Causes of Infertility

What is infertility?

The term “infertility” is used in the medical field to describe a couple’s inability to conceive after a year of unprotected intercourse where the female partner is younger than 35, or after six months where the female partner is older than 35, or the inability to carry a pregnancy to term.

It is important to know that you are not alone in facing infertility. The incidence of infertility worldwide is high. In fact, the World Health Organization (WHO) estimates that approximately 8-10% of couples experience some form of infertility problem. However, the incidence of infertility may vary from region to region.

It is also important to realise that “infertility” does not mean that you are unable to have a child, but rather that you will require medical assistance to achieve a pregnancy. Infertility is a medical disorder.

Unlike many other parts of your lives, infertility may be beyond your control. Don’t blame yourself if you are not getting pregnant. It is a medical problem, which often needs appropriate medical treatment.

The good news is that 80% of couples that seek care from a qualified specialist will carry a pregnancy to term (Human Reproduction Updates, vol. 6, 2000).

Various causes of infertility

The cause of a couple’s infertility may be related to the female partner or the male partner or both partners.

In around 40% of cases, the cause of a couple’s infertility problems is a male factor. In a further 40% of cases, a couple’s infertility is caused by a female factor. In the remaining 20% of couples with fertility problems, the cause can be attributed to mixed male and female factors.

The most common causes of infertility are ovulatory disorders, endometriosis, fallopian tube problems and male infertility.

While unexplained infertility is uncommon, there are rare cases in which the cause of infertility is undetermined.

Common causes of infertility in women

There are a number of possible causes of infertility in women.

A woman may experience problems with her cervix, or suffer from uterine problems such as, for example, fibroids growing on her womb. She may have poor ovarian function due to advanced age or premature ovarian failure, or she may face failure to ovulate, which means her eggs are not being released. There may be damage to the fallopian tubes, for example, following a pelvic infection or surgery. Or she might suffer from endometriosis which can interfere with reproductive function and cause pelvic pain.

Common causes of infertility in men

There are also many possible causes of male infertility. Some are obvious, such as male sterilization or vasectomies, or spinal cord injuries, or erection or ejaculatory dysfunction. Other possible causes may be more difficult to pinpoint, such as medical conditions, medications, previous mumps infection, any STDs (sexually transmitted diseases), previous surgery or old injuries especially in the groin area such as a torsion.

Lifestyle factors such as being overweight, smoking and drinking, or the use of steroids or testosterone can affect the quality of the sperm.
Male fertility levels can also decline due to several causes such as age, stress, a compromised immune system, environmental factors like working with chemicals and heat caused by tight briefs, hot tubs and saunas.

Problems with sperm production or the quality of the sperm are, however, a top cause of infertility in men. In fact, male fertility is defined by the “sperm quality”, which refers to semen volume, sperm count, sperm motility (movement) and sperm morphology (shape).

The normal ranges for sperm quality is as follows:

• Sperm count – more than 15 million per millilitre is normal
• Sperm motility – more than 42% of the sperm is motile
• Sperm morphology – more than 4% of the sperm must have a normal shape (oval head, mid-piece and tail)
• Semen volume – more than 1.5 millilitres.

How to determine the cause of your infertility

Given all these many and diverse possible causes of infertility, how can you determine which of these causes are preventing you as a couple from achieving a healthy pregnancy?

The assessment and treatment of couples with fertility problems is best done by fertility specialists who are registered with the Health Professional Council of South Africa (HPCSA) as a sub-specialist in Reproductive Medicine.

Fertility specialists have the necessary experience, expertise and advanced equipment required to make an accurate diagnosis regarding the cause of your infertility. Further tests and infertility investigations will be done according to the likely causes of your fertility problem.

Sometimes the investigations may be done in conjunction with your referring gynaecologist. They may include, for example, a semen analysis for the male partner and a pelvic transvaginal ultrasound for the female partner to visualise the uterus and ovaries. An assessment of the pelvis will also include a hysteroscopy and laparoscopy to check the uterine cavity, fallopian tubes and the pelvis for endometriosis or scar tissue. A hysterosalpingogram X-ray may also be requested.

Other tests that are frequently used to determine the cause of infertility include blood tests for HIV, hepatitis B and C, syphilis, thyroid function, prolactin, rubella and day 21 progesterone to check for ovulation. Additional tests will be requested depending on the history and findings and the type of treatment needed.

Treating the cause of infertility

Once a diagnosis has been made regarding the cause of your infertility, treatment can be started immediately.

Fortunately, there are as many treatments for infertility as there are causes, and your fertility specialist will discuss all the possible treatment options with you and explain which procedure would be best for you.

Cape Fertility ranks as one of the best fertility clinics in the world. Among the reasons for this is location in the beautiful City of Cape Town, superb facilities, renowned specialists and experienced fertility experts, a range of advanced fertility treatments, excellent results and inspiring feedback from patients.

At Cape Fertility, you will meet one of our four reproductive specialists: all with impressive qualifications and extensive experience. They are supported by a full team of fertility experts and can help you find the cause of your infertility, and the right medical treatment for it.

We offer many advanced treatments at our purpose-built premises in the beautiful city of Cape Town, with procedure rooms and a modern sophisticated laboratory adjacent to our Main Reception and Staff Offices. These facilities, along with our experienced team, ensure all the latest fertility treatments are used with great success at Cape Fertility.

But our proudest achievements are the feedback we receive from our patients, who often describe Cape Fertility and our staff as “the best”. We invite you to read more reviews here… to find out what our patients say about their experience at our clinic.

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises in the beautiful city of Cape Town.

Your first step in uncovering the cause of your infertility – and the treatment for it – is simply to contact us by clicking here.