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Causes of infertility

The American College of Obstetricians and Gynecologists (ACOG) defines infertility as a couple’s inability to conceive after one year of trying, or six months for women over the age of 35.

Potential causes of infertility

There are many different possible causes of infertility in both men and women, so it’s recommended that couples who are struggling to conceive visit a fertility specialist to identify and treat the particular condition of infertility. Many fertility problems can be fixed, and couples go on to have healthy, successful pregnancies.


Women can suffer from a range of different infertility conditions with various causes, including hormonal and anatomical issues.

  • Polycystic Ovarian Syndrome (PCOS) – PCOS develops from a hormonal imbalance that usually results in the growth of small, benign cysts on the outer edge of the ovaries. Women with PCOS tend to have irregular and absent periods and ovulations, making getting pregnant more difficult. The disorder can have wide-ranging effects, from weight gain, acne, and increased risk of diabetes, to thinned hair on the head and excess hair growth on the face and body. People with PCOS can benefit from tracking their cycles to best predict their ovulation, but if this is ineffective by itself, a fertility specialist may recommend an ovulation-inducing medication like Clomid, possibly in conjunction with Metformin. Surgical options like ovarian drilling, which induces ovulation by making tiny holes in the ovaries, also have significant success rates and minor recoveries. There is no test to diagnose PCOS, so doctors will often only diagnose PCOS if all other explanations have been ruled out.
  • Endometriosis – Caused by a buildup of uterine tissue in the pelvic area outside of the uterus, endometriosis can result in fallopian tube blockages, scarring, cysts, and other damage. These blockages bar eggs that the ovaries release from making their way through the tubes, preventing fertilization. Endometriosis can also be quite painful, especially during your period. Women who have endometriosis may want to consult a fertility specialist about surgical options, both to better understand the extent of the extent of the possible tissue damage and to remove it. Laparoscopic surgery can remove the obstructive tissue and help clear the way for eggs to move through the fallopian tube. In vitro fertilization (IVF), in which the egg is fertilized in a laboratory before being transferred to the womb, is another option for women battling endometriosis.
  • Hormonal problems – Oftentimes, women who have irregular cycles will have trouble getting pregnant, due to irregular, infrequent, or absent ovulations. Short luteal phases may also contribute to the problem, in which menstruation begins before a fertilized egg would have time to implant in the uterine lining. Hormone supplements are a good option for women with hormonal disorders, in order to regulate the condition and induce ovulation.


  • Poor sperm quality: Whether due to age, lifestyle factors, or bad luck, some men’s sperm have trouble making their way to, or fertilizing, an egg waiting in the fallopian tube. Some men may have a low sperm count, while others could have poor sperm motility. Couples can still get pregnant if a man has poor sperm quality, but the likelihood is reduced. A fertility specialist may be able to recommend a course of action for the best chance of conception.
  • Varicocele: Varicoceles are enlarged veins in the scrotum that raise the temperature of the testes, hindering sperm production. Because varicoceles can reduce sperm count or harm the quality of sperm produced, they make conception difficult. If the varicocele is severe enough, a fertility specialist might recommend surgery to cut the veins contributing to the varicocele. Surgery is relatively minor, and men recovery fully within about a week.
  • Blockages: Some men may have blockages in the vas deferens or epididymis, which can prevent healthy sperm from reaching and fertilizing the egg. A fertility specialist might recommend a surgical procedure to remove the obstruction. Men with blockages also generally have otherwise healthy sperm, meaning in vitro fertilization with one’s own sperm is entirely possible.

Read more
  • Mayo Clinic Staff. “Infertility Causes.” Mayo Clinic. Mayo Clinic, 7/2/2014. Web.
  • “What Causes Female Infertility?” Stanford University. Stanford University, n.d. Web.

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