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What are the primary causes of male and female infertility?

Dr. Sankar Das Mahapatra

Obstetrician
Infertility Specialist
Gynecologist
Causes of infertility in men and women may exist from birth, or may develop later in life. Common causes of male infertility include: • Issues with Sperm Production or Functioning: These arise due to undescended testicle (a testicle that hasn't moved into the scrotum before birth), genetic defects, diabetes, infections (chlamydia, mumps, gonorrhea and HIV) or varicocele (enlarged veins in the scrotum). • Issues with Sperm Delivery: These arise due to sexual problems like premature ejaculation, certain genetic disorders (like cystic fibrosis), structural problems (like testicle blockage) or damage to the reproductive organs. • Excessive Exposure to Certain Substances: Environmental elements like pesticides, radiation and certain chemicals can be harmful for male fertility. Similarly, regular exposure to heat through saunas or hot baths can increase the core body temperature and impact sperm production in men. Alcoholism, smoking, drug abuse (marijuana) and medications (certain antibiotics, anti-hypertensives and anabolic steroids) also have ill effects on fertility in men. • Damage Caused by Cancer or Its Treatment: Chemotherapy, radiation and other forms of cancer treatment can adversely hamper sperm production in men increasing the risk to infertility. • Low Sperm Count: Low sperm count is a condition when semen carries fewer sperm than normal. Sperm count lesser than 15 million sperm per milliliter of semen qualifies as low sperm count. Varicocele (swelling of veins in the scrotum), infections (gonorrhea or epididymitis), tumors in testicles, hormonal abnormalities, ejaculation troubles, anti-sperm antibodies in the immune system, injuries or other issues with the tubes that transport sperm are the causes of low sperm count. It is a risk factor to male infertility. Low sex drive, watery sperm, erectile dysfunction, pain in the testicle area and decreased facial or body hair are few symptoms of low sperm count. Common causes of female infertility include: • Ovulation Disorders: These include hormonal disorders (PCOS), hyperprolactinemia (a condition of excessive prolactin - the hormone responsible for breast milk production), hyperthyroidism/hypothyroidism (both can impair menstruation and fertility) and injuries/tumors that impact release of eggs from the ovaries. • Uterine or Cervical Abnormalities: These include abnormalities with opening of the cervix, polyps (abnormal tissue growth) in uterus and noncancerous uterine tumors that either hamper implantation of fertilized eggs or block the fallopian tubes. • Damage to or Blockage of the Fallopian Tubes: This is caused by conditions like pelvic inflammatory disease that may inflame or block the fallopian tubes, increasing the risk to infertility. • Endometriosis: It is a condition of the growth of endometrial tissue outside of the uterus that can impact functioning of the uterus, ovaries and fallopian tubes. It is a risk factor to female infertility. • Early Menopause: Primary ovarian insufficiency is a condition when the ovaries stop functioning and menstruation stops before the age of 40 in women. It is a risk factor to female infertility. Apart from the above, other risk factors of infertility in men and women are tobacco abuse, alcoholism, being over/underweight, lack of physical activity, etc.
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