, stress and other factors that affect hormone balance may also contribute to reduced fertility.
  

Recognising and addressing these risk factors early can help improve the chances of conception.