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Infertility- Causes and Treatments

The major causes of infertility are divided into several categories and are discussed in detail throughout our Web site:

  • Male factor Infertility- Some degree of male factor is present in approximately 50% of infertile couples and occurs when the male cannot produce and ejaculate a sufficient number of sperm that can reach, penetrate and fertilize an egg. Male factor is a major cause of infertility.

  • Ovarian Factor Infertility- The ovary contains a full complement of eggs at birth and an egg develops within an ovarian follicle during each menstrual cycle. Sometimes, ovulation does not occur (an ovulation) or is irregular (oligoovulation) and is most often due to hormonal imbalances. Polycystic ovarian disease is a common cause of infertility. Some medical treatments such as chemotherapy or high dose radiation therapy can damage the ovary. Additionally, some women are born with eggs that do not fertilize properly for unknown reasons. Ovarian factor is present in approximately 30% of sub fertile females.

  • Endometriosis- Endometriosis is a major cause of infertility and can be present with or without symptoms. Endometriosis occurs when the cells that normally line the endometrium enter the pelvic cavity and adhere to internal organs. Endometriosis can penetrate, obstruct, and otherwise damage organs such as the tubes, ovaries and uterus. The presence of endometriosis also causes an inflammatory response which can impair fertility.

  • Cervical Factor Infertility- Sperm travel through the cervical fluid, where they are nourished and supported, to reach the uterus. Sometimes the female's immune system mistakenly identifies the sperm as invading pathogens (virus, bacteria, etc.) and seeks to destroy them in an antigen antibody reaction. The mucus must also be of the appropriate consistency to facilitate sperm passage.

  • Tubal Factor Infertility- If the tubes are damaged, the eggs cannot travel from the follicles to the site of fertilization at the end of the fallopian tubes. Damage to the tubes may occur from pelvic inflammatory disease, endometriosis, genetic abnormalities or other causes.

  • Uterine Factor- Rarely, a woman may be born with structural abnormalities of the uterus that prevent implantation of the embryo and support of the developing fetus. In many cases, these conditions can be treated surgically; however, sometimes a surrogate mother must be used to carry the fetus to term.

  • Idiopathic or Unknown Factors- In a significant percentage of cases, no specific cause for a couple's infertility can be identified. This does not mean there is no cause; rather, science has not advanced to the point where it can be identified.

Fortunately, the majority of conditions causing infertility can be effectively treated medically or surgically. Most women become pregnant using first line therapies such as medication and/or intrauterine insemination. When these therapies fail, assisted reproductive technologies such as IVF are often indicated.

IVF has given new hope to thousands of couples who otherwise could not produce a genetically related child. With technologies such as IVF with intracytoplasmic sperm injection (ICSI), men with severe sperm defects can now father children.

Perhaps the most important step a couple can take is to see a specialist early in the course of their treatment. As females' age, egg "quality" can decline, sometimes precipitously, in a very short time. It is critically important that women in their thirties consult a reproductive endocrinologist as soon as possible.



President Elias Sarkis Avenue, Saab Bldg, 3rd floor, Sodeco, Beirut-Lebanon  

Phone:+961-1-610400, Fax:+961-1-612400, email: info@meivf.com