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 Hui Zhi
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Does having hypothyroidism mean lifelong infertility?

Having hypothyroidism does not necessarily mean permanent infertility. Hypothyroidism primarily involves reduced secretion of thyroid hormones in the body, leading to slowed metabolism. For women, symptoms such as reduced menstrual flow, amenorrhea, or even infertility may occur. However, if diagnosed with hypothyroidism, it is advisable to visit an endocrinology specialist promptly for thyroid hormone replacement therapy. It is recommended to monitor the Thyroid-Stimulating Hormone (TSH) during treatment; many patients with TSH levels below 2.5 can consider pregnancy. Moreover, it is crucial to continue taking thyroid hormones during pregnancy to avoid affecting the fetus.

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When to go for infertility check-ups?

The timing of infertility examinations cannot be generalized and should be determined based on the specific test and gender. For males, the primary tests include semen analysis and sperm morphology exams. These require the male to abstain from ejaculation for 2-7 days because if the abstinence period is too short, less than 48 hours, both sperm quality and semen volume may be low, which does not reflect the true level. Conversely, if the abstinence exceeds seven days, it can also affect the results of the test. For females, if undergoing a six-item hormone test, it is best conducted during days 2-5 of the menstrual cycle. For a fallopian tube patency test, it is safer to conduct it between days 3-7 after the menstrual period has ended. The exact timing of these tests should be advised by the attending physician.

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Written by Yue Hua
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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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Written by Zhang Shu Kun
Traditional Chinese Medicine
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Can a cold uterus and overall body coldness lead to infertility?

Cold womb and overall bodily coldness can lead to infertility. Since a cold womb and overall coldness can cause menstrual irregularities, scanty menstrual flow, and painful menstruation, it is essential to expel the cold promptly. Firstly, drinking ginger water can warm the womb and dispel coldness, or drinking brown sugar water can also effectively regulate these conditions. Moreover, it is important to avoid cold and raw foods in your diet; instead, focus on consuming warm foods and drink plenty of plain hot water to accelerate the healing process.

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Written by Kang Jian Hua
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Can infertility be inherited?

Regarding the question of whether infertility is hereditary, we cannot generalize. We should analyze specific situations individually. For infertility caused by chromosomal or genetic abnormalities, it may be inherited by offspring. In such cases, one should choose targeted treatments under the guidance of a specialist. However, infertility due to non-genetic factors can often be cured through proactive treatment. Usually, the female can conceive and the condition will not be passed on to the offspring. For better treatment and diagnosis, it is recommended to visit a reputable public hospital locally to get a clear diagnosis and treatment, which can save both time and money.