The Most Common Causes of Infertility and How They are Treated

Infertility can affect both men and women when they are trying to build a family naturally. When an individual or couple has been trying to conceive for more than a year without success, they may be experiencing infertility. What typically causes infertility is not narrowed down to one specific thing, therefore each case has to be assessed individually. That being said, in a majority of cases, infertility can be treated with medical intervention. 

Female Fertility Issues

A woman's uterus, fallopian tubes and ovaries must be healthy in order for her to become pregnant. This is regulated by a healthy diet and lifestyle which support healthy hormonal production. There are medical conditions that can cause a woman not to become pregnant even with a healthy lifestyle and diet. Endometriosis, polycystic ovary syndrome (PCOS) and a lowered ovarian reserve have a negative impact on female fertility. If one still desires to build their family, they may do so with the help of assisted reproductive technologies (ART), which have been known to bypass some reproductive challenges. 

PCOS and Infertility

Cysts occur commonly in women, and typically resolve on their own without any medical intervention. They typically develop when antral follicles continue to develop past the ovulation phase of a woman’s cycle. In some cases, the egg within the follicles is released, but the follicle closes up, fills up with fluid and continues to develop. At times, the egg within is not released at all, but the follicle continues to develop. PCOS occurs when a person’s ovaries develop so many cysts that it interferes with the natural menstrual cycle.

PCOS causes hormonal imbalances which interfere with natural conception. Typically lifestyle changes, exercise and improved diet help to manage PCOS. As well, medications are sometimes prescribed to help regulate the menstrual cycle, particularly where a person desires to become pregnant naturally. If PCOS has caused infertility, medical treatments like IVF are used to help in family building.  

Endometriosis and its Impact on Conception

The endometrium is another word used to refer to the uterine lining. Typically in a menstrual cycle, the uterine lining prepares for pregnancy by building up a specialized padding of rich blood tissue. When pregnancy does not occur, this padding is released through menstruation. Endometriosis occurs when this type of tissue is found outside the uterus, without a way to exit the body naturally. It results in discomfort, pain, and hormonal imbalances.  

Usually endometriosis is treated with surgical interventions. However surgery could result in scar tissue blocking the fallopian tubes and preventing sperm from fertilization. As well, the presence of endometriosis can interfere with embryo implantation. As a result, ART interventions tend to assist people with endometriosis to build their families. However, it depends on the type of endometriosis and how severe it is. 

Low Ovarian Reserve and Age-related Decline

Women’s ovaries are the storage unit for all the eggs they will ever produce in their lifetime. This is called an ovarian reserve. Once a female reaches puberty, hormones are released which cause her body to begin having a menstrual cycle. During each cycle, several eggs are released and developed until one fully matures and is released for fertilization. If it is not fertilized, a menstrual cycle occurs. The eggs that are underdeveloped in that cycle are discarded by the body. 

Over time, the ovarian reserve declines until it is depleted, resulting in a phase of a woman’s life called menopause. There are circumstances where a woman will have a low ovarian reserve outside of age-related factors. This is when she has a genetic disorder, autoimmune conditions or endometriosis. As well, if she has undergone chemotherapy, surgery on her reproductive system, or smokes, her ovarian reserve will decline. Whatever the cause of a lowered ovarian reserve, treatments such as IVF have been effective in treating infertility and helping people to still build their families.

Male Fertility Issues

Since sperm from the male is the other half of the fertility equation, we must address the issues that impact male fertility. At the core of male fertility is the production of the hormone testosterone. It is responsible for healthy testicles and sperm production. Men produce fresh sperm regularly, therefore they do not have a sperm reserve. While this can be advantageous, the quality of sperm produced could impact fertility negatively. Some of the causes of infertility in men is poor hormone production which impacts sperm count, sperm motility and sperm morphology. As well, the reproductive organs could have blockages in the tubes that lead the sperm from the testicles through the penis. 

Low Sperm Count and Poor Motility

When hormonal imbalances occur, it results in low sperm count an poor sperm motility. This is often as a result of poor sperm production. Factors such as stress, lifestyle, medical issues, genetic conditions and medical treatments like chemotherapy can cause disruptions in a man’s natural sexual function. 

The quantity of sperm and how well they can swim has a direct impact on a man’s ability to build a family naturally. When these factors are low, it reduces the chances of fertilization. Natural interventions are recommended before medical interventions can be used to address infertility. It has been observed that lifestyle changes to healthier habits, regular exercise, lowered stress and sufficient rest improve fertility.

Varicocele and its Impact on Sperm Health

Varicoceles is a common condition that occurs when the blood vessels around the testicles become enlarged. Typically, this does not have an impact on fertility, but when they become extremely enlarged they can prevent the testicles from properly draining the sperm within. This creates a situation where sperm production is lowered and the sperm produced having lowered motility. This in turn results in challenges when one is trying to build their family naturally.  Typically this is treated through minimally invasive procedures and various surgical interventions. 

Unexplained Infertility: What It Means

While all possible measures are taken to explore the causes and remedy infertility, there are situations where no medical explanation exists. This occurs when the health and medical backgrounds have been analyzed alongside diagnostic tests, and the results return as normal, but the individual or couple still cannot become pregnant. While this sometimes does occur, ART has assisted these families to overcome their infertility challenges and go on to build their families.  

Fertility Treatment Options for Every Condition

Every condition that impacts fertility negatively has treatment options. What makes the treatment effective or otherwise is based on the cause of infertility and the degree to which a person’s reproductive health has been affected. Each person and family structure is unique, as are the family building goals. Therefore professional medical experts will address treatments on a case by case basis. Sometimes, fertility treatments may not work, so the doctor may recommend alternative family building methods. 

FAQs

What are the top causes of female infertility?

The top causes of female infertility are age-related decline of the ovarian reserve, conditions such as PCOS and endometriosis, anomalies in the uterus such as polyps and fibroids, hormonal imbalances and blocked or damaged fallopian tubes. 

What is unexplained infertility?

Unexplained infertility is said to occur when standard diagnostic tests for infertility do not bring to light a clear cause for the infertility.

Can infertility be cured?

Yes. However it depends on the cause of infertility. Some cases of infertility can be treated using natural methods, while others may require medical interventions. 

How do I know if I need IVF?

To know if you need IVF you would have to consult with a fertility specialist. IVF will be recommended if after diagnostic testing, it is determined that that would be the best course of treatment. 

What are my options if I have low ovarian reserve?

There are several options for people who want to build their families, but have low ovarian reserves. Some options include freezing their eggs or banking embryos, using donor eggs, taking supplements such as CoQ10 and DHEA to improve fertility metrics, or undergoing aggressive ovarian stimulation.