How is infertility caused?

Written by Zhang Wei Wei
Integrative Medicine
Updated on January 13, 2025
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Common causes of infertility in women often stem from ovulatory disorders and tubal factors. The common ovulatory disorders mainly include dysfunction of the hypothalamic-pituitary-ovarian axis, ovarian diseases, and endocrine metabolic diseases such as hyperthyroidism or hypothyroidism. Other causes include systemic diseases, chronic consumptive diseases, severe malnutrition, excessive obesity, and excessive thinness. The second aspect involves tubal factors, such as inflammation and blockage of the fallopian tubes leading to infertility. The third aspect is uterine factors, which include poor uterine development, uterine abnormalities, endometritis, and endometrial tuberculosis, all of which can cause infertility. The fourth aspect is cervical factors, including cervical myomas, cervical inflammation, and abnormalities in cervical immunological function. The fifth aspect is factors related to the vaginal and perineal areas, where abnormal development, inflammation, and scarring of the vagina can cause infertility. As for men, the causes of infertility include abnormalities in semen, sexual function, and immunological factors. Immunological factors primarily involve the production of antibodies against one's own sperm in the body, causing ejaculated semen to agglutinate with itself and fail to pass through cervical mucus. Thus, from the perspectives of both men and women, these are the main causes of infertility.

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How many abortions can lead to infertility?

How many abortions lead to infertility is uncertain. Some people become infertile after just one abortion, while others may still be able to conceive normally after four or five abortions. This varies greatly depending on the individual's constitution, their condition after the procedure, and the doctor performing the surgery. Some people have weaker immune systems and may experience infections within the uterine cavity after surgery; such conditions can easily lead to uterine adhesions and blockages in the fallopian tubes, resulting in infertility. Others with stronger immune systems can recover quickly after surgery, generally without impacting their ability to conceive. Inexperienced surgeons might cause damage to the endometrium and uterine adhesions, which can also lead to infertility.

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What are the tests for infertility?

For infertility examinations, men typically undergo a routine semen analysis to check for any abnormalities. If there are abnormalities in the semen analysis, further testing might be needed for conditions such as varicocele or inflammation of the testicles and epididymis. For women, the examinations generally focus on the fallopian tubes to ensure they are patent, usually assessed through hysterosalpingography or a tubal patency test. Additionally, infertility tests include an ultrasound to monitor the follicles and check for any organic diseases in the uterus and ovaries. For women with menstrual irregularities, it's crucial to perform an endocrine test, specifically the six-item sex hormone check, as normal hormonal levels are necessary for regular menstruation and ovulation, and for the normal development of a fertilized egg. Other investigations for infertility might cover immune-related infertility among others, which require specific hospital tests. Moreover, if there has been a previous incidence of miscarriage, tests might include chromosomal analysis, tests for hemolysis, mycoplasma testing, and a set of tests for genetic counseling, all of which are part of the infertility examination process.

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What are the precautions for infertility?

For women with infertility, it is first necessary to determine the survival rate of the man's sperm by conducting a sperm test. Additionally, women need to undergo routine examinations and follicle checks. If there are no issues found, a fallopian tube examination should be done for the woman. In daily life, it is important to ensure adequate sleep and to pay attention to rest and avoid alcohol and tobacco. Furthermore, it is crucial to eliminate tension, adjust one’s mindset, and adopt a positive attitude. Bad habits such as staying up late and pulling all-nighters need to be changed.

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What are the reasons for infertility despite having intercourse during the ovulation period?

The reasons for not getting pregnant despite having intercourse during the ovulation period primarily involve considering whether there is an issue with the male partner’s sperm. Additionally, although it is the ovulation period, the development of the follicles must also be examined. If the follicles are undeveloped, or if they are very small, pregnancy is unlikely in such cases. Moreover, the condition of the fallopian tubes should be checked, as both the egg and the sperm need to travel through these tubes. If the fallopian tubes are blocked, it will prevent pregnancy because the sperm and egg cannot meet, leading to infertility.

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Secondary infertility is how it comes about?

Secondary infertility is when a woman has been pregnant before but has not conceived after a year of not using contraception. The causes of secondary infertility are divided into male factors and female factors. Common male infertility factors include older age or habitual smoking and drinking, leading to decreased sperm quality. Female infertility factors are more numerous, such as excessive sexual activity during reproductive years or weak immune system leading to pelvic inflammatory disease. This inflammation can affect the fallopian tubes, causing blockages and resulting in infertility due to tubal factors; it can also spread to the endometrium, causing endometritis and altering the intrauterine environment, making conception difficult. Some women may suffer from endometriosis, which can also lead to infertility. In some cases, women who have had uterine procedures may experience adhesions in the cervical canal and uterine cavity or abnormal uterine shapes, leading to infertility. Additionally, some women experience significant blood loss after childbirth, leading to pituitary necrosis, hormonal imbalances, and ovulation disorders, which can affect normal conception.