Trying to conceive can be an exciting time, but for some individuals and couples, pregnancy does not happen as expected. Infertility can have many possible causes, and it can affect either partner or both partners. Understanding the potential causes can be an important first step toward seeking appropriate medical advice.
If you are concerned about fertility, a professional evaluation can help identify factors that may be affecting your ability to conceive. Depending on the findings, treatment may involve lifestyle changes, medication, procedures, assisted reproductive techniques, or a combination of approaches.
In this guide, we explore the common causes of infertility in men and women, when to consider an evaluation, and what a fertility assessment may involve.
What Is Infertility?
Infertility is a condition affecting the reproductive system. The World Health Organization defines it as the inability to achieve pregnancy after 12 months or more of regular, unprotected sexual intercourse. Infertility may be related to factors involving the female reproductive system, the male reproductive system, both, or sometimes no identifiable cause.
Infertility can be classified as primary or secondary. Primary infertility refers to difficulty achieving a pregnancy when there has not previously been a pregnancy, while secondary infertility refers to difficulty achieving another pregnancy after a previous pregnancy.
Importantly, infertility is not always caused by a single problem. Several factors can sometimes contribute to difficulty conceiving, which is why a comprehensive evaluation of both partners can be important.
What Is Unexplained Infertility?
Sometimes fertility investigations do not identify a clear cause even after appropriate testing.
This is known as unexplained infertility.
It does not mean that the fertility problem is imaginary or that pregnancy is impossible.
Common Causes of Infertility in Women
Female infertility can result from problems involving ovulation, the fallopian tubes, uterus, ovaries, hormones, or other aspects of reproductive health.
Some of the most common factors include the following.
1. Ovulation Problems
Ovulation occurs when an ovary releases an egg. Regular ovulation is important for natural conception.
Problems with ovulation can make it difficult to become pregnant because an egg may not be released regularly or may not be released at all.
Conditions associated with ovulatory problems can include:
- Polycystic ovary syndrome (PCOS)
- Certain hormonal disorders
- Thyroid disorders
- Problems involving the hypothalamus or pituitary gland
- Reduced ovarian function
Irregular or absent menstrual periods can sometimes be a sign that ovulation is not occurring regularly. However, menstrual patterns alone cannot determine the cause, so medical assessment may be necessary.
2. Age-Related Changes in Fertility
Age is an important factor in female fertility.
Female fertility generally declines with increasing age, with the decline becoming more significant as a woman gets older. This is one reason fertility specialists may recommend earlier evaluation for women in older age groups.
Age can affect both the number and quality of available eggs. It can therefore influence the likelihood of conception and pregnancy.
This does not mean that pregnancy is impossible at an older age. Rather, it means that fertility evaluation and appropriate medical guidance may become increasingly important.
3. Blocked or Damaged Fallopian Tubes
The fallopian tubes provide a pathway through which an egg and sperm can meet.
If the tubes are blocked or damaged, fertilization may be affected. Tubal problems can occur because of previous pelvic infections, certain sexually transmitted infections, endometriosis, or previous pelvic or abdominal surgery.
A fertility evaluation may include tests that assess whether the fallopian tubes are open.
4. Endometriosis
Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. It can affect the reproductive organs and may be associated with difficulty conceiving.
The condition can sometimes affect the fallopian tubes, ovaries, or surrounding pelvic structures.
Not every person with endometriosis will experience infertility, but when pregnancy is difficult to achieve, endometriosis may be considered as part of the evaluation.
5. Uterine Conditions
Conditions affecting the uterus may sometimes interfere with fertility.
Examples include:
- Uterine fibroids
- Certain congenital uterine abnormalities
- Polyps
- Inflammation or scarring
The effect of these conditions on fertility varies depending on their location, size, and other individual factors.
Ultrasound and other imaging procedures may be used when appropriate to assess the uterus and other reproductive structures.
6. Hormonal and Endocrine Conditions
Reproductive hormones play an important role in ovulation and the menstrual cycle.
