According to European data, every sixth couple is faced with infertility.

The causes of infertility can be identified in a woman (female infertility), in a man (male infertility) or in both. When they are not detected, we speak of  unexplained infertility .

According to their origin, causes of infertility in both sexes can be congenital or acquired. The most common causes of infertility in the developed world can differ significantly from those in other parts of the world. Some factors are causes for infertility in both sexes:  

• Sexually transmitted diseases (chlamydia, others)
• Inadequate weight: too high and too low
• Stress 
• Polluted environment 
• Nicotine 
• Alcohol 
• Caffeine in large quantities 

CAUSES OF FEMALE INFERTILITY

The causes of female infertility can be divided into:

• endometriosis
• ovarian causes
• tubular causes
• uterine causes

80 % of female infertility are represented by only  three causes:  

• ovulation disorders ( polycystic ovary syndrome, obesity) 
• endometriosis  and 
• tuboperitoneal causes with  blocked fallopian tubes. 

Other factors are the  age of the woman,  developmental abnormalities of the uterus,  fibroids,  excess body weight, sexually transmitted diseases, systemic diseases (diabetes, thyroid diseases), medications (antidepressants, steroids).

ENDOMETRIOSIS is the most common cause of female infertility, as 30-50% of patients with endometriosis are infertile and 30-40% of women who have problems conceiving have endometriosis.

In moderate or extensive endometriosis, infertility is the result of anatomical changes and cyclic bleeding, which cause an inflammatory reaction of the tissue with all the consequences (adhesions, fibrosis).

In mild or the minimal form is the result of an increased number of activated macrophages, a larger volume of peritoneal fluid and an increased concentration of inflammatory mediators in it. You can find more on the disease and treatment here (link na endometriozo).

OVULATION DISORDERS are all causes that prevent ovulation in a woman:

• polycystic ovary syndrome (PCOS)
• premature menopause
• renal failure
• hyper- and hypothyroidism
• hyperprolactinemia
• tumors of the hypothalamus and pituitary gland

By far the most common cause of ovarian infertility is PCOS, which affects 5-10 % of women of childbearing age. You can find more on the disease and treatment here (link na PCOS).

TUBAL CAUSES include all abnormalities and diseases of the fallopian tubes:

• abnormalities in the anatomical structure
• abnormalities in fallopian tube function
• psychogenic causes

The most common causes of fallopian tube damage are endometriosis, surgical causes, infections (Chlamydia trachomatis, gonorrhea), consequences of injuries and ectopic pregnancies. 

UTERINE CAUSES are less common. The cause is anatomical changes such as fibroids, septum and polyps.

CAUSES OF MALE INFERTILITY

The causes of infertility can be divided in several ways. They also often overlap. One of the divisions can be: 

• Genetic (cystic fibrosis, Kleinfelter syndrome)
• Anatomical (undescended testis, obstruction of the vas deferens) 
• Hormonal (hyperprolactinemia) 
• Infectious (sexually transmitted diseases and their consequences, e.g. impenetrable vas deferens)  
• Internal (hypogonadotropic hypogonadism)
• Exogenous (influences of the environment, diet, drugs, damage to the testicles, overheating of the testicles) 
• Psychosomatic (stress)
• Iatrogenic (oncological or consequences of other diseases, together with the consequences of their treatment)

Male infertility is reflected in semen quality and is thus first diagnosed by semen analysis. Semen quality is a measure of male fertility and indicates the ability of sperm in the seminal fluid to fertilize an egg cell.