Discovering the Underlying Cause
Infertility - Understanding the Common Causes
Infertility is a broad condition that can be caused by one or more factors. Determining the cause of fertility problems is key to overcoming them, so each patient undergoes a thorough testing process before beginning infertility treatment at our practice in the Chicago, Illinois area. Understanding what causes infertility not only makes it possible to effectively treat it, but also helps patients cope with their condition. Every obstacle to fertility that we are able to recognize interferes with one or more of the following processes.
- Male Infertility
- Anatomical and Tubal Problems
- Unexplained Infertility
Common problems that can decrease sperm concentration and quality are a varicocele (a varicose vein in the scrotum), any kind of infection, or frequent and prolonged overheating of the testicles. Problems can also occur as healthy sperm try to enter the female reproductive system, movement of the sperm from the testicles into the female reproductive system may be inhibited by a blocked or damaged vas deferens or a problem in the epididymis. Many types of male factor infertility are treatable, or can be overcome with assisted reproductive technology. Very rarely, azoospermia, or a complete lack of sperm, may be caused by testicular failure or a genetic condition, such as Klinefelter's syndrome.
Read Dr. Jacobs' article about lifestyle changes and male infertility (PDF)
Irregular ovulation or a failure to ovulate is generally caused by some kind of hormonal problem, although diminished ovarian reserve is a potential factor in patients over the age of 35. Fertility medications are generally successful in stimulating the ovaries, causing eggs to be matured and released.
Polycystic ovarian syndrome, or PCOS, is a relatively common endocrine disorder that is closely linked with diabetes, obesity, and infertility. Women with PCOS either do not ovulate or ovulate irregularly, but this problem can often be corrected through lifestyle changes that help reduce weight and balance hormonal levels. Visit our Fitness for Fertility page to learn more.
Read Dr. Jacobs' article about PCOS strategies (PDF)
Even if a healthy egg is released and plenty of motile sperm are present, there are still plenty of common infertility problems that can prevent the sperm and egg from uniting. A blockage in the fallopian tube, hostile cervical mucus, and anti-sperm antibodies are among these. Most obstacles to conception can be bypassed through in vitro fertilization (IVF), but minimally invasive surgery or another infertility treatment option may be recommended first.
Anatomical and Tubal Problems
There are also many anatomical problems that contribute to infertility. As mentioned above, blockages in the fallopian tubes, also known as tubal factor infertility, can cause infertility by preventing the sperm from reaching the egg, and the egg from reaching the uterus. Tubes can be fully or partially blocked. If only one tube is blocked, pregnancy may still be possible, but it may take a bit longer.
Tubal blockage can be caused by:
- Previous infection, often a sexually transmitted disease causing pelvic inflammatory disease (PID)
- Scarring of the tubes from previous pelvic surgery
- Tubal ligation (sterilization)
- Congenital defects
- Hydrosalpinx, a special type of blockage which causes the tube to dilate and fill with fluid
Other female anatomical problems that may interfere with fertility include:
- Ovarian tumors, adhesions, or congenital malformation
- Uterine tumors or fibroids
- Endometriosis, which causes obstruction through pelvic adhesions, distorted anatomy, or ovarian and tubal damage
Most anatomical infertility problems can be treated through surgical procedures to remove blockages. When surgery is not successful or not recommended, pregnancy is usually still possible through IVF or another type of assisted reproductive technology.
Once conception has occurred, the embryo must embed itself in the uterine lining, a process known as implantation, in order for pregnancy to truly begin. This process may be impeded by a malformation of the uterus, as well as scar tissue, fibroids, or inadequate thickening of the uterine lining.
It is not rare for a couple to receive normal results from all of the infertility testing procedures we administer and still be unable to become pregnant naturally. This is known as unexplained infertility. It can be a frustrating diagnosis, but it is important to understand that treatment is still available. We generally begin with the least invasive treatment methods, such as ovulation induction with fertility medications, and move on to in vitro fertilization, if necessary.
Contact Our Infertility Center in Chicago, Illinois
If you have been unable to become pregnant or would like to learn more about the common causes of infertility, please contact our Chicago-area offices in Illinois.