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Although getting pregnant may seem like the easiest thing in the world, it is actually not so for many
people. There are several reasons for this, and any one or more of the following may be applicable.

Infertility is due to a female factor, in 40% of cases, infertility is caused by male factors, in 10% of
cases there is a combination of female and male factors and the remaining 10% may be due to unknown


T ubal




Primary idiopathic
testicular failure
Varicocele 12% 10%
Male accessory
glanmd infecton
No demonstrable
cause 49% Abnormal sperm
morphology 6%

Endocrine and Other seminal fluid

other causes 4% abnormalities 4%

Azoospermia Decreased sperm

owing to Immunological motility 4%
obstruction 1% causes 3%

Advanced age

The trend today is for women to complete their education and establish their careers before they think of
settling down and starting a family. However, for a woman over the age of 35, conceiving becomes a
problem. Infertility increases with age. Tubal infections, fibroid tumors and endometriosis are more

common in older women and are a common cause for infertility.

Excessive drinking, smoking, drug use

Research has shown that the excessive consumption of alcohol or smoking or the use of illicit drugs by a
potential father prior to pregnancy can be the cause of infertility. Illicit drugs can also reduce the sperm
count, damage the sperm, reduce testosterone levels, and change testicular functioning. (These are
generally ejaculated with the sperm.) Heavy drinking can affect a woman's menstrual cycle as well.

Ovulation/menstruation problems

Ovulation is a pre-requisite for getting pregnant. In women with regular menstrual cycles of 28-35 days,
ovulation takes place once every cycle. However, many women have erratic menstrual cycles (often
getting periods 3-4 times a year or even less). This means that they have fewer chances of getting pregnant
not only because they have fewer possible fertile periods, but also because they may not be ovulating in
every cycle. (Note that ovulation does not necessarily take place in every menstrual cycle).

Polycystic ovaries

Cysts are formed when the follicle fails to rupture at the time of ovulation and begins to grow instead. This
condition occurs due to hormonal imbalance and is marked by absent or infrequent menstruation. Women
having this condition have a chronic tendency to have their periods at intervals ranging from every six
weeks to six months. Conception becomes difficult due to irregular ovulation.

Low sperm count (for males)

The normal sperm count ranges from 20 million and more sperm per ml. Counts below 20 million may be
a cause for difficulty in conception. Factors such as fatigue, excessive alcohol, smoking or other drug
abuse, prostate gland infection, poor diet, or occupational exposure to chemicals can cause a small,
temporary decrease in the sperm count. Varicocele is a condition when there are varicose veins on the
scrotum. This is another cause for infertility and can only be corrected through surgery.

Intercourse pattern

Very often, you may simply be mistiming your intercourse. In order for you to get pregnant, it is essential
for you to have sex during your fertile days. It could also be possible that you may be trying too often in a

particular cycle, and thereby causing a reduction in sperm count.

Pelvic inflammatory disease and untreated STDs

Pelvic inflammatory disease (PID) is a very serious abdominal inflammation that results from untreated
vaginal or cervical infections, most commonly chlamydia and gonorrhea. If left untreated, bacteria make
their way up through the uterus and into the fallopian tubes, ovaries, and surrounding tissues. PID does
serious damage to the reproductive tract, often scarring and blocking the fallopian tubes. Scarring prevents
fertilization from ever occurring.

PID is one of the major causes of infertility among women of reproductive age. In one study, for example,
21% of the women with PID were infertile compared to only 3% of the women without PID. And the more
episodes of PID a woman experiences, the greater her risk for infertility.

Abnormal hormone levels

The endocrine system regulates the production, actions, and interactions of hormones. Hormones are
produced by the hypothalamus, pituitary gland, adrenal glands, thyroid gland, pancreas, ovaries, and testes.
Diseases that affect any of these structures can lead to infertility, because the activities of all of the
hormones are intricately interconnected. An excess or deficiency of any hormone can cause anovulation
and infertility.

For example, in hypothyroidism, increased levels of prolactin (PRL) and thyroid-stimulating hormone
(TSH) can affect levels of the sex hormones and may cause infertility. Hypothyroidism can be caused by
failure of the thyroid gland, pituitary failure, or disorders of the hypothalamus. In hypopituitarism (failure
of the pituitary gland), deficiencies of luteinizing hormone (LH) and follicle-stimulating hormone can
produce amenorrhea (the absence of menstruation) and infertility in women, and impotence (erectile
dysfunction) and infertility in men. Hypopituitarism can also cause TSH deficiency, which results in

Weight: Women who are substantially heavier or lighter than their ideal body weight are more likely to be
anovulatory, and consequently infertile, than women who are within their normal body weight range.

Exercise and stress: Strenuous exercise and stress can lead to anovulation and infertility.

Eating disorders: A history of eating disorders has been associated with anovulation and infertility.