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.

Other Voices

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Written by Li Li Jie
Obstetrics and Gynecology
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Can a ruptured corpus luteum lead to infertility?

The destruction of corpus luteum cells can lead to infertility. The most common issue is the obvious rupture of the corpus luteum, accompanied by excessive pelvic fluid, which requires surgical treatment. Post-surgery, there could be pelvic adhesion, leading to partial fallopian tube adhesion, which may result in blockages or obstructions in the fallopian tubes. Therefore, during pregnancy, an ectopic pregnancy may occur, and even infertility, particularly in some women who do not seek timely medical treatment after a corpus luteum rupture. This leads to the spread of pelvic inflammatory disease, which may even develop into chronic pelvic inflammatory disease. It is essential to be cautious and avoid vigorous physical activities to prevent the dangerous rupture of the corpus luteum.

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Written by Kang Jian Hua
Reproductive Center
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What should infertile women check for?

The examination of infertile women mainly includes the following aspects. First is the physical examination, which covers a general examination and an examination of the internal and external genitalia. Through the physical examination, it can be determined whether the female sexual characteristics are normal and whether there are any abnormalities in the development of the external genitalia. The second type of examination is auxiliary examination, the most common of which are blood tests and ultrasound exams. Blood tests can provide information on whether there is any infection, the type of blood, and the endocrine situation. They can also examine chromosomal conditions. Through ultrasound, it is possible to find out if there are any abnormalities in the uterine adnexa. Additionally, there are some special tests, including ovarian function tests, fallopian tube patency tests, hysteroscopy, laparoscopy, and post-coital tests, among others.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Secondary infertility refers to a condition where a person is unable to become pregnant or carry a pregnancy to term following the birth of one or more biological children.

Infertility is divided into primary infertility and secondary infertility. Primary infertility refers to never having been pregnant before, which is called primary infertility. Secondary infertility generally occurs in individuals who have had children or a history of miscarriage and have been unable to conceive again after trying for a year, thus constituting secondary infertility. It is essential for those with secondary infertility to undergo relevant fertility tests at a hospital. Typically, the clinical evaluation includes a semen analysis for the male partner, and for the female partner, tests such as Mycoplasma and Chlamydia detection, endocrine examinations, immunological tests, and assessments for fallopian tube patency and related endocrine tests. Generally, through these tests, the cause of secondary infertility can be identified, and treatment can be tailored based on the results. In cases of secondary infertility, the vast majority can achieve conception through targeted treatment.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Is infertility immunotherapy effective?

Infertility immunotherapy is effective, first looking at the cause of infertility. If infertility arises due to immune dysfunction, immunotherapy can be employed for targeted treatment at that time. If it is caused by fallopian tube blockage, tubal hydrotubation can be performed, followed by further fallopian tube treatment. Furthermore, if infertility is caused by anovulation of the ovaries, initially monitor the follicles via ultrasound. If indeed the follicles are not ovulating, medication can be used to stimulate ovulation. If infertility is caused by endocrine disorders, it is essential to regulate the endocrine system accordingly. Therefore, whether infertility immunotherapy is useful depends on the cause. If infertility occurs due to immune dysfunction, immunotherapy can be effective. If infertility is caused by other reasons, immunotherapy will be ineffective, hence it is crucial to evaluate the situation accordingly.

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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.