Conceiving a child is considered a normal biological process, nevertheless, it is also true that many couples do face complications along the way. There are common causes of infertility such as increasing age and health issues, however, there are some lesser-known causes that can also make it difficult for one to conceive. Here, we discuss eight factors that can limit couples from achieving pregnancy.
Male infertility
Male factor infertility is a common cause of difficulty in conceiving, accounting for nearly 40-50% of infertility cases. It is often linked to issues such as low sperm count (oligospermia), poor sperm motility (asthenospermia), or abnormal sperm morphology (teratospermia). Obstructions in the male reproductive tract, hormonal imbalances, or genetic conditions like Klinefelter syndrome can also impair fertility. Lifestyle factors, such as smoking, excessive alcohol consumption, obesity, and exposure to environmental toxins, further reduce sperm quality. Infections, such as mumps orchitis or sexually transmitted infections, and conditions like varicocele may damage sperm production. Certain medications, chemotherapy, or radiation therapy can also impact male fertility. Diagnosis involves semen analysis and other investigations, with treatments ranging from lifestyle changes and medication to assisted reproductive techniques like ICSI (intracytoplasmic sperm injection).
Uterine abnormalities
Another cause of pregnancy issues is submucosal fibroids or a misshapen uterus as they can prevent implantation of the fertilized egg. The prenatal uterine septum or the bicornuate uterus may arise from congenital issues or surgeries affecting how much space there is for implantation. 5-10% of women may have major uterine malformations that might render them unable to conceive.
Ovulation disorders
Polycystic ovary syndrome (PCOS) has been included regularly in a broad range of ovulation disorders which can have an effect on the pattern of ovulating hence making it extremely difficult to conceive. Irregular menstrual patterns and hormone changes characterize PCOS, which impacts 6 to 12 percent of women in their reproductive years. Stress, excessive exercise, low body weight are few of the many factors that can worsen the situation and result in irregular menstrual cycles and infertility.
Fallopian tube obstruction
Pelvic infections, intense endometriosis or STDs can lead to obstructions in the fallopian tubes which cause an inability to reach the egg or block transfer of the fertilized egg to the uterus, ultimately leading to decreased chances of conception. Even if fertilization occurs, the eggs can get trapped in the fallopian tubes which would lead to an ectopic pregnancy. Ectopic pregnancy can be life threatening as such pregnancies are unable to be brought to full term.
Mental health
When trying to conceive, a woman can endure stress and anxiety, which in turn becomes detrimental for fertility. Being stressed or anxious can lower one’s fertility through disturbing secretion patterns of several fertility-related hormones. In addition, depression can affect men too, as it can lead to erectile dysfunction which poses a barrier to conception. Education about fertility eases vagueness and empowers couples through the conceiving process, reducing stress and anxiety. Yoga and meditation also help, hence if such activities are incorporated in a routine, they promote relaxation. Seeking support from friends, family, or professional counselors can provide emotional relief and foster open communication about feelings related to fertility
Age-related factors
While many are aware that after 40 years of age, female fertility declines, it is the same even for males. The age factor does make it a lot harder for couples to conceive. Approximately one in six couples faces difficulties conceiving naturally due to age-related factors, highlighting the importance of considering both partners’ ages in fertility planning.
Hormonal imbalances
Women suffering from hormonal disruption due to increased levels of prolactin or cortisol levels experience dysmenorrhea (painful periods) and absence of ovulation. Hyperprolactinemia arises when there is excess prolactin and affects normal menstruation and prevents the ovaries from releasing eggs by hindering the secretion of estrogen. Other than medications, stress or underlying illnesses such as pituitary tumors can also contribute to increasing the imbalance. It is essential for couples facing infertility to undergo hormonal testing to identify and address these issues.
Lifestyle choices
Poor lifestyle habits such as smoking, high alcohol intake, and bad eating habits can reduce fertility in both males and females. It is also important to consider healthy weight maintenance because severe overweight and underweight conditions can influence ovulation frequency.
In conclusion, understanding these unexpected factors is vital for couples facing difficulties in conceiving. By addressing these issues with medical professionals, couples can develop tailored treatment plans that enhance their chances of successful conception.
Endometriosis
Endometriosis can cause infertility through several mechanisms. It often leads to inflammation and scarring in the pelvic region, which can damage the ovaries, fallopian tubes, or uterine lining. Adhesions and endometriotic cysts (endometriomas) may block the fallopian tubes or distort pelvic anatomy, preventing egg and sperm from meeting. The condition can also affect egg quality, implantation, and hormonal balance. Chronic inflammation associated with endometriosis may impair the fertilization process or embryo development. While not all women with endometriosis are infertile, the severity of the condition often correlates with reduced fertility. Treatment options include surgery, medications, or assisted reproductive technologies like IVF.
(Dr. Nandita Palshetkar, Obstetrician, Gynecologist, Medical Director of Bloom IVF, Lilavati Hospital)
