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Infertility: Causes and Treatments

Infertility: Causes and Treatments

October 18, 2024Labryo Fertility Center
Educational
Before we delve into the medical terms, Labryo Fertility Center wants to remind you that you’re not alone. Infertility is a deeply personal journey that varies from individual to individual. We are committed to supporting you every step of the way. Many of our staff have experienced infertility firsthand, understanding the pain and frustration associated with each attempt and appointment. Helping you create a family is our greatest achievement. 

Infertility is a condition affecting millions worldwide where a person or couple is unable to conceive a child after a certain period of trying. It affects about 1 in 6 people of reproductive age. This definition can vary based on age and other factors, but generally:
  • For people under 35: Infertility is diagnosed if a couple has been trying to conceive for at least 12 months of regular, unprotected sexual intercourse.
  • For people over 35: Infertility is diagnosed if a couple has been trying to conceive for at least 6 months of regular, unprotected sexual intercourse.
There are several causes of infertility, and trying to figure out and understand each one of the reasons can be incredibly frustrating, disheartening, and painful. But there are also many ways to address infertility. By understanding different treatments and determining your personal goals, you can tackle infertility, as well as the entire journey, into your own hands. While lifestyle and genetics play a part in fertility, it’s important to remember that infertility may stem from different factors.

1. Infertility Causes

1.1 Female Factors 

Female factor infertility takes up around thirty percent of general cases. It’s important to understand at this stage that nobody is to blame. Some of these factors may be genetic or unknown. We are here to help you be aware of your choices and educate you on making the best decisions for yourself. 
  • Endometriosis: This is a condition in which tissues and cells in the endometrium grow outside the uterus, causing extreme pelvic pain, painful urination and bowel movements, and painful periods that could lead to infertility and chronic pain. 
  • Polycystic Ovarian Syndrome: Otherwise known as PCOS, it is the most common condition that affects how females’ ovaries function. The biggest three symptoms of PCOS are irregular periods, polycystic ovaries, or excess androgen, which causes higher levels of “male” hormones in your body.
  • Fallopian tube blockage: Damaged or blocked fallopian tubes prevent semen from reaching the egg. It is sometimes possible to open blocked fallopian tubes with surgery, but if unsuccessful, the only other option is to proceed with IVF. Fallopian tubes can also scar from surgery or pelvic scarring. You’re able to see if your fallopian tubes are blocked through a hysterosalpingogram, otherwise known as an HSG. It typically requires no anesthesia and is usually an outpatient procedure. People with blocked or damaged tubes may experience pain during the procedure.
  • Fibroids: Fibroids can be myomas or leiomyomas. They’re usually non-cancerous muscle and tissue that grows around your uterus, thereby changing its shape or creating blockage. Some may have no symptoms and others may have painful and heavy periods.  
  • Ovulation problems: Some females may develop anovulation, which is the lack of ovulation, or delayed ovulation. This can be treated with medicine that stimulates ovulation and accurately tracking your ovulation dates. 
  • STIs: Sexually transmitted infections like chlamydia or gonorrhea may cause pelvic inflammatory disease, which in turn may scar or create blockages to your fallopian tubes. 
  • Cancer treatment: As harsh as it is, cancer treatments like chemotherapy, radiotherapy, or hormone therapy may significantly hinder your fertility by damaging reproductive organs and hormone production. The treatment may cause permanent or temporary changes, and it is recommended to talk to your physician thoroughly regarding any future fertility plans you may have.
 

