The word "infertility" or "sterility" often evokes fear and anxiety in couples dreaming of a child. However, it is important to understand that this is not a verdict, but a medical diagnosis that describes difficulties with conception and, most importantly, has many possible solutions. Infertility is a shared problem of the couple, as its causes can relate to the woman, the man, or both partners simultaneously. This article will help you understand the main causes and symptoms so you know what to look out for.
What is infertility from a medical perspective?
The diagnosis of "infertility" is made if a couple cannot achieve pregnancy after **12 months** of regular sexual intercourse without using contraception. This period shortens to **6 months** if the woman's age is 35 years or older. For more details on when to see a doctor, read the article on identification of fertility problems.
Causes of female infertility
Approximately one third of cases are related to the woman's health.
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Ovulation disorders: This is the most common cause. If the egg does not mature or is not released from the ovary, conception is impossible. This can be caused by:
- Polycystic ovary syndrome (PCOS).
- Hormonal imbalances related to thyroid function or prolactin levels.
- Age-related depletion of ovarian reserve, which we discuss in the article "Age and Fertility".
- Significant weight fluctuations, stress.
These conditions often result in anovulation — a complete lack of ovulation.
- Fallopian tube blockage: After ovulation, the egg travels into the fallopian tube where it meets the sperm. If the tubes are damaged or blocked (e.g., due to past inflammatory processes, infections, or endometriosis), this pathway becomes impossible.
- Uterine pathologies: Structural anomalies of the uterus, fibroids, polyps, or scarring can hinder implantation of a fertilized egg.
- Endometriosis: A condition where tissue resembling the endometrium grows outside the uterus, which can cause inflammation, scar formation, and disrupt the function of the ovaries and tubes.
Causes of male infertility
The male factor also accounts for about one third of all infertility cases.
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Disorders of sperm production or function: This is the most common cause. Problems may involve low concentration, poor motility, or abnormal sperm morphology. Causes can include:
- Varicocele (enlargement of the veins of the spermatic cord).
- Genetic abnormalities.
- Past infections (e.g., mumps).
- Hormonal imbalances.
Read more about this in the article "Fertility: Male and Female".
- Issues with sperm delivery: Blockage of the vas deferens, problems with ejaculation or erection.
- Lifestyle and environmental factors: Testicular overheating, exposure to toxins, smoking and alcohol, use of certain medications.
Combined and unexplained causes
In approximately 10-20% of couples, fertility problems exist in both partners. In another 10-15% of cases, even after comprehensive evaluation, doctors cannot find an obvious cause. This is called **unexplained (idiopathic) infertility**.
Symptoms: What to look out for?
The main symptom of infertility is the absence of pregnancy. However, there are also indirect signs that may indicate possible problems:
- In women: Irregular or absent menstrual cycle, very painful or heavy periods, pain during intercourse.
- In men: Problems with erection or ejaculation, pain or swelling in the testicular area.
If you notice these symptoms in yourself or simply cannot become pregnant within the expected timeframe, do not postpone a visit to the doctor. Modern medicine has a wide arsenal of methods for diagnosis and treatment of infertility, which help thousands of couples become happy parents.
