Causes of infertility
Evidence suggests that around 30% of infertility is associated with male factor, 30% to female factor, 20% to combined factors and 20% unexplained factors.
Male Factors
Sperm
The most common fertility issues experienced by men are associated with sperm. The 3 important parameters that WFI will check are:
- Concentration - this is the number of sperm that are produced in the semen sample
- Motility - how well the sperm swim
- Morphology - are they a normal shape or do they have abnormal features such as two sperm heads or two tails.
Issues with any of these parameters can be difficult to solve and therefore, if we are not confident that there will be sufficient sperm to undertake IVF, we may recommend ICSI (Intra Cytoplasmic Sperm Injection) as a way of achieving fertilisation.
Blocked or missing sperm ducts
The ducts that carry the sperm from the testicles (known as the vas deferens) may be missing or blocked resulting in no or low quality sperm being produced in the ejaculate. Should this be the case we may recommend that sperm be collected surgically
Overheating testicles
The testicles produce and store the sperm. If they get too warm the quality and number of sperm can be affected. Overheating can be due to a number of factors: frequent hot baths, tight fitting underwear or sportswear (cycling shorts), frequent use of laptops and even just sitting for long periods of time can all raise testicular temperature. Therefore it is best to avoid these situations if possible.
Alcohol and smoking
Excessive alcohol intake and smoking can both adversely affect sperm number and quality. We strongly recommend abstaining from both if you try to conceive.
Medication
Many types of medication can have an effect on the quality of sperm a man produces, most obvious are those involved in Chemotherapy that can severely reduce the number and quality sperm that are produced and for this reason we recommend freezing sperm before any treatment is undertaken. However other drugs taken routinely for other medical conditions may have an effect and you should discuss these with your clinician when you discuss your treatment.
Anabolic steroids can drastically reduce sperm counts and increasingly WFI has seen an increase in men who have decreased sperm quality which can only be attributed to the use of protein shakes. When men stop using them their sperm quality has dramatically improved.
Female Factors
Ovulation Disorders
There are various causes of ovulation disorders. These may be hormonal in nature, originating in the brain and resulting in incorrect hormone release which the leads to irregular or no ovulation (anovulation). These hormonal effects can be caused or influenced by weight, stress or certain conditions such as PCOS (Poly Cystic Ovarian Syndrome) other ovulation issues may be caused by complete lack of ovaries or premature ovarian failure. Surgery and other treatments such as chemo/ radiotherapy may also lead to ovulation disorders.
Ovulation disorders are often characterised by irregular periods (too frequent or infrequent) although this is not always the case. Your clinician will be able to investigate this further with you, often with use of blood tests and/ or ultrasound scans before deciding on the right form of treatment for you
Uterine and Fallopian tube problems
The Fallopian tubes carry eggs from each ovaries to the uterus (womb) can be damaged or become blocked preventing the eggs ever meeting sperm. Common issues are:
- Adhesions from a previous surgery
- Endometriosis
- Fibroids
- Pelvic Inflammatory disease
If we suspect that you may suffer from any of these issues we may refer you for specialist treatment for the condition Once treated, you clinician will be able to decide the best course of treatment in your particular case.
Alcohol and smoking
Excessive alcohol intake and smoking can both adversely affect female fertility and we strongly recommend abstaining from both if you try to conceive. Being overweight also has an impact on fertility. Patients accessing NHS treatment are required to ensure they are non-smoking, vaping non nicotine and have a BMI within the range of 19-30.
Medication
Many types of medication can have an effect on female fertility, most obvious are those involved in Chemotherapy and for this reason we recommend freezing embryos or eggs before any treatment is undertaken. However, other drugs taken routinely for other medical conditions may have an effect and you should discuss these with your clinician when you discuss your treatment.