Causes of infertility

Medically speaking, a couple is said to be infertile when they have had regular unprotected sex for 12 months without achieving a pregnancy. Up to 15% of all couples fit this definition. The aim of investigating infertile couples is to identify potentially treatable causes of infertility (diagnosis), and to identify their chances of achieving a pregnancy without further assistance (prognosis). While infertility is classified into causes affecting women and causes affecting men, the reality is that there is often a bit of both that compounds the situation. Almost 50% of the time, no clear reason is found at all (which is called unexplained infertility).

The common causes are:

• Ovulation (egg production) disorders, causing complete absence of or reduced production of eggs e.g.
• Polycystic Ovary Syndrome
• Premature menopause
• Tubal disorders - blockage or absence of one of both fallopian tubes e.g. pelvic infection, scarring from surgery
• Abnormal semen test - low or no sperm, inactive sperm, abnormal appearing sperm or any combination of these
• Other factors such as age, genetic disorders and endometriosis can also have an impact on the chance of pregnancy.

Making a diagnosis

• Testing for egg production - this might involve keeping a temperature chart, hormone testing and ultrasound scans, depending on the individual situation.
• Testing the Fallopian tubes for blockage - which can be done either using an X-ray called a hysterosalpingogram (or HSG) or surgery called a laparoscopy.
• A semen analysis - this needs to be repeated at Fertility Solutions to be sure of the severity of the problem.

Sometimes the cause of a couple's infertility is so obvious that no testing is needed (e.g. the man has had a vasectomy), but for most couples it isn't that clear cut. The tests that are carried out include:

Once a problem has been identified, more tests may be required to determine the precise cause and whether it will respond to treatment. Sometimes no problem at all will be identified. This is called Unexplained Infertility.

Treatment Options

IVF can be used as a treatment for any cause of infertility, provided we can get an egg, some sperm and there is a uterus. However, depending on the cause(s) of infertility there can be other treatments that might also be successful. Disorders of egg production can be treated with a variety of medicines to bring on ovulation. Surgery might be an option for some forms of fallopian tube problems. Mild abnormalities of the semen can be treated with insemination. If you aren't clear about why IVF is the best option for you at this present point in time, discuss your specific situation with your IVF nurse or specialist.