CAUSES OF INFERTILITY

causes

When researching causes of the infertility both partners must always be taken into account. The investigation of andrological causes should have priority in order not to expose the woman to unnecessary invasive measures. 50% of the impossibility of pregnancy can be traced back to the female sex, while andrological causes make up a proportion of 30%.

Andrological causes of infertility

Malformations (e.g. lack of Testicles)

Hormonal disorders (e.g. testosterone deficiency due to insufficient Leydig cells, which are responsible for testosteroproduction)

Infection (e.g. mumps) with consequential damage to testicles

Varicocele (formation of Varicose veins in the spermatic cord) with overheating of the temperature-sensitive sperm

psychological causes in the form of functional disorders during sexual intercourse (libido disorder, Erectile dysfunction)

STDs

Diagnosis of andrological causes

Already the physical examination of the infertility By considering the secondary sexual characteristics (e.g. extent of hair growth) and palpation of the testicle, initial conclusions can be drawn about possible undesirable developments. An objective, laboratory test of male fertility is done by creating a Spermiogram.
This enables essential statements to be made about the quality of the ejaculate and the sperm it contains. The ejacute volume (standard: more than 2ml), their pH (norm: 7.2-7.8) and the sperm concentration (standard: more than 20 million / ml) collected.
The Total sperm count got to more than 40 million per ejaculate. These rough parameters are not yet sufficient to classify the man as fertile. The nature of the sperm provides further clues about the quality of the sperm. They play Motility (Agility) and the morphology (Shape) of the sperm plays an essential role. More than half of the sperm must be able to move forward. In addition, less than a third should have atypical shapes and more than half must be vital.

Gynecological causes

gynecological causes of infertility

The causes more feminine infertility lies the anatomy of the female genital organs and the physiology of the Fertilization process underlying.

a) Ovarian infertility (Frequency of 30%)
Here it is important to mention the disruption of the hypothalamic-pituitary axis. The hypothalamus and pituitary are links in a chain that connects the ovary with gonadotropins (Sex hormones) to the formation of follicles and ovulation stimulate. If one of these limbs fails, gonadotropins are not formed, such as the follicle-stimulating hormone (FSH). The function of the ovary is interrupted and no follicles can mature. The cause of the susceptibility of the hypothalamic-pituitary axis is psychological stress and high-performance sport.

b) Tubar conditional infertility (Frequency of 30%)
Inflammatory changes in the fallopian tube mucosa affect the transport of the egg from the ovary to the uterus and can therefore lead to infertility to lead. Because the mucous membrane can be changed in such a way that the fallopian tube can become blocked. These changes are often caused by bacteria like the Chlamydia triggered. Inflammatory processes in the area of the small pelvis form attachments to the tube, which reduces its mobility. The collecting mechanism of the fallopian tube can no longer be guaranteed. Because when ovulating, the egg cell has to be picked up by the funnel in order to be transported further in the fallopian tube.

c) uterine related infertility (Frequency of 5%)
Malformations of uterus in the form of uterine septa represent an obstacle to the implantation of the fertilized egg cell. Damage to the mucous membrane in the uterus, the endometrium, also hinders implantation. The endometrium experiences negative changes from frequent curettages (scraping) or endometritis.

d) cervical sterility (frequency of 5%)
Cervical tears or inflammation are erosive for the patency of the sperm. In particular, the property of the cervical mucus at the time of the woman's ability to fertilize can be changed by a lack of estrogens in such a way that the sperm can continue to rise vagina Remains blocked towards the uterus.

e) vaginal infertility (Frequency of 5%)
Malformations or stenoses prevent sexual intercourse from occurring. Inflammatory processes such as colpitis favor one Premature birth.