Problems involving hormones produced by the thyroid, pituitary gland, ovaries, or other parts of the endocrine system may affect fertility.
Depending on a person’s symptoms and medical history, a fertility specialist may recommend blood tests to evaluate hormone levels.
Can Lifestyle Factors Affect Fertility?
Lifestyle is only one part of fertility, but certain habits and health factors may influence reproductive health.
Factors associated with fertility problems can include:
- Smoking
- Excessive alcohol consumption
- Certain recreational drug use
- Obesity
- Being significantly underweight
- Poor overall health
- Exposure to certain environmental toxins
WHO notes that smoking, excessive alcohol intake, obesity, and exposure to environmental pollutants or toxins can affect fertility.
However, lifestyle factors should not automatically be assumed to be the cause of infertility. Fertility problems can have medical, anatomical, hormonal, genetic, or unexplained causes.
That is why professional evaluation is important rather than relying on lifestyle changes alone.
Can Lifestyle Factors Affect Fertility?
The evaluation is usually tailored to the individual or couple.
It may begin with a detailed discussion about:
- Medical history
- Reproductive history
- Menstrual cycles
- Previous pregnancies
- Previous surgeries
- Medications and supplements
- Lifestyle factors
- Family history
- Previous infections
- How long you have been trying to conceive
Depending on the circumstances, additional investigations may be recommended.
Tests for Women
Possible investigations can include:
- Blood tests
- Hormonal evaluation
- Ovulation assessment
- Ultrasound
- Assessment of ovarian reserve
- Tests to evaluate the fallopian tubes
- Other procedures when clinically indicated
Not every patient needs every test. The evaluation should be based on the individual’s medical history and clinical findings.
Common Causes of Infertility in Men
Infertility is not only a female health concern. Male factors can contribute to infertility, either independently or together with female factors.
WHO identifies problems involving sperm production, sperm quality, sperm movement, sperm shape, semen ejaculation, and reproductive tract obstruction among possible causes of male infertility.
1. Low Sperm Count
A low sperm count means that fewer sperm are present in the semen than expected.
Because conception requires sperm to reach and fertilize an egg, reduced sperm numbers can make conception more difficult.
A semen analysis is commonly used to assess sperm concentration and other semen characteristics.
2. Reduced Sperm Motility
Sperm motility refers to the ability of sperm to move effectively.
Sperm need appropriate movement to travel through the female reproductive tract and reach the egg. Reduced motility may therefore affect the likelihood of natural conception.
3. Abnormal Sperm Morphology
Morphology describes the size and shape of sperm.
Some sperm may have structural differences that can affect their ability to function normally. A semen analysis can provide information about sperm morphology alongside other parameters.
4. Hormonal Problems
Hormones are involved in sperm production and male reproductive function.
Disruptions involving hormones produced by the hypothalamus, pituitary gland, or testes can affect sperm production.
Depending on the clinical situation, a fertility specialist may recommend hormone testing as part of a broader evaluation.
5. Blockages in the Reproductive Tract
Blockages can interfere with the movement or ejaculation of sperm.
These may occur in structures involved in transporting semen. Previous infections, injuries, or certain medical conditions can sometimes contribute to reproductive tract obstruction.
6. Testicular Conditions
The tests are responsible for producing sperm and testosterone.
Conditions affecting testicular function can therefore influence fertility. Varicoceles, certain injuries, infections, genetic conditions, and some medical treatments may be associated with impaired sperm production.
A medical evaluation can help determine whether a testicular or hormonal factor may be involved.
- Letrozole
- Clomiphene Citrate
- Gonadotropin injections
For many women with PCOS, these treatments can be the initial medical step within Infertility Treatment in Dubai.
IVF Treatment for PCOS Patients
For women who don’t respond to medication, or who have other fertility concerns on top of that, IVF treatment in Dubai can be a solid, effective option.
