30% of the causes of infertility in women are premature depletion of ovarian reserve, endometriosis, blockage of or damage to the fallopian tubes, uterine malformations or ovulation problems. 30% on the man's side are due to testicular abnormalities, blockage of the seminal ducts, prostate disease, erectile dysfunction, ejaculation difficulties or changes in the semen analysis. 20% are a combination of male and female factors, and 20% remain unknown.
In women:
- Advanced age – after the age of 35, reproductive capacity gradually begins to decline, and after 42 the probability of becoming pregnant is only 10%. This is mainly due to egg quality.
- Impaired patency of the fallopian tubes is responsible for nearly 25% of the causes of female infertility. In this case we speak of tubal factor infertility. The fallopian tubes “pick up” the egg after ovulation and transport the sperm to it. Fertilisation takes place here. A few days later, the fertilised egg, as it divides, reaches the uterine cavity, where it implants. Partial or complete blockage of the fallopian tubes would prevent this process. Impaired patency may be due to past infections, abdominal surgery (e.g. appendicitis) or endometriosis.
- Endometriosis comes from the word “endometrium” (the lining of the uterus), which in this condition is found outside the uterine cavity, most often in the area of the fallopian tubes, ovaries, uterine ligaments and pelvis, and more rarely in distant organs such as the intestines, bladder or lungs. This tissue is also affected by the hormonal changes that occur during menstruation, which is why the symptoms of endometriosis most often appear during menstruation. Although some patients have no complaints at all, the main symptoms are pelvic pain during menstruation and infertility. As endometriosis progresses, pseudocysts form in the ovaries (consuming ovarian tissue) and adhesions develop reactively between the pelvic organs (the fallopian tubes, for example). A gynaecological ultrasound examination may reveal a so-called chocolate cyst of the ovary, but an accurate diagnosis is only made after laparoscopy. Endometriosis can be treated with medication or surgery.
- Polycystic ovaries – about 20% of women have polycystic ovaries. The name comes from the appearance of the ovaries on ultrasound, where an increased number of cysts can be seen on their surface, which are in fact antral follicles. These women do not have regular ovulation and/or periods.
- Other risk factors for infertility are fibroids, sexually transmitted diseases, chronic diseases, diabetes, thyroid disease, depression, and taking medication or drugs.
