Infertility Causes

What causes fertility issues?

Many different factors and problems can cause infertility, including problems in the female reproductive system, the male reproductive system, or a combination of the two.

Center for Minimally Invasive Gynecologic Surgery (MIGS), Newton-Wellesley Hospital
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Female Infertility Causes

The following are some of the conditions or factors that are associated with female infertility:

• Anatomical problems: Anatomical problems: Abnormal development or function of the female anatomy can prevent the egg and the sperm from meeting. The most common anatomical problem is blockage of the fallopian tubes. Other anatomical problems may include the presence of pelvic scar tissue from previous surgeries or infections.


• Birth defects: Abnormal development and function of reproductive organs resulting from birth defects can affect fertility. One of the most common reproductive system birth defects occurs following a woman's exposure to DES (diethylstilbestrol) taken by her mother during pregnancy. In years past, DES was given to women at risk for pregnancy loss. Fetal DES exposure often causes abnormal development of the uterus and cervix.


• Endometriosis: Endometriosis is a condition in which the tissue that lines the uterus develops outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle by building up and breaking down, resulting in small amounts of internal bleeding, which can cause scar tissue to form and affect reproductive organ function.


• Immunological problems: A problem with a woman's immune system can lead to pregnancy loss. Antibodies (immune or protective proteins) in a woman's system can fail to recognize a pregnancy, or there may be an abnormal immune response to the pregnancy.


• Infection: Pelvic inflammatory disease (PID) is caused by bacteria, such as gonorrhea and chlamydia. PID can affect the uterus, fallopian tubes and/or the ovaries. It can lead to pelvic adhesions and scar tissue that develops between internal organs, sometimes causing ongoing pelvic pain and the possibility of an ectopic pregnancy (the fertilized egg becomes implanted outside the uterus).


• Ovulation dysfunction: The woman's reproductive system does not produce the proper amounts of hormones necessary to develop, mature and release a healthy egg.

Male Infertility Causes

The following are some of the conditions or factors that are associated with male infertility:

• Abnormal sperm function: Sperm must have proper motility and the ability to penetrate the egg.


• Birth defects: Abnormalities in a man's reproductive system can occur during fetal development. Some birth defects are due to a man's exposure to DES taken by his mother during pregnancy.


• Chromosomal defects: Certain chromosomal abnormalities are associated with male infertility.


• Hormonal disorders: Improper male hormone or endocrine function can affect sperm production and fertilization ability.


• Immunological problems: A man may have antisperm antibodies (immune or protective proteins) that attack and destroy sperm.


• Lifestyle: Use of recreational drugs (e.g., marijuana, cocaine), heavy alcohol use, cigarette smoking, certain medications, and excessive heat to the genital area (as in hot tubs) can affect sperm quality and function.


• Low or absent sperm production: Without proper numbers of healthy sperm, the chance of fertilization is decreased.


• Varicocele: This is a condition in which varicose veins develop around the testes. It is a very common cause of male factor infertility and is usually treatable and reversible with surgery.

Unexplained Infertility

About 20 percent of couples have unexplained infertility, for which a cause, despite all investigations, is not found. Unexplained infertility does not mean there is no reason for the problem but that the reason is unable to be identified at the present time.

If you suspect you are experiencing infertility, seek medical consultation early. The age of the woman and the duration of the couple's infertility may influence the success of treatment.