Common Infertility Diagnoses: What You Need to Know

Infertility affects approximately 1 in 6 couples globally, making it a far more common challenge than many might think. Despite its prevalence, infertility remains a sensitive and often misunderstood topic. Understanding the potential causes of infertility can help alleviate some of the anxiety surrounding the process, while also providing a clearer path forward. This article will outline some of the most common infertility diagnoses for both men and women, explaining their causes, symptoms, and available treatment options.

Infertility in Women

Infertility in women can stem from a variety of conditions that impact ovulation, egg quality, or the reproductive organs. Below are some of the most frequently diagnosed causes:

1. Polycystic Ovary Syndrome (PCOS)

PCOS is one of the most common causes of infertility, affecting approximately 1 in 10 women of reproductive age. This hormonal disorder disrupts normal ovulation, often resulting in irregular or absent menstrual cycles. Additionally, women with PCOS may develop small cysts on their ovaries, although not all women with the condition will experience this symptom.
Symptoms:

• Irregular or missed periods
• Excess hair growth (hirsutism)
• Acne or oily skin
• Weight gain or difficulty losing weight

Why It Causes Infertility:
PCOS leads to an overproduction of androgens (male hormones), which interfere with the development and release of eggs during ovulation. Without regular ovulation, conception becomes difficult.

Treatment Options:

• Ovulation induction with medications such as clomiphene citrate or letrozole.
• Lifestyle changes like weight loss, exercise, and a healthy diet can improve ovulation.
• In vitro fertilization (IVF) may be recommended for women who do not respond to medication or have additional fertility factors.

2. Endometriosis

Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, often on the ovaries, fallopian tubes, and pelvic lining. This condition affects about 10% of women globally and can cause pain, inflammation, and scar tissue, all of which may interfere with fertility.
Symptoms:

• Painful periods (dysmenorrhea)
• Pain during intercourse
• Chronic pelvic pain
• Heavy menstrual bleeding

Why It Causes Infertility:
Endometrial tissue can block the fallopian tubes, preventing the egg and sperm from meeting. In severe cases, it can also affect the ovaries, leading to the formation of cysts that impair egg quality.

Treatment Options:

• Laparoscopic surgery to remove scar tissue and lesions.
• Hormonal treatments like birth control pills or GnRH agonists to manage symptoms.

3. Diminished Ovarian Reserve (DOR)

DOR refers to a lower number or quality of eggs in the ovaries, which naturally occurs with age but can also result from genetic factors, medical conditions, or previous surgeries.

Symptoms:

• Shortened menstrual cycles
• Poor response to ovarian stimulation during fertility treatments
• No noticeable symptoms until conception is difficult

Why It Causes Infertility:
Fewer eggs mean fewer chances for successful fertilization and implantation. Egg quality is also critical, as chromosomal abnormalities increase with age.

Treatment Options:

• Ovarian stimulation to maximize the number of eggs retrieved during IVF.
• Egg freezing (vitrification) at a younger age.
• Donor eggs may be recommended if the ovarian reserve is extremely low.

Infertility in Men

Male infertility accounts for nearly 40-50% of all infertility cases. The most common causes involve issues with sperm production, function, or delivery.

1. Low Sperm Count (Oligospermia)

Oligospermia refers to a sperm count below the normal range, which is typically defined as fewer than 15 million sperm per milliliter of semen.

Causes:

• Hormonal imbalances
• Genetic conditions
• Varicocele (enlargement of veins within the scrotum)
• Exposure to heat, toxins, or radiation

Treatment Options:

• Lifestyle changes such as reducing alcohol intake and quitting smoking.
• Hormonal therapy to address imbalances.
• Surgical repair of varicoceles.
• IVF with ICSI (intracytoplasmic sperm injection) to fertilize eggs directly.

2. Poor Sperm Motility (Asthenospermia)

Even if sperm count is normal, poor motility (movement) can prevent sperm from reaching and fertilizing the egg.

Causes:

• Infections or inflammation
• Antibodies attacking sperm
• Genetic abnormalities

Treatment Options:

• ICSI during IVF to bypass the motility issue.
• Sperm selection techniques like PICSI, which filter the most viable sperm.

3. Genetic Abnormalities

Genetic factors can impair sperm production, leading to infertility.

Treatment Options:

• Genetic counseling and testing.
• PGT-M (Preimplantation Genetic Testing for Monogenic/Single Gene Defects) to screen for specific disorders

Unexplained Infertility

Sometimes, despite thorough testing, no clear cause of infertility is found. This accounts for 10-15% of infertility cases.

Treatment Options:

• Lifestyle changes
• Timed intercourse
• IUI or IVF

When to Seek Help

• Women under 35: After 1 year of trying to conceive.
• Women over 35: After 6 months.
• Men and women with risk factors: Sooner rather than later.

Empowering Your Journey

Infertility is a challenge, but with the right support and medical advances, parenthood is often possible. Taking the first step toward diagnosis and treatment is key to finding the best path forward.