Infertility affects approximately 1 in 6 couples worldwide, making it more common than you might think. Although it’s a sensitive topic surrounded by doubts, understanding its possible causes can relieve anxiety and provide a clearer path. Below you’ll find the most frequent diagnoses in men and women, their causes, symptoms, and available treatments.
Main causes of female infertility
In women, infertility usually stems from issues with ovulation, egg quality, or reproductive structures. These are the most common causes:
1. Polycystic ovary syndrome (PCOS)
PCOS affects 1 in 10 women of reproductive age. It’s a hormonal disorder that interferes with ovulation, causing irregular or absent cycles and small cysts on the ovaries.
Symptoms:
- Irregular or absent menstrual periods
- Excess hair growth (hirsutism)
- Acne or oily skin
- Weight gain or difficulty losing weight
Treatments:
- Ovulation induction with clomiphene or letrozole
- Lifestyle changes: balanced diet, exercise, and weight loss
- In vitro fertilization (IVF) if medications are ineffective
2. Endometriosis
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, affecting 10% of women. It causes pain, inflammation, and adhesions that can block the tubes or damage egg quality.
Symptoms:
- Severe menstrual pain
- Pain during intercourse
- Chronic pelvic pain
- Heavy menstrual bleeding
Treatments:
- Laparoscopic surgery to remove adhesions
- Hormonal therapies: oral contraceptives or GnRH agonists
3. Diminished ovarian reserve (DOR)
DOR means fewer or lower-quality eggs. It can result from age, genetics, illnesses, or surgeries.
Symptoms:
- Shorter menstrual cycles
- Poor response to ovarian stimulation
- No obvious symptoms until difficulty conceiving
Treatments:
- Ovarian stimulation in IVF to retrieve more eggs
- Egg cryopreservation at a younger age
- Egg donation in severe cases
Common diagnoses in male infertility
Men account for 40%–50% of cases. The main issues affect sperm production, function, or transport.
1. Low sperm count (oligospermia)
Defined as fewer than 15 million sperm per mL. It can be due to hormonal imbalances, genetic conditions, varicocele, or exposure to heat and toxins.
Treatments:
- Lifestyle changes: reduce alcohol and quit smoking
- Hormone therapy to correct imbalances
- Varicocele surgery
- IVF with ICSI to fertilize the egg directly
2. Low sperm motility (asthenospermia)
Sperm can’t swim properly, so they don’t reach the egg. Causes include infections, antibodies, and genetic abnormalities.
Treatments:
- ICSI to bypass motility issues
- Sperm selection techniques, such as PICSI
3. Genetic abnormalities
Genetic defects can affect sperm production. Genetic counseling and specific tests help identify the issue. With PGT-M, embryos are analyzed before transfer.
Unexplained infertility: what to do?
Accounts for 10–15% of cases when no visible cause is found. Options include lifestyle changes, timing intercourse on fertile days, IUI, or IVF.
When to see a specialist:
- Under 35: after 12 months of trying
- Over 35: after 6 months
- With risk factors: as soon as possible
Understanding each diagnosis and treatment empowers you on this journey. Consult a reproductive specialist for the appropriate support and guidance. We’re with you every step of the way.