In Vitro Fertilization (IVF) basically works like this,
- Stimulating the ovaries to produce multiple eggs
- Retrieving mature eggs
- Fertilizing eggs in a laboratory
- Transferring healthy embryos into the uterus
A lot of the more modern fertility clinics in Dubai use advanced embryo picking methods, together with tailored treatment plans. Because of that, quite a few women who have PCOS are able to get to successful pregnancies through IVF. Doctors also watch hormone levels very carefully all the way through the whole cycle, so some complications are less likely and the overall outcomes usually end up better.
Can Infertility Affect Both Partners?
Yes.
Infertility can result from:
- A female factor
- A male factor
- Factors affecting both partners
- An unexplained factor
It is therefore not appropriate to assume that infertility is caused by the woman or the man alone.
A fertility assessment may involve evaluating both partners so that potential contributing factors are considered together. ASRM guidance also recommends parallel evaluation of the male partner when applicable.
This approach can help avoid unnecessary delays and ensure that treatment planning is based on the complete clinical picture.
When Should You Consider an Infertility Evaluation?
A fertility evaluation may be appropriate when pregnancy has not occurred after a period of regular, unprotected intercourse.
In general, an evaluation is recommended after 12 months of trying to conceive for women under 35. For women aged 35 or older, evaluation is generally recommended after 6 months of trying. Women over 40 may benefit from more immediate evaluation.
Earlier evaluation may also be appropriate when there are known or suspected fertility-related conditions.
Examples include:
- Irregular or absent periods
- Known or suspected endometriosis
- Previous pelvic surgery
- Known reproductive tract problems
- Previous chemotherapy or radiation
- Suspected male-factor infertility
- Sexual dysfunction
- A history of conditions known to affect fertility
You do not necessarily need to wait 6 or 12 months if there is already a known medical concern.
Tests for Men
A semen analysis is an important part of evaluating male fertility.
It can assess characteristics such as:
- Sperm concentration
- Sperm movement
- Sperm morphology
- Semen volume
Additional hormone testing or other investigations may be recommended depending on the findings and medical history.
How Is Infertility Treated?
Treatment depends entirely on the cause, the age and health of the individuals involved, reproductive history, and other clinical factors.
Potential approaches may include:
Lifestyle and Medical Management
Where appropriate, addressing certain health or lifestyle factors may form part of fertility care.
Medication
Medication may be recommended for certain hormonal or ovulatory problems.
Surgical Treatment
Some structural problems, such as certain blocked tubes, endometriosis, fibroids, or male reproductive conditions, may sometimes be treated surgically.
Assisted Reproductive Treatment
Depending on the circumstances, assisted reproductive techniques such as intrauterine insemination (IUI) or in vitro fertilization (IVF) may be considered.
IVF involves fertilization outside the body followed by transfer of an embryo as part of the treatment process.
The appropriate option should be determined by a fertility specialist after evaluating the individual circumstances. A treatment that is appropriate for one couple may not be appropriate for another.
Infertility Treatment in Dubai at Lakeshore Clinic
If you are looking for Infertility Treatment in Dubai, a proper evaluation should be the starting point rather than choosing a treatment based only on general information.
At Lakeshore Clinic, patients can discuss their fertility concerns with a medical professional and receive guidance based on their individual circumstances.
A fertility consultation can help you understand:
Possible causes of difficulty conceiving
Whether fertility testing may be appropriate
Which investigations may be recommended
Potential treatment options
Whether further specialist fertility care is required
Treatment decisions should always be made after appropriate medical assessment.
FAQs
Ovulation problems are among the common causes of female infertility. Other factors can include fallopian tube problems, endometriosis, uterine conditions, age-related fertility changes, and hormonal disorders.
Male infertility is commonly associated with problems involving sperm production or sperm function. These can include low sperm count, reduced motility, or abnormal sperm morphology.
Yes. Fertility factors may affect one partner or both partners, which is why evaluating both individuals can be important.
Many forms of infertility can be managed or treated, depending on the underlying cause. Treatment may involve medication, surgery, lifestyle changes, or assisted reproductive techniques. Sometimes no specific cause is identified, but treatment may still be possible.