Synonyms
Infertility, sterility (lat. sterilitas), infertility
- Sperm associated
- Organic
- Functional
Causes in women
- Ovarian-associated causes
- Tubal-associated causes
- Uterus-associated causes
- Cervical associated causes
- Vaginal causes
- Mental causes
- Other causes
In one third of cases, the cause of the unfulfilled desire for children lies with the man. The causes are divided into sperm associated, organic and functional.
- Sperm associated The examination of the ejaculate (spermiogram) is the simplest and most uncomplicated method for clarifying an unresolved unfulfilled desire for a child.
Based on the normal findings (normozoospermia), pathological changes can be defined quite precisely: Oligozoospermia refers to a too low sperm concentration in the ejaculate, while asthenozoospermia refers to an abnormal motility of the sperm. Teratozoospermia represents the abnormal shape of the sperm. If all three abnormalities in the ejaculate occur simultaneously, it is called OAT syndrome.
If there are no sperm at all in the ejaculate, it is called azoospermia, and if even the ejaculate is missing, it is called aspermia. If one or more of these factors are present in a man, this can of course seriously affect his fertility. Therapeutically, any harmful influences such as nicotine or stress should be avoided.
Drug trials are carried out with the male sex hormone testosterone or with hormones that stimulate the pituitary gland directly and thus indirectly the testosterone production.
In women, numerous factors, which will be explained below, can influence fertility and thus the unfulfilled desire for children.
- Ovarian-associated causes Infertility caused by problems in the ovary (See Ovaries) is found in one third of affected couples. Common to the various forms is that the maturing or cracking of the egg, and thus a basic requirement for pregnancy, does not occur.
The reason for this can be a lack of hormones produced in the brain, which stimulate the maturation and finally the cracking of the egg. The basis for this can be damage to the brain itself or severe physical strain, as caused by stress, massive underweight (e.g. anorexia) or competitive sports. However, the cause can also be the ovary itself, if malformations, genetic disorders or radiation or chemotherapy as part of cancer therapy (e.g. breast cancer, ovarian cancer) are present.
Overproduction of the male hormone testosterone or the hormone prolactin, as occurs during therapy with dopamine antagonists (contained in tricyclic antidepressants, neuroleptics, methyldopa and MCP) or tumours, also impairs fertility. A diagnosis can be made, among other things, by hormone testing directly in the blood and indirectly via the so-called basal body temperature curve (when body temperature is measured daily, the temperature usually rises by 0.5 °C in the second half of the cycle). More invasive methods are also used to examine the course of the cycle.
Therapeutically, prolactin inhibitors and so-called ovulation triggers (anti-estrogens), such as clomiphene, are used here. If these do not lead to success, other hormones (HMG, HCG, GnRH) are administered. With these very effective treatment methods, however, there is a risk of ovarian hyperstimulation syndrome (see below), which can be very dangerous, as well as an increased probability of multiple pregnancies.
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
- Artificial insemination
- Conception
- Egg donation
- Freezing oocytes
- FSH
- Pregnancy
- Birth
- Premature Birth
