Infertility Causes & Risk Factors
Infertility causes at a glance
- Infertility is the inability to conceive a baby after trying for a year to get pregnant through sex without contraception.
- For women, conditions associated with causing infertility include irregular or abnormal periods, hormone issues, diseases such as endometriosis and polycystic ovary syndrome (PCOS), and reproductive structural problems.
- For men, conditions include difficulty with erections or ejaculation, insufficient sperm production or unhealthy sperm, or problems with reproductive anatomy.
- Common risk factors for infertility are age (more so in women), genetic abnormalities, inflammation or structural problems in the reproductive organs, prior surgeries, harmful lifestyle issues, and sexually transmitted diseases.
- Fertility testing offers a clinical diagnosis of the potential causes in men and women, which guides the treatments our fertility specialists recommend.
What is infertility and what causes it?
Simply put, infertility is the inability to conceive after one year of trying to get pregnant through fairly frequent intercourse without any kind of birth control. For women over age 35, infertility exists if pregnancy doesn’t occur after six months of trying.
It’s important to realize that infertility affects men and women at the same rate. The American Society for Reproductive Medicine reports that the male is a sole cause or a contributing cause of infertility in about 40% of cases. More than one cause is present in about 25% of couples experiencing infertility.
Infertility involves physiological conditions that either prevent the release of the female’s egg, prevent fertilization of the female’s egg by the man’s sperm, prevent successful implantation of an embryo after fertilization for a pregnancy, or prevent the woman from carrying a pregnancy to term and a live birth.
Often, the reasons for not getting pregnant aren’t clear or detectable at the outset. One reason for this is that it is impossible to simultaneously assess all of the critical events necessary for pregnancy in a woman’s body (ovulation, sperm delivery, fertilization, tubal transportation, embryo development and implantation). Studying these events in women while the couple are trying to conceive would obviously interrupt the ability to get pregnant that cycle and so, for ethical reasons, studying all steps of fertility in a woman’s body is challenging.
The lack of a clear, obvious cause of infertility can create confusion, frustration and sadness for aspiring parents. This is particularly true for those who have not sought the advice of a fertility specialist.
Getting pregnant can be a more complicated process than couples realize. There are a number of reasons why conceiving or carrying a child to term could be difficult, including genetics, age, structural problems in the reproductive system, prior surgery, sexually transmitted disease, and lifestyle factors such as smoking and obesity.
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Signs of infertility conditions in women
- Irregular or abnormal periods.
- No periods.
- Painful periods that may involve cramping or back and/or pelvic pain.
- Pain during sex.
- Hormone problems, such as increased body hair or acne, weight gain or loss of sex drive.
Signs of infertility conditions in men
- Problems with erections or ejaculation.
- Pain, lumps, swelling or firmness in the testicles.
- Changes in sexual desire.
- Body changes, such as hair growth or loss.
- Sexually transmitted disease.
Causes of infertility
- Ectopic pregnancy occurs in 1 in 50 pregnancies. Also known as a tubal pregnancy, this condition can become life threatening if left untreated, it must be terminated and it may cause infertility.
- Pelvic inflammatory disease (PID) affects more than 1 million women in the United States every year. This infection causes chronic pain and infertility.
- Causes of infertility are not always reversible, but for some men and women, improving health and making smarter lifestyle choices can improve fertility.
- Abnormal periods are menstrual cycles that differ from a woman’s typical cycle, or from the normal range of menstruation and can impact fertility.
- Pelvic pain refers to pain in the pelvic region – the area below the belly button and between the hips. It can be associated with a range of systems in the body, including gynecologic, gastrointestinal, urinary or musculoskeletal issues.
- Anovulation occurs when a woman does not release an egg during her menstrual cycle. In most cases, the woman has irregular, unpredictable or absent menses.
- Women with diminished ovarian reserve have few eggs left or eggs that are of poor quality, reducing the chances of conceiving with in vitro fertilization. See how we test ovarian reserve.
- Endometriosis occurs when the lining inside the uterus (endometrium) grows outside the uterus. The two most common symptoms are pain and/or infertility.
- When a woman has increased body hair, similar to that seen in men, she may have hirsutism. The symptoms often improve with medical or cosmetic treatment.
- Male factors contribute to about half of the identifiable causes of infertility, and males are generally included in initial infertility evaluations.
- Ovarian cysts are solid or fluid-filled sacs located within or on the surface of the ovaries. Ovarian cysts can result in abnormal ovulation and, depending upon source or size, can hamper a woman’s fertility.
- Women with polycystic ovary syndrome do not ovulate on a regular basis, and infertility is a very common complaint. PCOS occurs in about 7 percent of women.
- Recurrent pregnancy loss (RPL) is when a woman has experienced two or more consecutive miscarriages with the same partner. There are many possible causes of RPL, categorized as chromosomal, anatomic, immunologic, infectious, hormonal or genetic, environmental, and unknown.
- Tubal disease can include endometriosis, infection or other reasons that may cause a woman's fallopian tubes to become blocked. IVF is generally recommended.
- Uterine anomalies are anatomical problems with the uterus that women are born with – developing when a female is growing in her mother’s womb.
- Uterine fibroids are non-cancerous growths in a woman’s uterine cavity. Several methods of controlling symptoms are available for women with fibroids.
- Uterine polyps are bulb-shaped growths that develop in the uterus, and they can prevent the fertilized egg from implanting in the uterine wall correctly.
- Unexplained infertility does not mean there is no cause for a couple’s infertility. It just means that our diagnostic tools and examinations have failed to detect the cause. Treatments can still result in pregnancy.