Infertility affects approximately 10-15% of today’s population. It is a growing issue that many couples face when trying to start their family. The medical definition of infertility is a failure to conceive after one year of unprotected intercourse. It is imperative to determine the source of infertility in order to address the cause so that it can be resolved.

It is a common misconception that the female of the reproductive-aged couple is the one responsible for infertility. In many cases, the infertility is in the male partner. It is important to evaluate both partners in order to determine the, in most cases correctable, a cause of infertility.

Factors That Influence Female Infertility

In order to better understand female infertility, it is important to understand the anatomy of a female. The reproductive tract begins with the vagina, which is connected to the uterus. The beginning of the uterus is known as the cervix. The uterus is then connected to a left and right fallopian tube, which then have fimbriae which surround the left and right ovary.

Each month the female will undergo ovulation. Ovulation is when an egg has become mature and is released from either the right or the left ovary. It then travels down the respective fallopian tube and towards the uterus and continues to look for the sperm to allow for fertilization. If there is no sperm, then there is no fertilization and the endometrium of the uterus sloughs off, resulting in a menstrual period. The menstrual period occurs once a month unless the egg released during ovulation is fertilized by a sperm.

The most common cause of infertility in women is a failure to ovulate, otherwise known as anovulation. The female may notice changes in the frequency or duration of her menses. Each portion of the female reproductive tract may contribute to a female’s infertility. If there is an abnormal pH within the vaginal mucosa, then this may result in abnormal interaction between the mucus and sperm causing infertility.

If infertility stems from the uterus, it is usually a result of a defect in the anatomy of the uterus. The defect may be congenital or acquired and affect either the endometrium or the myometrium of the uterus. These defects may result in infertility.

If there are any abnormalities in the fallopian tubes, infertility may result. The defect may be congenital, meaning the women were born that way; or acquired, meaning it is the result of a trauma or illness. Scarring of the fallopian tubes can occur from previous ectopic pregnancies or other trauma as well.

Infections, adhesions from previous surgeries, ovarian masses or other anatomic defects can also cause infertility.

Factors That Can Influence Male Infertility

Men can also be the cause of infertility. There are several factors that can contribute to male infertility. They all occur within, or in some way affect the male reproductive tract.

These causes are categorized as before testicles, within the testicles, or after the testicles, in the reproductive tract. Pre-testicular means that infertility occurs as a result of an external factor outside of the testicles. These are diseases that are present in either the hypothalamus, pituitary or other peripheral organs, that interfere with the natural functioning of the hypothalamus-pituitary axis. These diseases may either be acquired or congenital. The next portion of the male reproductive tract is the testicular portion. This can be resultant from birth, or it can be acquired. Finally, post-testicular means that the infertility is a result of other factors that interfere with the sperm’s ability to travel through the ductal system. Meaning there is some reason why the sperm cannot get to the egg. It is imperative to understand where in male infertility originates from so that an appropriate intervention and/or treatment plan can be established and infertility can be resolved.

External Factors That Can Influence Infertility

There are other external factors that can also contribute to infertility. If the anatomy of the female and male reproductive tracts are within normal limits, and all testing is negative, then it may be the appropriate time to evaluate external factors that may be contributing to infertility. External factors include environmental or occupational factors, toxins, poor diet, extreme exercise, extreme weight loss, and/or increased age. Toxins can include but are not limited to, tobacco and other drugs. It is important to speak with your healthcare provider about any supplements, medications or drugs that are being taken by either the male or the female, to better understand what external factors may be able to help aid in determining the cause of infertility.