Infertility

A failure to achieve a clinical pregnancy after 12 months or more of regular unprotected intercourse, reflecting impaired fecundity due to female, male, or combined reproductive factors.

Causes

• Female reproductive factors

  • Advanced maternal age with reduced ovarian reserve

  • Ovulation disorders

    • Polycystic ovary syndrome (PCOS)

    • Hypothalamic or pituitary dysfunction

    • Premature ovarian insufficiency

  • Fallopian tube disorders

    • Tubal damage due to Chlamydia trachomatis infection

    • Pelvic inflammatory disease

    • Previous pelvic surgery

    • Tubal obstruction

  • Uterine and pelvic disorders

    • Structural uterine abnormalities

    • Uterine fibroids

    • Endometriosis

    • Intrauterine adhesions

  • Cervical factors affecting sperm transport

• Male reproductive factors

  • Abnormal semen quality

    • Reduced sperm concentration

    • Impaired sperm motility

    • Abnormal sperm morphology

  • Structural abnormalities

    • Obstruction of the vas deferens

    • Epididymal obstruction

    • Congenital absence of the vas deferens

  • Retrograde ejaculation

  • Erectile dysfunction

  • Testicular disorders

    • Varicocele

    • Testicular injury

    • Hormonal disorders affecting sperm production

• Lifestyle and environmental factors

  • Tobacco smoking

  • Excessive alcohol consumption

  • Severe underweight

  • Obesity or severe overweight

  • Poor nutrition

  • Exposure to reproductive toxins

• Infectious and inflammatory causes

  • Untreated sexually transmitted infections

  • Chronic pelvic infections

  • Autoimmune diseases affecting reproductive function

• Treatment-related causes

  • Chemotherapy

  • Radiation therapy

  • Other gonadotoxic treatments

• Genetic abnormalities

• Unexplained infertility despite normal evaluation