PART IV: WHAT ARE THE COMMON CAUSES OF INFERTILITY?

In recognition of National Infertility Awareness Week, Rocky Mountain Fertility Center is publishing a 7 Part Series on Infertility (one each day).

For Part IV, we discuss the Common Causes of Infertility

There are a number of factors that can cause infertility.  Problems in the female may include tubal damage, lack of ovulation, endometriosis, hormonal imbalances, and fibroids.   The male partner may experience hormonal or anatomic issues that decrease the number of viable sperm.

There are a number of causes of infertility in women and nearly one-third of all cases of infertility involve only a problem in the female partner.  Some of the most common causes include:

• Poor egg quality – Older women and women experiencing menstrual cycles less than 25 days apart often will have problems with egg quality.  Additionally,  woman that have smoked in the past, have a family history of early menopause or ovarian surgery  may experience problems with the eggs or ovaries that make it difficult to conceive.

• Fallopian tube blockages and damage – Inflammation of the fallopian tube, damage and blockage are  a common cause of infertility in women.  Sexually transmitted diseases, endometriosis, or prior pelvic surgery can cause damage to the fallopian tube(s) which make it difficult to conceive.

• Endometriosis – A medical condition causing the growth of uterine lining tissue outside of the uterus is known as endometriosis.  This condition can affect fertility. Endometriosis can be minimal, mild, moderate or severe.  It is often associated with pelvic pain at the time of menstruation. The more severe the disease the harder it will be to achieve pregnancy.

• Fibroids – It has been debated if fibroids can cause infertility. Most experts however believe that fibroids inside the uterus can interfere with implantation of the embryo and prevent the embryo from proper attachment to the uterus.  Fibroids that are small and grow in the wall of the uterus or entirely on the outside are less likely to cause infertility issues.
• Polyps- Uterine polyps have been shown to decrease fertility in several medical studies.  A uterine polyp is an overgrowth of the lining of the uterus. The abnormal cells in the lining of the uterus can effect implantation of the developing embryo.

• Pelvic problems – Inflammation, scar tissue or chronic pelvic infections can lead to fertility issues in women.  Scar tissue buildup and formation can prevent a woman from being fertile. Scar tissue can develop after pelvic surgery, surgery for appendicitis (especially if the appendix ruptured) and bowel surgery.

• Hormonal imbalances – Prolactin levels tend to increase in women who are pregnant or nursing.  However, women who are not pregnant or nursing, and still have high levels of this hormone in their system may be at risk of infertility because the hormone can affect ovulation and implantation. Thyroid imbalances may lead to infertility and increased risk for miscarriage.  Hormonal imbalances can also lead to inability to ovulate on a regular basis. Woman who do not have regular monthly menses more often than not will have hormonal imbalances that lead to the irregular or absent ovulation.

• Age – Men over the age of 50 can be less fertile than younger men.

• Sperm delivery problems – Premature ejaculation, structural problems such as blockage, retrograde ejaculation or genetic diseases (such as cystic fibrosis with congenital absence of the vas deferens) can contribute to sperm delivery problems.

In many of cases of infertility, even after a comprehensive evaluation at a Denver fertility clinic a single factor that causes the couples infertility is not found.  About 30% of couples presenting to an infertility center will have no reason discovered for their difficulty conceiving. However, when the cause of infertility cannot be identified, most couples will achieve pregnancy with fertility treatments.

Dr. Deborah Smith was recently named the top Reproductive Endocrinologist in Colorado by HealthTap. She offers comprehensive treatments in a modern setting for fertility and gynecology issues. Her success rates are very high, and she has received the Patients Choice Award for the past 3 years and is one of the Best Fertility Doctors in country!