Causes of Infertility in Men and Women

Infertility is a growing concern among couples trying to conceive. It affects millions worldwide and can be a distressing and emotionally draining journey. Understanding the infertility causes is the first step toward finding the right treatment and improving the chances of a successful pregnancy. Both male infertility and female infertility contribute equally to infertility cases. This blog explores the most common infertility causes in both men and women, offering insights into diagnosis and available treatments.

What is Infertility?

According to WHO, infertility is a disease of the male or female reproductive system, defined by failure to achieve pregnancy after 12 months or more of regular unprotected intercourse.

Infertility Prevalence
Globally, infertility affects millions of individuals and couples, with estimates ranging from 48 million couples to 186 million people. In India, primary infertility affects approximately 3.9% to 16.8% of couples; about 8% of these cases require advanced treatments like IVF.

Distribution of Causes

About 20–30% of infertility cases are due to male factors, 20–35% due to female factors, and 25–40% are combined issues. Around 10–20% remain unexplained. In India, early evaluation is recommended for women above 35, and immediate evaluation for those above 40, due to age-related fertility decline risks.

Male Infertility Causes

1. Low Sperm Count – One of the leading infertility causes in men.
2. Poor Sperm Motility – Limits sperm’s ability to reach the egg.
3. Abnormal Sperm Morphology – Makes fertilization difficult.
4. Varicocele – Enlarged veins affect sperm production.
5. Hormonal Imbalance – Affects sperm production.
6. Lifestyle Factors – Smoking, alcohol, obesity, and stress.
7. Genetic Disorders – Like Klinefelter syndrome.
8. Immunological Causes – Antisperm antibodies.
9. Environmental Exposures – Heat, radiation, and toxins.

Female Infertility Causes

1. Ovulation Disorders – PCOS, thyroid issues; leading causes.
2. Fallopian Tube Damage – Prevents sperm-egg interaction.
3. Endometriosis – Causes inflammation and scarring.
4. Uterine/Cervical Abnormalities – Interfere with implantation.
5. Age-Related Infertility – Decline in egg quality after 35.
6. Hormonal Imbalances – Affect menstrual cycle and ovulation.
7. Lifestyle and Environmental Factors – Obesity, stress, and toxins.
8. Infections and Pelvic Surgeries – Increase infertility risk.
9. Immunological Issues – Autoimmune factors.

Shared & Unexplained Causes

• Chronic illnesses like diabetes or thyroid disease.

• STIs and pelvic infections.

• Certain medications and treatments like chemotherapy.

• Environmental factors like pollution and toxins.

• Around 10–20% of infertility cases remain unexplained.

Diagnosis and Evaluation

• Semen analysis for male infertility.
• Ovulation tracking and hormone testing for female infertility.
• Imaging tests like ultrasound, HSG, or laparoscopy.
• Genetic testing when needed.

Treatment Options

For Male Infertility:

• Hormonal treatments and medications.
• Surgery for varicocele or obstruction.
• Assisted reproductive technologies like IUI or IVF.

For Female Infertility:

• Ovulation-inducing drugs.
• Surgery for endometriosis or fibroids.
• IVF and ICSI.
• Lifestyle modifications.

Government Guidelines

• Women > 35 years: expedited evaluation.
• Women > 40 years: immediate evaluation.
• Testing includes: hormonal panels, ultrasound, semen analysis, STI screening.

Coping with Infertility

• Counseling and support groups.
• Open communication with partners.
• Stress management techniques like yoga and meditation.

Conclusion

Infertility is a complex issue, but with the right knowledge and support, it is manageable. Whether it is male infertility, female infertility, or combined infertility causes, early diagnosis and the right approach can lead to successful outcomes. If you're struggling to conceive, consult a fertility expert and explore your options.