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Houston Fertility Journal

What are some of the causes of infertility?

[fa icon="calendar"] Aug 27, 2018 11:44:34 AM / by Center of Reproductive Medicine   

Center of Reproductive Medicine

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When you’re trying to have a baby, there is nothing more frustrating than a long string of negative pregnancy tests. At some point you might start wondering - “Is something wrong with me?” You might even wonder if it’s your partner. To help you stop the guessing game, today, we’ll cover the most common causes of infertility.

First off, it’s important to note that infertility is not a strictly female or male issue. It could be one or both of you that is leading to your inability to achieve pregnancy. The causes we’ll share in this post fall into one of three categories:

  1. Male Causes
  2. Female Causes and
  3. Genetic Causes of Infertility (Both male and female)

Let’s jump right in, shall we?

Common Male Causes of Infertility

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Why are we starting with the males, you ask? Well, we want to drive home the point that fertility complications are not just female related. It takes a male and a female to make a baby, and infertility is not sexist or biased in terms of who it will impact.

According to the Office on Women’s Health, the Centers for Disease Control and Prevention (CDC) reported, “About 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant.”

They went onto say, “infertility is not always a woman's problem. Both women and men can have problems that cause infertility. About one-third of infertility cases are caused by women's problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture of male and female problems or by unknown problems.”

The most common causes of male infertility are:

  1. Problems with male reproductive organs
  1. Sexually transmitted diseases or infections
  1. Exposure to heat or toxic chemicals
  1. Drugs and medications

Problems with male reproductive organs

Male fertility is dependent upon both male reproductive organs and hormones. If just one part of this process is misfiring - the whole process is compromised.  The three likely causes of infertility related to the male reproductive organs are difficulty maintaining an erection, problems with ejaculation, and issues with sperm production.

Difficulty maintaining an erection

When the male has trouble maintaining an erection, it can make intercourse impossible. High blood pressure, depression, anxiety, poor diet, and a variety of other factors can lead to erectile dysfunction.

Problems with ejaculation, and sperm production

Production of Sperm

The time frame for sperm to become mature, and therefore be able to fertilize an egg is roughly 70 days. If anything goes awry in this duration, the sperm could become defective. Just two of the things that could go wrong include defects of the tubes that transport the sperm, as well as cancers and non malignant tumors that block transportation of the sperm or decrease its quality or motility.

Andrology Australia reported that about 66% of men have difficulty making sperm in the testes, and many suffer from low quality or low quantities of sperm. Add disease, aging and a whole host of elements to the mix, and it can become that much harder for a male to produce enough good, high quality sperm.

A Short Window

During intercourse, the sperm is forced through the urethra and ejaculated through the penis. It is contained in a gelatin-like substance - semen - which provides a slightly alkaline environment to protect the sperm from the acidity of the female vagina. But this climate is short-lived. If the sperm does not reach the woman's cervix within a few hours, the semen itself becomes toxic and the sperm dies.

The odds of any one sperm surviving to fertilize the egg are astounding. In each ejaculation, between 80 and 300 million sperm are delivered. Of those, only about 2 million make it into the cervix, and half of those actually get to the uterus. Yet, even with these large numbers, only 200 or so finally make it to the egg where only one can enter the egg and attempt to fertilize it.

It’s no wonder they call conception a miracle, because even an otherwise healthy couple has no guarantee that if they have intercourse they will get pregnant.

Having a varicocele

Another issue that can wreak havoc on a male’s reproductive organs is a varicocele. This is what happens when there is swelling in the veins that drains the testicle. There is no known cause of varicoceles, but they lead to sperm quality being reduced. The good news is, that if you have one, it is considered to be one of the most common reversible causes of infertility in males.

Hormonal Imbalance

For some men, the problems they have with their reproductive organs are related to a hormonal imbalance. If a male has low testerone for example, his sperm production decreases. Hormonal imbalances and deficiencies are on the rare end of the spectrum, but we felt they should be mentioned since they do have a connection with male reproductive organs. If your family has a history of hormonal imbalances, it may be worth mentioning to your fertility specialist.

Sexually Transmitted Diseases or Infections

If you have a sexually transmitted disease or infection, this can have a negative impact on your partner’s ability to achieve pregnancy. Depending on the infection or disease you have, your sperm count, quality or motility could be altered. You could also have issues with painful intercourse, or difficulty ejaculating and/or maintaining an erection.

Exposure to Heat or Toxic Chemicals

Sperm wants a healthy, stable environment to grow, mature and thrive. It doesn’t like heat, and it doesn’t like toxic chemicals. Exposure to these elements can cause your sperm production to become lower, and lead to low quality and low motility.

Drugs and Medications

Drugs and medications are also important factors when determining causes of infertility in males. Anabolic steroids can cause a man to have lower sperm production, for example. Marijuana can decrease sperm production and sex drive too. On the legal end of things, many prescription drugs can cause a decrease in sexual drive, and lead to erectile dysfunction. This is why, if you are struggling to achieve pregnancy, you may want to consider the things you are putting in your body.

Female Causes of Infertility

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Now that we’ve covered the most common causes of infertility in males, let’s switch gears and discuss the females causes. For females that are under 35, and of reproductive age, the most common causes are:

  1. Ovulation and menstruation related problems
  1. Dysfunction of female reproductive organs
  1. Sexually transmitted diseases or infections
  1. Lifestyle and diet choices

Ovulation and Menstruation

A female must be ovulating and menstruating to have the ability to achieve pregnancy. According to the National Institute of Child Health and Human Development, “The most common overall cause of female infertility is the failure to ovulate, which occurs in 40% of women with infertility issues.”