1.2 Male Factors 

Male factor infertility also makes up approximately thirty percent of the cases. Like females, it’s important to understand at this stage that nobody is to blame. There are often cases where some people may feel shame or discouragement once finding out their cause, but rest assured your physician will always try to make it work for you. 
  • Abnormal semen analysis: Abnormal semen may have different reasons. There may be a lack of sperm, or low sperm count. Sometimes, some sperm that may not be moving properly to reach the egg, or abnormally-shaped sperm could cause harder movement to fertilize an egg.
  • Testicular injury or undescended testicles: If testicular tissue is damaged, it is not impossible to repair it, but it may cause fertility issues. Another condition may be undescended testicles when the testicles do not occupy their usual place. 
  • Blocked sperm ducts: This makes up about 5% of male factor infertility, in which the semen won’t contain any sperm. This can be surgery, or your physician may decide to extract sperm physically.
  • Ejaculation disorders: Retrograde ejaculation happens when semen enters the bladder during an orgasm instead of emerging out of the penis. A lot of health conditions could cause retrograde ejaculation, so it’s important to talk to your physician about this as well.
  • Cancer treatment: Cancer treatments affect anyone who comes across it. Like females, cancer treatments may cause permanent or temporary changes to your hormone and reproductive organs, and it is recommended to talk to your physician thoroughly regarding any future fertility plans you may have before proceeding. 
  • Erectile dysfunction: Problems with sexual intercourse may also hinder male fertility. This can include having trouble maintaining or keeping an erection, premature ejaculation, painful intercourse, or psychological and physiological problems that restrict sexual intercourse. 

1.3 Female and Male Factors

A combination of both female and male factors in infertility makes up another thirty percent and can occur in various ways. Here are some common scenarios:
  • Anatomical issues: Both partners may have anatomical abnormalities that contribute to infertility. For example, heavy bleeding in females can disrupt the menstrual cycle, while the man may have a blockage in the vas deferens.
  • Hormonal imbalances: Both partners may have hormonal issues that affect fertility. For instance, the female may have polycystic ovary syndrome (PCOS), while the partner may have low testosterone levels.
  • Genetic factors: Both partners may carry genetic mutations that interfere with fertility. For example, both may have a genetic predisposition to infertility.
  • Infections: Both partners may have had infections that have damaged their reproductive organs. For example, both may have had sexually transmitted infections (STIs) in the past.
  • Autoimmune disorders: Both partners may have autoimmune disorders that attack their reproductive systems. For example, both may have endometriosis.
  • Environmental factors: Both partners may be exposed to environmental factors that affect fertility. For example, both may be exposed to toxins or pollutants.
In many cases, the combination of female and male factors is complex and may involve multiple issues.

1.4 Unexplained Infertility 

Unexplained infertility takes up around ten percent of the causes for most cases. This usually means that both parties, both male and female, have done corresponding analyses and evaluations that determine there is nothing abnormal regarding their reproductive organs. There are several reasons and causes that your physician would be able to offer you for unexplained infertility, such as having an undiagnosed underlying illness, psychological issues, egg and sperm quality, poorly timed intercourse, and much more.
  • Psychological issues: Your mental state is also a factor that should not be overlooked; oftentimes people with underlying psychological, mental, or emotional issues could experience infertility or have trouble getting pregnant. Regardless of the cause and the reason, you must not undermine the importance of being in a good and healthy mental state. 
  • Lifestyle: Your lifestyle includes but is not limited to your diet, exercise routine, sleeping habits, and mental state. 
  • Environmental factors: This can include several causes like pollution, use of excess plastic, or even mold in your house sometimes. Environmental factors can contribute to your fertility and overall well-being. 
  • Emotional and mental factors: The stress hormone may play a huge part in your fertility journey. As stated above, people sometimes forget how important it is to practice self-care. Nurturing your body means your physical and mental self. 
At Labryo Fertility Center, we offer a range of personalized treatments, including IUI, IVF, and artificial reproductive technologies. Whether you require egg or sperm donors or gestational surrogacy, our team is dedicated to helping you navigate your fertility journey and achieve your family-building goals.  

Infertility - Causes and Treatments


2. Medicinal Treatments 

Medicinal treatments are mainly medications that regulate, stimulate, or induce certain hormones or ovulation. One of the causes of infertility includes delayed or irregular ovulation. Mayo Clinic states that certain medications that work like natural hormones are given to females to trigger more timely ovulation or a healthier batch of eggs during ovulation. Fertility drugs, like all medications, can sometimes cause unpleasant side effects or enhance underlying diseases. Treatment and medication cycles should vary from person to person and accordingly to a medical professional. 
  • Clomiphene citrate (commonly known as Clomid): this oral medication encourages the healthy release of an egg, or induces regular ovulation, in females who have irregular, delayed, or nonexistent ovulation.
  • Gonadotropins: this injected medication stimulates the ovary to produce multiple eggs, and may improve fertility in men.
  • Metformin: this medication is used mainly in females who suffer from polycystic ovary syndrome (PCOS), it works to improve insulin resistance, in turn improving the chances of a healthy ovulation.
  • Bromocriptine: the medication, a dopamine agonist, is used when a physician has diagnosed that the excess production of prolactin by the pituitary gland is the cause of ovulatory problems. 

