Infertility is common, affecting up to 12 percent of couples in the United States.  The causes of infertility are commonly divided by the organ system affected. For example, tubal factor infertility is caused by conditions that interfere with the eggs successful transport through the fallopian tubes from the ovaries to the uterus.  Other causes include uterine factor, cervical factor, ovarian factor, ovulatory disorders, endometriosis, unexplained infertility, and male infertility.

Our infertility causes Web pages are linked from the topics below and we have separate Web pages devoted to infertility treatments.

Infertility Causes

Cervical Factor - Cervical factor infertility is caused by the presence of antisperm antibodies in the female that seek to destroy sperm as if they were bacteria, viruses, or other pathogens. Rarely, antisperm antibodies exist in the male. The mucus may be too thick or thin or be in insufficient quantities. Cervical factor is often treated using intrauterine insemination (IUI) because it avoids the cervical mucus.

Ovulatory/Ovarian Factor - Each month ovulation of an egg(s) occurs after recruitment and development of healthy follicles (each containing an egg) on the ovaries. The ovulatory cycle is controlled by several reproductive hormones, the levels of which are monitored by the hypothalamus.  The hypothalamus instructs the pituitary to increase or decrease production of FSH, LH, and estrogen based upon hormonal feedback. Conditions affecting the levels of reproductive hormones can lead to anovulation (no ovulation) or oligoovulation (irregular ovulation). Two of these conditions are PCOS and hyperprolactenemia.

Ovarian Factor – Ovarian factor relates to the viability of the eggs within the ovaries.  Low ovarian reserve, usually evidenced by abnormally high FSH levels, means that the eggs are declining in quality and will not fertilize and develop as readily as normal eggs. When ovarian failure occurs the eggs have lost their capacity to develop into healthy embryos. The only reproductive option for women with ovarian failure is to use a donor’s eggs.

Endometrial Development Luteal Phase Defect - Progesterone is needed for the endometrium to thicken and provide nutrition and support to an embryo.  When the endometrium fails to develop it is sometimes due to a luteal phase defect.  The luteal phase is the part of the ovulatory cycle when the endometrium usually develops under the influence of progesterone.  This condition is often treated with additional progesterone administered to support endometrial development.

Endometriosis is a common cause of infertility.  Endometrial cells, which rapidly divide and grow, attach to organs such as the tubes, uterus, or ovaries and can create damage even penetrating the organ. Endometrial implants have been found throughout the body. Endometriosis is much more common in patients with infertility, and can impair fertility even when there is mild disease.  All of the mechanisms by which endometriosis affects fertility are still unknown.

Uterine Factor - The uterus must be regularly shaped and free of obstructions. Uterine abnormalities can lead to increased miscarriage.

Unexplained Infertility - Sometimes no cause for a couple’s infertility can be identified. Treatment depends upon many factors such as female age, previous treatment history, etc.

Male Factor Infertility - Male infertility is much more common than once believed being present in up to half of all infertile couples.  The semen analysis is a mandatory fertility test which must be done prior to female treatment. Causes of male infertility include environmental, immune, a varicocele, and others.  Effective treatments include IVF with ICSI or in some cases, the use of a sperm donor.

The infertility treatments section of this web site contains the latest treatments recommended for the conditions linked above. Also, be sure and visit the staff section which details the extensive experience of our infertility specialists.