The average menstrual cycle is between 28 and 35 days. Between day 11 and day 21 of your cycle is when ovulation typically occurs. At this point, the luteinizing hormone (LH) rises, and as a result an egg is released. The mucus in your cervix then alters into a slippery state so that sperm can easily make its way to the egg. If the egg is not fertilized in time, it essentially disintegrates, your progesterone hormone levels will fall, and it along with blood and tissues from the lining of your uterus will be shed from your body. This is also known as your menstruation period.

Several factors can disrupt the ovulation and menstruation processes in your body, however. These factors include, but are not limited to:

  • Hormonal imbalances - i.e. a dysfunction of your luteinizing hormone (LH) or follicle stimulating hormone (FSH)
  • Being over or underweight
  • Malnourishment or lack of vitamins
  • Overexertion from exercising or working too much
  • Stress
  • Polycystic ovarian syndrome (PCOS)
  • Underactive or overactive thyroid
  • Low ovarian reserve or low egg quality

Dysfunction of Female Reproductive Organs

Just a few of the causes of infertility related to female reproductive organs are damage/blockage of the fallopian tubes, endometriosis, and other complications with the uterus or cervix.

Damaged or Blocked Fallopian Tubes

If you suffer from damaged or blocked fallopian tubes, sperm will be blocked from getting to the egg, or the fertilized egg will be blocked from getting to the uterus.

Endometriosis

Endometriosis happens when tissue that normally grows in the uterus is implanted and growing in other locations. If this extra tissue is removed surgically, it can lead to scarring which can also block the fallopian tubes. Endometriosis can also disrupt implantation of a fertilized egg because of its impact on the lining of the uterus.

Other Complications with the Cervix or Uterus

  • Polyps and tumors can sometimes show up in the uterus. In some cases, these growths can block the fallopian tubes.
  • For some women, their cervix has trouble producing the best fluids to help the sperm travel to the uterus.
  • Another cervical issue is called cervical stenosis, and this is a narrowing of the cervix
  • An abnormally shaped uterus can also make it difficult to get or stay pregnant.

Sexually Transmitted Diseases or Infections

Like their male counterparts, sexually transmitted disease or infections are sometimes causes of infertility in females. For example, untreated chlamydia and gonorrhea can lead to pelvic inflammatory disease which can cause blockage to the fallopian tubes. Women with untreated syphilis may be able to get pregnant, but are more prone to stillbirths. Finally, Human papillomavirus (HPV) can lead to infections in the cervix preventing pregnancy.

This is far from an exhaustive list, however. If you suspect you could have a sexually transmitted disease of infection, tell your doctor right away.

Lifestyle and Diet Choices

While it is true that no diet can ensure your ability to get pregnant, it is important that you have a healthy diet. This is especially important if you’re trying to get pregnant because you want your body to be as good of an environment as possible. You need to be getting enough vitamins, and consuming enough calories.

Alcohol and drug use can cause disruptions in menstruation. And, consuming too much alcohol can pack on the pounds making you far more likely to become diabetic, or have another weight related illness.

If you’re currently taking any prescription medications, it’s important to discuss your desire to achieve pregnancy with your doctor. Some medications can alter your hormones, disrupt your menstrual cycle, and cause a variety of other issues that make it harder for you to conceive.

Genetic Causes of Infertility

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We’ve discussed the most common causes of infertility in males and females, but we can’t forget about the genetic causes. Genetic causes of infertility plagues both sexes equally. However, this doesn’t mean all hope is lost if you have a genetic condition.

Genetic conditions that can impede fertility for females include:

  • Hormonal imbalances
  • Heart disease
  • Thyroid disease
  • Chromosome abnormalities
  • Inherited genetic diseases such as cystic fibrosis or Tay Sachs

Genetic conditions that can impede fertility for males include:

  • Y chromosome deletions
  • Klinefelter’s syndrome
  • Down syndrome
  • Hormonal imbalances
  • Heart disease

If there are genetic problems in your family, you should bring these things up with your doctor. The sooner your fertility specialist knows your family’s history, the sooner they can decide if your genetic issue is the cause of your infertility.

What to Do If You’re Suffering from One or More Causes of Infertility

If you and your partner have been having unprotected intercourse regularly for more than a year, it is time to see a fertility specialist. If you’re between the ages of 35 and 39, you should see a doctor if you have been trying unsuccessfully for six months.

Having a physical, complete with full blood test may reveal what’s causing your infertility right away. And, ruling out infertility causes in men is sometimes easier to do than it is with females. However, for some couples it takes a lot of time, and several tests to get to the root cause.

It’s also important to note that there is a clock on your ability to conceive. Unfortunately, as we age our bodies aren’t as capable of having babies as they were in our youth. For women their ovarian reserve becomes depleted, and their egg quality diminishes. Men though they will produce sperm for the rest of their lives, might not have the quality or quantity of sperm they once did.

In other words, if you are struggling to achieve pregnancy, don’t wait to make an appointment with a specialist. The reality is that if you wait too long, you could be risking no longer having the ability to get pregnant. To learn more about working with the Center of Reproductive Medicine, click here.

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Topics: Signs of Infertility, Health, Infertility

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