3. Surgical Treatments 


Surgical interventions are often considered and are used to correct or investigate underlying anatomical issues relating to infertility. It is important to work with a healthcare provider to determine specific causes of infertility and develop an appropriate treatment plan. 

3.1 Female-Related Procedures:


  • Laparoscopy: A minimally invasive procedure that uses a small camera and surgical instruments to inspect the reproductive organs to diagnose and treat conditions such as endometriosis.
  • Hysteroscopy: A procedure that uses a small, lighted tube to examine the inside of the uterus. It can be used to investigate causes of abnormal bleeding and remove polyps, fibroids, or adhesions.

3.2 Male-Related Procedures:


  • Vasectomy Reversal: A procedure to reconnect the vas deferens after a vasectomy.
  • Varicocelectomy: A procedure to correct varicocele, a condition where the veins in the scrotum are enlarged.
  • Testicular Sperm Extraction (TESE): A procedure to extract sperm directly from the testicles when there is a blockage or other issue preventing sperm from reaching the ejaculate.

4. Assisted Reproduction Technology (ART) Treatment Options


This stands for assisted reproduction technology or ART for short. These are the most commonly used methods to conceive and have the highest rates of success. 
  • Intrauterine insemination (IUI): it is also known as artificial insemination, places sperm directly inside the womb via the cervix using a long, thin, plastic tube. In an IUI procedure, the sperm is collected and washed first before choosing the best ones for insertion. IUI does not involve a female’s eggs being taken outside the body.
  • In vitro fertilization (IVF): also known as test tube procedure, IVF procedures are one of the most common and have achieved the highest success rates in the world. This procedure allows the egg to be fertilized with sperm outside the body, then placed back when it is successfully fertilized. IVF procedures are delicate and millions of couples per year choose IVF to conceive. 
  • Sperm or egg donors: if you or your partner has infertility, you may consider having an egg or sperm donor to help you conceive. The process is usually then completed through IVF. Egg and sperm donors also go through extensive screening and evaluations before proceeding with donation. The laws and regulations regarding donors vary from country to country and state to state, with some legally entitling a child born out of donors to find out the identity of the donors once the child reaches 18 years of age. 
  • Gestational surrogacy: Gestational surrogacy as a fertility treatment option has steadily increased over the years, and it is a process in which a surrogate, who has no genetic relationship with the child, carries a fetus through pregnancy and birth for another female or couple. This is usually a lengthy procedure that involves a fertility clinic and a legal contract. This is achieved through the use of IVF and also through extensive screening and evaluation. 
These are some options to personalize your journey. It is completely normal to have occasional doubts or to feel like your emotions are on a rollercoaster. Whether or not you want to proceed with these treatments is entirely up to you, and if you do decide to in the end, you can take however much time you need to fully embrace it. During family planning, each process and each decision is hard enough, and understanding everything in detail is even harder. Labryo Fertility Center is always here to sit down with you one-on-one to answer every single question you may have, even the ones you didn’t know to ask. Remember, it is always your decision. 

Disclaimer: The information provided is intended for general knowledge only, and individual circumstances may vary. If you're concerned about infertility, consulting with a healthcare professional for personalized advice is recommended. 



References: 
  1. Treatment Infertility, NHS, https://www.nhs.uk/conditions/infertility/treatment/, Accessed Nov 27, 2023. 
  2. Conrad, Marissa., Forbes Health., https://www.forbes.com/health/womens-health/fertility-treatments-guide/, Accessed Nov 27, 2023
  3. Female Infertility, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313, Accessed Nov 27, 2023
  4. Surgical Infertility Treatment, Loma Linda University, https://lomalindafertility.com/treatments/surgical-infertility-treatment/. Accessed Oct. 16, 2024