How does infertility arise?

Written by Zhao Min Ying
Reproductive Medicine
Updated on January 22, 2025
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Couples who live together and have normal sexual relations without any contraceptive measures for over a year are diagnosed with female infertility in the case of the woman, and male infertility in the case of the man. Infertility is related to many factors. For men, the main factors are abnormalities in the semen, which include low sperm count, weak sperm motility or even a complete absence of sperm, as well as sexual dysfunction, where various factors prevent the completion of normal sexual activities. For women, the main factors include, first, ovulatory disorders, which are primarily abnormalities in menstruation, although some may have normal menstruation but still experience ovulatory disorders. Second, factors related to the fallopian tubes; these can include previous conditions like pelvic inflammatory disease, appendicitis, etc., or infections caused during procedures involving the uterine cavity leading to blockages in the fallopian tubes, which can be diagnosed via hysterosalpingography. Third, conditions such as endometriosis and adenomyosis, which can also affect the chances of pregnancy. Fourth, factors related to the uterus, such as uterine fibroids, polyps, and malformations, which can create barriers to pregnancy. Lastly, some immunological factors, including antisperm antibodies or other antibody factors, etc.

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Written by Zhang Lu
Obstetrics
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Why does endometriosis cause infertility?

Endometriosis is a common cause of infertility. The reasons endometriosis leads to infertility mainly include the following aspects: First, if endometriosis occurs above the ovaries, this condition is referred to as ovarian chocolate cysts. This disease can cause ovarian ovulation disorders. Second, endometriosis easily leads to pelvic adhesions, which can affect the function of the fallopian tubes, making it difficult for the fimbrial end of the tubes to capture eggs. Endometriosis is very common among women with infertility; therefore, a thorough examination is essential when screening for causes of infertility. If endometriosis is present, surgical or medical treatment should be chosen to improve the symptoms of endometriosis as much as possible and alleviate the causes of infertility.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Can low estrogen cause infertility?

If a woman's blood test reveals low estrogen levels, it may affect normal conception. Firstly, with low estrogen levels throughout the menstrual cycle, there can't be a peak change, which may lead to abnormal ovulation or anovulation. Additionally, if estrogen levels are low, the endometrium cannot proliferate effectively, leading to insufficient endometrial thickness and making it difficult for the fertilized egg to implant. Some women may conceive despite these issues; however, due to insufficient hormone levels, they may experience abdominal pain, vaginal bleeding, threatened miscarriage, or even arrested fetal development.

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Written by Jia Rui
Obstetrics and Gynecology
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Can cold in the uterus cause infertility?

Cold in the uterus can lead to infertility. It can affect the vitality of sperm and create an environment unsuitable for fetal development. Women with cold in the uterus should avoid getting cold, especially avoid eating cold drinks and cold foods during menstruation and can eat more blood-nourishing foods like donkey-hide gelatin and deer antler glue after menstruation. There are many treatment methods for cold in the uterus, including using Chinese medicine to warm the kidneys and dispel cold, as well as external application of Chinese medicine and acupuncture. During menstruation, patients with cold in the uterus should eat more walnuts, dates, and peanuts to nourish qi and warm the body.

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Written by Zhang Lu
Obstetrics
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How long does it take to be considered infertile when trying to conceive?

Pregnancy for women requires a certain amount of time to be successful, and if one cannot become pregnant in the short term, it does not necessarily mean infertility. It could be due to irregular ovulation or incorrect timing of sexual activity. In clinical practice, it is generally considered that if one has been trying to conceive normally without deliberate contraception and still cannot become pregnant after a year, then infertility should be diagnosed. For cases where conception hasn't occurred after a year of trying, examinations should be carried out for both partners to determine if there are any pathological factors. First, the male partner should have chromosome and sperm analysis; Second, the female partner should be checked for chromosomal infections, immune factors, rheumatology factors, etc. After clearly identifying the reasons, interventions should be made as much as possible to guide normal conception.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Does taking contraceptive pills cause infertility?

Contraceptives are categorized into short-acting, long-acting, or emergency contraceptives. Commonly, long-acting contraceptives, such as those taken orally once a month, have significant side effects. Prolonged use can lead to menstrual irregularities, facial pigmentation, hyperpigmentation, and amenorrhea. Therefore, long-term use of long-acting contraceptives may result in decreased ovarian function, leading to infertility. Generally, emergency contraceptives and short-acting contraceptives have relatively minor side effects. Occasional use does not have a significant impact, but prolonged use can cause menstrual disorders and hormonal imbalances, which in turn can lead to infertility. Thus, contraceptives are not suitable for everyone, and it is not recommended for women who have never given birth to use oral contraceptives for contraception.