Infertility: Types, Causes, Symptoms, Diagnosis & Treatment

Infertility is a condition that affects millions of people worldwide, making it difficult to conceive and carry a pregnancy to term. It can result from a variety of factors, ranging from medical conditions to lifestyle choices. Understanding the causes, types, symptoms and treatment options for infertility is crucial for those who are trying to conceive.

Table of Contents

• What Is Infertility?
• Types of Infertility
• Causes of Infertility
• Diagnosing Infertility
• Symptoms of Infertility
• Can You Get Pregnant with Secondary Infertility?
• How Do I Check My Fertility?
• Fertility Treatment Options
• How Can I Remove Infertility?
• How Do I Know If My Fallopian Tubes Are Blocked?
• Unexplained Infertility
• Endometriosis and Infertility
• Healing from Infertility
• Conclusion

What Is Infertility?

Infertility is defined as the inability to conceive after one year of regular, unprotected intercourse. For women over the age of 35, this timeframe is reduced to six months. Infertility affects both men and women and is not limited to individuals who have never conceived before. Secondary infertility, for instance, refers to difficulty conceiving after previously having a child.

Types of Infertility

There are two primary types of infertility:

Primary Infertility:

This occurs when a person has never been able to conceive despite trying for a significant period.

Secondary Infertility:

This occurs when a person has successfully conceived in the past but is now unable to do so.

Causes of Infertility

Infertility can be caused by various factors affecting either the male or female reproductive systems. In some cases, it may be due to a combination of factors or remain unexplained.

Male Infertility

Male infertility is often linked to issues with sperm. Common causes include:

• Low sperm count: A reduced number of sperm in the semen can affect the chances of fertilisation.

• Poor sperm motility: Sperm that cannot swim effectively may struggle to reach the egg.

• Abnormal sperm morphology: Irregularly shaped sperm may not function properly.

• Blockages or structural issues: Conditions like varicoceles (enlarged veins in the scrotum) can interfere with sperm production or delivery.

• Hormonal imbalances: Low levels of testosterone or other hormonal disorders can impact fertility.

Female Infertility

Female infertility can result from a range of medical conditions and reproductive issues. Four common causes include:

• Polycystic ovary syndrome (PCOS): This hormonal disorder disrupts ovulation and is a leading cause of infertility in women.

• Endometriosis: The presence of endometrial tissue outside the uterus can cause inflammation and scarring, interfering with conception.

• Ovulation disorders: These include irregular or absent ovulation, often caused by hormonal imbalances or conditions like thyroid disease.

• Blocked fallopian tubes: Damage or blockages in the fallopian tubes prevent sperm from reaching the egg and hinder fertilisation.

Diagnosing Infertility

If you are struggling to conceive, seeking an infertility diagnosis is an essential first step. A fertility specialist can conduct tests to identify underlying issues and recommend appropriate treatments.

For Women

• Ovulation tests: Blood tests can check hormone levels to determine if ovulation is occurring.

• Imaging tests: Ultrasound scans or hysterosalpingography (HSG) can assess the uterus, ovaries and fallopian tubes for abnormalities or blockages.

• Laparoscopy: This minimally invasive procedure allows doctors to examine the pelvic organs for signs of endometriosis, scarring or other issues.

For Men

• Semen analysis: This test evaluates sperm count, motility and morphology.

• Hormone tests: Blood tests can detect hormonal imbalances affecting sperm production.

• Imaging: Scans may be used to check for structural abnormalities in the reproductive organs.

Symptoms of Infertility

The most common symptom of infertility is the inability to conceive despite regular attempts. Additional symptoms may vary based on the underlying cause.

For women:

Irregular or absent menstrual cycles, pelvic pain or symptoms of conditions like PCOS or endometriosis.

For men: 

Changes in sexual function, reduced facial or body hair or signs of hormonal imbalances.

Can You Get Pregnant with Secondary Infertility?

Yes, it is possible to overcome secondary infertility with the right treatment. While this condition can be emotionally and physically challenging, seeking help from a fertility specialist can significantly improve your chances of success. Treatments like in vitro fertilisation (IVF) or ovulation induction may be effective, depending on the cause.

How Do I Check My Fertility?

Checking your fertility involves consulting a specialist and undergoing diagnostic tests. For women, fertility can be assessed by tracking ovulation, testing hormone levels and evaluating the reproductive organs. For men, a semen analysis is the primary method for determining fertility.

Home fertility tests are available, but they cannot replace the accuracy and depth of medical evaluations. If you suspect fertility issues, seek professional advice to understand your options.

Fertility Treatment Options

There are a variety of fertility treatment options available, tailored to the specific cause of infertility.

Assisted Reproductive Technology (ART)

ART encompasses several techniques that help couples conceive. The most common form is in vitro fertilisation (IVF) treatment, which involves fertilising an egg with sperm in a laboratory and transferring the resulting embryo to the uterus. Other forms of ART include intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI).

Fertility Drugs

Fertility drugs like clomiphene citrate and letrozole are often prescribed to stimulate ovulation. These medications can be effective for women with ovulation disorders. Injectable hormones may also be used in more advanced treatments.

Surgery

Surgical procedures can address physical issues such as blocked fallopian tubes or uterine abnormalities. In men, surgeries may correct conditions like varicoceles or remove blockages in the reproductive tract.

How Can I Remove Infertility?

Removing infertility often involves addressing its underlying cause. For example, lifestyle changes such as maintaining a healthy weight, reducing stress and avoiding smoking or excessive alcohol consumption can improve fertility in both men and women. Medical treatments like surgery, medication or ART may also be required.

Improving fertility is a journey that often requires patience and support. Fertility specialists can provide guidance and develop personalised treatment plans to increase your chances of conceiving.

How Do I Know If My Fallopian Tubes Are Blocked?

Blocked fallopian tubes can be diagnosed using imaging tests like hysterosalpingography (HSG). This procedure involves injecting a contrast dye into the uterus and fallopian tubes to identify blockages. Alternatively, laparoscopy may be performed for a more detailed examination.

Unexplained Infertility

In some cases, doctors may be unable to identify a specific cause of infertility. This is known as unexplained infertility. While it can be frustrating, many couples with unexplained infertility achieve success through treatments like IUI or IVF.

Endometriosis and Infertility

Endometriosis is a common cause of infertility, affecting up to 50% of women with the condition. Treatment options include medications to reduce inflammation, surgery to remove endometrial tissue or fertility treatments like IVF. Early diagnosis and intervention can improve outcomes for women with endometriosis.

Healing from Infertility

Coping with infertility is an emotional process that requires resilience and support. Seeking counselling or joining support groups can provide a safe space to process feelings and connect with others facing similar challenges.

Taking care of your mental and physical health is essential. Practising stress-reducing techniques like mindfulness, yoga or therapy can improve your overall well-being and potentially enhance your fertility journey.

Conclusion

Infertility can be a challenging and emotional experience, but with the right support and treatment, many individuals and couples can achieve their dream of parenthood. Understanding the causes and types of infertility, as well as seeking a timely diagnosis, is crucial in addressing the condition. From fertility treatment options like IVF to lifestyle changes and surgery, there are numerous paths to overcoming infertility.

If you are struggling to conceive, consult a Lenmed fertility specialist to explore your options and develop a personalised plan.

With advances in assisted reproductive technology and a compassionate approach to care, hope and healing are within reach.

For more information, please contact:

Dr L Brits
Discipline: Gynaecologist, Obstetrician
Hospital: Royal Hospital and Heart Centre
Telephone: +27 53 045 0557