Causes of infertility

Synonyms

Sterility, Infertility

When investigating the causes of infertility, both partners must always be taken into consideration. Priority should be given to the investigation of andrological causes, so that the woman is not exposed to unnecessary invasive measures. The impossibility of pregnancy is 50% attributable to the female sex, while andrological causes account for 30%.

Andrological causes of infertility

  • Malformations (e.g. absence of testicles)
  • Hormonal disorders (e.g. testosterone deficiency due to insufficient Leydig cells, which are responsible for testosterone production)
  • Infection (e.g.

    mumps) with subsequent damage to testicles

  • Varicocele (formation of varicose veins in the spermatic cord) with overheating of temperature-sensitive sperm
  • Psychological causes in the form of functional disorders during sexual intercourse (libido disorder, erectile dysfunction)
  • Venereal diseases

Already the physical examination of infertility by observing the secondary sexual characteristics (e.g. extent of hair growth) and the palpation of the testicles allow first conclusions to be drawn about possible maldevelopments. An objective laboratory examination of male fertility is carried out by means of a spermiogram. This allows essential statements to be made about the quality of the ejaculate and the sperm in it.

The ejaculate volume (norm: more than 2ml), its pH (norm: 7.2-7.8) and the sperm concentration (norm: more than 20 million/ml) are determined. The total sperm count must be more than 40 million per ejaculate. These rough parameters are not yet sufficient to classify the man as capable of fertilization.

The nature of the sperm provides further clues as to the quality of the sperm. The motility (motility) and morphology (shape) of the sperm play an important role. More than half of the sperms must show forward motility.

In addition, less than a third should have atypical forms and more than half must be vital. The causes of female infertility are based on the anatomy of the female reproductive organs and the physiology of the fertilization process. a) Ovarian infertility (frequency of 30%)Here it is important to mention the disorder of the hypothalamic-hypophysical axis.

The hypothalamus and pituitary gland are links in a chain that stimulate the ovary to form follicles and ovulation by means of gonadotropins (sex hormones). If one of these limbs fails, gonadotropins such as the follicle-stimulating hormone (FSH) are not produced. The functioning of the ovary stops and no follicles can mature.

The hypothalamic-hypophysical axis is vulnerable to psychological stress and competitive sports. b) Tubar-related infertility (frequency of 30%)Inflammatory changes in the fallopian tube mucosa affect the transport of the egg from the ovary to the uterus and can thus lead to infertility. This is because the mucous membrane can be altered in such a way that the fallopian tube can become blocked.

These changes are often caused by bacteria such as Chlamydia. Inflammatory processes in the area of the pelvis form attachments with the tube, which reduces its mobility. The collection mechanism of the fallopian tube funnel can no longer be guaranteed.

This is because during ovulation the egg must be collected by the funnel in order to be transported further down the fallopian tube. c) Uterine infertility (frequency of 5%)Malformations of the uterus in the form of uterine septums are an obstacle to the implantation of the fertilized egg. Damage to the mucous membrane in the uterus, the endometrium, also hinders implantation.

The endometrium undergoes negative changes due to frequent curettage (scraping) or endometritis. d) Cervical sterility (frequency of 5%) Cervical tears or inflammation are detrimental to the passage of sperm. In particular, the properties of the cervical mucus at the time of the woman’s fertilization may be altered by a lack of estrogens in such a way that the sperm are prevented from further ascending from the vagina to the uterus. e) Vaginal infertility (frequency of 5%)Malformations or stenoses prevent the woman from having intercourse. Inflammatory processes such as colitis favour premature birth.Further interesting information from the field of gynecology: An overview of all topics in gynecology can be found at Gynecology A-Z

  • Infertility
  • Male infertility
  • Unfulfilled desire to have children
  • The ice release syringe
  • Sterilization
  • Pregnancy
  • Birth
  • Premature Birth