Causes of Infertility

Infertility has many possible causes. In some couples more than one factor is present, and in about 1 in 5 no cause is found even after tests.

Female factors

• Ovulation problems: polycystic ovary syndrome (PCOS), thyroid disease, high prolactin, premature ovarian insufficiency, very low or high body weight
• Blocked or damaged fallopian tubes: often from pelvic infection, previous surgery or endometriosis
• Endometriosis
• Uterine problems: fibroids, polyps, scarring or structural differences
• Age: egg number and quality decline with age, especially after 35
• Cervical factors in some cases

Male factors

• Low sperm count, poor movement or abnormal shape of sperm
• Varicocele: enlarged veins in the scrotum
• Blockage in the sperm ducts, or problems with ejaculation
• Hormonal problems, undescended testes, infections such as mumps in adulthood
• Medicines and treatments, such as chemotherapy, and some steroid use

Lifestyle and general factors (both partners)

• Smoking, heavy alcohol use and recreational drugs
• Overweight, underweight or very intense exercise
• Chronic stress and poor sleep
• Exposure to heat, pesticides or certain chemicals
• Untreated diabetes and other long-term illness
• Sexually transmitted infections such as chlamydia and gonorrhoea

Unexplained infertility

Tests are normal, but pregnancy does not occur. Treatment is still available.

Ayurvedic view

Ayurveda links difficulty conceiving to imbalanced doshas, poor agni and weak reproductive tissues. This is a traditional framework and not a modern explanation.

Key point

A cause is often treatable. Both partners should be evaluated, rather than assuming one is the reason.

Before your appointment

Come as a couple if you can. Note how long you have been trying, cycle length and regularity, past pregnancies, surgeries, infections and medicines. Bring past reports and, if available, a semen analysis. List supplements and herbs you take, along with smoking, alcohol and exercise habits. Ask about tests, treatment options, costs, success rates and the warning signs that mean you should call 112 or 102.