What are the main causes of sterility and infertility?

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To find out the cause of the couple's infertility, a series of tests must be done. With the results you can know if the fertility problem is male, female or a combination of both. Also, it can be determined if the infertility is temporary or permanent. Once the cause is found, a personalized treatment can be initiated. If necessary, an artificial insemination or in vitro fertilization (IVF) will be carried out.

It is important to be clear that infertility and sterility, although they are used colloquially as synonyms to designate the inability to have offspring, do not have the same meaning. Infertility refers to the impossibility of achieving the fertilization of the ovule, while infertility is the inability to have a baby because we get the pregnancy to come to term.

For more information about the difference between both terms enter here: Sterility and infertility.

Below you have an index with all the points that we will discuss in this article.

Index

What are the main causes of sterility and infertility?

Main causes of infertility in the couple

The fertility problems of a couple can have their origin in the man, in the woman or in both members of the couple. Once the relevant fertility tests are done, in 30% the cause is male and in another 30% female.

The remaining 40% is divided between a mixed or combined cause, which occurs in 20% of cases, and an unknown cause, in another 20%. In the mixed cause, both members of the couple have alterations in their fertility that are causing the inability to have a child, while in cases of infertility of unknown origin can not find an explanation to the problem.

Origin of infertility in the couple

Female sterility

When talking about female sterility, the problem may be at different levels or caused by several factors. There, in the woman we can find the following alterations:

  • Ovarian factor: may be due to alterations in the ability to ovulate or poor quality ovules.
  • Tubal factor: problems in the fallopian tubes, hindering or preventing the passage of the ovum and sperm.
  • Cervical factor: refers to the cervix, alterations at this level make it difficult to even prevent the passage of sperm to the uterus.
  • Uterine factor: presence of fibroids, uterine adhesion, uterine malformations or a poorly developed endometrium can be included as alterations at the level of the uterus.

Find all the information regarding female sterility in this article: Feminine sterility.



Ovarian factor

The hormonal alterations in the menstrual cycle of the woman can prevent ovulation (anovulation), which occurs at an inappropriate time or the ovules do not occur correctly.

The endocrine system is in charge of controlling the ovarian cycle, so an alteration caused by stress, obesity, low weight, problems in the thyroid gland, medication, etc. It can affect the normal functioning of the ovary.

To study the ovary and ovulation, echographies and hormonal analysis in the blood are performed to look for pathologies that justify the couple's fertility problems.



Tubal factor

The tubal factor refers to any alteration or problem in the fallopian tubes of women. This part of the reproductive system has two fundamental roles: to allow the ovum and the sperm to meet so fertilization can occur and help the embryo reach the uterus.

Therefore, if the tubes do not fulfill their function there will be female sterility. This occurs when there is an obstruction in both tubes, as it can happen in cases of salpingitis, malformations, hydrosalpinx or endometriosis, among others.

To diagnose a problem in the tubes it is necessary to make a hysterosalpingography. This is a fundamental test in the study of fertility. With one of both tubes being permeable, that is, not blocked, pregnancy could occur.



Cervical factor

If the sperm can not pass through the cervix or cervix, they can not reach the egg. Abnormal growths in this part of the woman's body, such as polyps or myomas, as well as alterations in cervical flow, can cause sterility.



Uterine factor

Alterations in the uterus, whether uterine malformations or problems in the endometrium, can cause infertility by preventing the implantation or the development of pregnancy at term.

Among the most frequent alterations are endometriosis, myomas and polyps.

Male sterility

Regarding male sterility, there are also several factors that can cause it:

  • Pretesticular factor: due to hormonal alterations the testes have not developed or can not perform their function.
  • Testicular factor: problems in the testes either congenitally (from birth) or for any subsequent cause.
  • Post-testicular factor: alterations in the seminal ducts, sexual impotence or any type of urinary infection.
  • Spermatic factor: includes any problem that occurs in sperm.

Find out about sterility in men at this link: Male sterility.

Pretesticular factor

These are hormonal problems caused by inadequate endocrine regulation. Inadequate hormonal control can cause alterations in the development of testicles, seminiferous ducts, spermatogenesis (production of sperm) or the development of the male reproductive system in general.

To detect a hormonal cause of male sterility, a blood hormone test should be performed.

Post-testicular factor

This type of sterility is due to alterations or problems in the seminal tracts that the sperm must pass through to go outside once they are produced by the testicles: the epididymis, the vas deferens and the urethra.

In this case, sterility may be due to infections, obstructions or trauma that prevent the release of sperm in the ejaculate.

Spermatic factor

It is the most common cause of infertility or male sterility. It is caused by problems in the sperm, whether in their shape, mobility, vitality or quantity in the semen.

The most common alterations in sperm are the following:

  • Oligospermia or oligozoospermia: low sperm count
  • Asthenozoospermia: low mobility in sperm
  • Teratospermia or teratozoospermia: high number of abnormally shaped sperm
  • Necrospermia or necrozoospermia: high amount of dead sperm
  • Azoospermia: absence of sperm in the ejaculate

To diagnose a sperm problem, a semen study called semen analysis or semen analysis must be done.

Combined or mixed sterility

In some cases, both the man and the woman of the couple can be sterile. Therefore, fertility problems will be due to the combination of some of the causes of male and female sterility mentioned above.

However, there are cases in which sterility is caused by an immunological incompatibility. In these cases, the woman's immune system attacks the man's sperm. Therefore, it is possible that both partners are fertile separately but can not conceive together without medical help.

Sterility without apparent cause

When the cause of sterility is not known, we speak of idiopathic sterility or sterility of unknown origin (EOD). This occurs in 20% of cases of sterility. In spite of performing the pertinent examinations, there is no problem that justifies not achieving the pregnancy.

This does not mean that there is no alteration in the couple, but that the tests have not reached any specific diagnosis. Some diagnoses are extremely complex and it may not be possible to find out the exact cause of sterility with the tests currently available.

Even so, not getting a diagnosis of infertility does not have to prevent applying an assisted reproduction treatment such as artificial insemination or in vitro fertilization and getting pregnant.

Remember that in ORG Assisted Reproduction we can offer you a special price for your fertility treatment. With the download of our coupons discount in clinics, you have the possibility of going to a first free visit to guide you about your reproductive options.

You can find all the information in the following link: See discounts on assisted reproduction.

Questions from users

What are the causes of infertility at 40?

The most probable cause of infertility in those couples in which the woman is 40 years old or older is the alteration in an ovarian factor. It is very common that there are hormonal imbalances that make the menstrual cycle does not pass properly, as well as that there are few ovules available in the ovary (low ovarian reserve) due to advanced age.

If we already had a child, what can be the cause of infertility in a second pregnancy?

Having had a child previously does not mean that there can be infertility problems when looking for a second pregnancy. When this happens we are faced with a case of sterility or secondary infertility.

The causes may be the same as in a primary infertility, so the appropriate male and female fertility tests should be done to determine which of the aspects mentioned above is causing the problem.

Is it possible that the cause of sterility is the contraceptives I have used so far?

If the woman uses hormonal contraceptives for a prolonged period of time, it may take several months to recover normal menstrual cycles and therefore fertility. Therefore, contraceptives can cause transient sterility.


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