CAUSES OF INFERTILITY
About 15 to 20% of couples do not become pregnant within 12 months of trying to conceive a child.
Currently around four percent of all births are the result of assisted reproductive technology (ART), including IVF, insemination therapies with donor or partner’s sperm and various surgical options.
Infertility affects males and females in almost equal proportions. A substantial number of patients will have more than one cause of their infertility and it is these multiple causes that often make diagnosis and treatment difficult.
The charts below show some common causes of infertility and how they might be treated. It must be recognized that the majority of infertility treatments do not correct the problem (if known), they merely bypass the problem. Therefore each pregnancy desired will require the same or similar treatments. Also most treatments involve the female partner even if the infertility problem lies with the male partner. The fertility of the male partner, usually measured by a semen analysis, must be considered before starting infertility treatment.
Female Infertility
| CAUSE | INVESTIGATION | TREATMENT OPTIONS |
| Failure of ovulation | Hormone assessments | Fertility drugs (tablets or injections)
IVF Donor eggs/oocytes |
| Blocked or damaged fallopian tubes | Laparoscopy
Hysterosalpinogram (HSG) |
Tubal microscopy
IVF |
| Endometriosis | Laparoscopy | Surgical/ laser treatment
Drug therapy IVF |
| Fibroids | Laparoscopy
Hysteroscopy Ultrasound |
May not need treatment but if necessary can be removed surgically
Ovulation Induction |
| Polycystic Ovaries (PCO) | Hormone assessments
Ultrasound |
Ovulation induction
IVF |
| Unexplained | Hormone assessments | Ovulation induction
IUI (Intrauterine Insemination, also called Artificial Insemination) IVF |
Male Infertility
| CAUSE | INVESTIGATION | TREATMENT OPTIONS |
| Failure of sperm production | Semen analysis
Hormone assessment Chromosome analysis Testicular biopsy |
Surgical sperm collection with ICSI
Donor sperm |
| Blocked or absent vas deferens | Scrotal examination
Ultrasound Screen for cystic fibrosis |
Microsurgery
Surgical sperm collection with ICSI |
| Low sperm count and/or poor sperm movement (motility) | Semen analysis | IUI
IVF ICSI Donor sperm |
| High numbers of abnormal sperm forms | Semen analysis | IVF
ICSI Donor sperm |
| Antisperm antibodies | Antisperm antibody screen | IUI
IVF ICSI |