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A Quick Brief on the types and main causes of Infertility

What is infertility?

Infertility is the inability to conceive a child or achieve pregnancy after over a year of having unprotected sexual intercourse. Infertility is one of the most serious and common health concerns that affects 8-10% of couples worldwide. That amounts to 60-80 million couples all over the world, out of which around 15-20 million couples are from India.

What are the types of Infertility:

Infertility is further classified into two types:

  1. Primary infertility
  2. Secondary infertility

What is primary infertility?

When the couple has never conceived a child before, it is called Primary Infertility.

What is secondary infertility?

Secondary infertility refers to the inability to achieve pregnancy after already having conceived previously.

Primary and secondary infertility are mainly caused by the same factors causing infertility. Age and uterine damage from previous pregnancy or childbirth are some of the leading causes of primary and secondary infertility.

Main causes of Infertility:

Infertility can affect one or both partners. In general:

  • In about one-third of cases, there is an issue with the man
  • In about one-third of cases, there is an issue with the woman
  • In the remaining cases, there are issues with both the man and the woman, or no cause can be found (unexplained infertility).

Many of the risk factors for both male and female infertility are the same. They include:

  • Age: Women’s fertility gradually declines with age, especially in the mid-30s, and in the Indian population, it drops rapidly after age 35. This is due to the lower number and quality of eggs, and can also be due to other associated health problems that affect fertility. Men over age 40 may be less fertile than younger men.
  • Lifestyle: Poor lifestyle habits are one of the main causes of infertility. These include:
    • Tobacco use: Smoking tobacco or marijuana by either partner may reduce the likelihood of pregnancy. Miscarriages are more frequent in women who smoke. Smoking can increase the risk of erectile dysfunction and a low sperm count in men.
    • Alcohol use: For women, there’s no safe level of alcohol use during conception or pregnancy. Alcohol use may contribute to infertility. For men, heavy alcohol use can decrease sperm count and motility.
    • Weight: An inactive lifestyle and being overweight or even being underweight may increase the risk of infertility. For men, sperm count also may be affected by being overweight.
    • Unhealthy lifestyle: A lack of exercise contributes to obesity, which increases the risk of ovulatory problems and ultimately causes infertility.

Causes of infertility in Men:

The most common causes of infertility in men are due to the following factors:

  • Abnormal sperm production or function: Abnormal sperm production can be due to undescended testicles, genetic defects, health problems such as diabetes or autoimmune diseases, or infections such as tuberculosis, mumps, chlamydia, gonorrhea or HIV. Enlarged veins in the testes (varicocele) also can affect the quality of sperm.
  • Problems with delivering sperms: Sexual problems can be due to factors such as premature ejaculation or erectile problems. Some genetic diseases such as cystic fibrosis can also cause problems in production as well as delivery of sperms. Structural problems, such as a blockage in the testicle like a varicocele (enlarged veins in the testicles); or damage or injury to the reproductive organs are more common causes of infertility in men.
  • Toxins: Overexposure to certain factors such as cigarette smoking, alcohol, marijuana, anabolic steroids, pesticides and other chemicals, and radiation can lead to male infertility. Chronic use of some medications used to treat high blood pressure and depression also can affect fertility. Frequent exposure to heat, such as in saunas or hot tubs, can raise body temperature and may affect sperm production.
  • Cancer: Cancer itself and its treatment, including radiation or chemotherapy, can sometimes seriously impair sperm production.

All these factors can cause low or absent sperms, change in the sperm morphology (shape), decreased sperm motility or even an increased sperm DNA damage which ultimately are causes of infertility in men that makes it difficult to conceive without fertility treatment.

Causes of Infertility in Women:

The common causes of infertility in women are as follows:

  • Problems in ovulation: Such disorders affect the release of eggs from the ovaries. These include hormonal disorders such as polycystic ovary syndrome. Thyroid disorders and hyperprolactinemia, a condition in which you have too much prolactin also may interfere with ovulation. Other causes like too much exercise, eating disorders, tumors, or even inborn genetic disorders can also cause ovulatory problems.
  • Pathologies and abnormalities: Uterine or cervical abnormalities, including abnormalities with the cervix like stenosis, polyps in the uterus, or even the shape and size of the uterus can cause infertility. Disorders like fibroids or adenomyosis (a condition in which there is blood collection in the uterine wall) can also cause problems in the transport of sperm and eggs or even in the implantation of the embryo. Pathological cysts in the ovary like dermoid cysts or chocolate cysts are also common causes of infertility in women.
  • Tubal causes: Fallopian tube damage or blockage can result from various conditions like pelvic inflammatory disease, which is usually caused by a sexually transmitted infection, tuberculosis, chlamydial infection, endometriosis or adhesions. This can cause blockage or inflammation on the tubes which ultimately affects their function.
  • Endometriosis: Endometriosis is a painful condition in which the endometrial tissue grows outside of the uterus. This may affect the function of the ovaries, uterus, and fallopian tubes by various mechanisms and is an important cause of infertility.
  • Primary ovarian insufficiency (early menopause): Sometimes the ovaries stop working and menstruation ends before age 40. Although the cause is often unknown, certain factors are associated with early menopause, including immune system diseases, certain genetic conditions such as Turner syndrome, and radiation or chemotherapy treatment.
  • Cancer: Cancer itself and its treatment, particularly reproductive cancers, often impair female fertility. Both radiation and chemotherapy may contribute to premature ovarian failure and reduced ovarian reserve.
  • Other causes: Pelvic adhesions, intrauterine adhesions, fibrous bands of scar tissue that can form after pelvic infection, or even abdominal or pelvic surgery.

Fortunately, infertility in most cases can be treated with assisted reproductive technology. Various treatment modalities like Ovulation Induction with IUI or IVF-ICSI can help you achieve a pregnancy. If you are unable to conceive even after 1 year of intercourse or you are older than 35 years old and trying since 6 months, it is advisable that you start treatment at the earliest as age is the most critical parameter for successful results.

For more information on infertility treatments, visit us at BankerIVF, where we offer different fertility solutions for infertile couples. Do visit us so that we can assess and diagnose any underlying problems and create a personalized treatment plan for you. 

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