What is infertility?
Multiple factors to be researched and addressed
90% of the causes of infertility are equally attributable to female, male and mixed factors, while in the remaining 10% of cases the causes remain unknown.
Female factors:
- hormonal: failure to ovulate caused by hypothalamic-pituitary alterations (e.g. hyperprolactinemia, stress, anorexia), thyroid, ovarian (e.g. micropolycystic ovary, endometriosis, corpus luteum deficiency), metabolic (e.g. diabetes and obesity);
- tubal: caused by inflammatory processes, adhesions, endometriosis, surgical interventions;
- uterine: congenital (e.g. septate, subseptum, bicornuate) or acquired (e.g. polyps, fibroids, adhesions) malformations of the uterine cavity;
- cervico-vaginal: closure of the cervical canal caused by inflammation, diathermocoagulation, conizations or biochemical alterations of the cervical mucus;
- genetic: chromosomal anomalies and gonadal dysgenesis;
- immunological factors: presence of antisperm antibodies in the female cervical mucus or in the woman’s blood which alter the motility of the spermatozoa and their ability to penetrate the oocyte.
Male factors:
- hormonal: imbalance in the production of sexual hormones of congenital or acquired origin;
- secretory testicles: altered production of spermatozoa or seminal plasma due to congenital causes (e.g. small or absent testes), chromosomal (e.g. Klinefelter syndrome), genetic (e.g. microdeletions of the Y chromosome), inflammation (e.g. sexually transmitted diseases, mumps), varicocele (dilation of the veins of the testicle), cryptorchidism (failure of one or both testicles to descend into the scrotum), testicular torsion (blockage of blood flow which can seriously damage the testicle), smoking, alcohol abuse, exposure to high temperatures, ionizing radiation and microwaves, toxic substances (e.g. pesticides, solvents, chemotherapeutics), drugs, medicines (e.g. neuroleptics, tricycle antidepressants, anabolic steroids);
- excretory testicles: pathology of the excretory tracts (obstacle to the exit of spermatozoa from the testicle) with normal characteristics of spermatozoa and seminal plasma due to congenital causes (agenesis of the vas deferens), genetic (e.g. cystic fibrosis), inflammation (e.g. chlamydia trachomatis , gonococcus, mycoplasma), surgical interventions (e.g. vasectomy), neoformations (e.g. epididymal cysts).
- erectile: inability to achieve or maintain an erection due to psychological, organic (e.g. neurological damage, diabetes, hypertension, trauma, surgery), hormonal (e.g. hypothyroidism, hyperprolactinemia), pharmacological (e.g. antidepressants), alcohol abuse causes and drugs;
- ejaculators: failure to ejaculate due to psychological or pharmacological problems (e.g. antidepressants), retrograde or in the bladder due to surgery on the prostate or bladder, neurological damage, diabetes;
- immunological: development of antibodies on the surface of spermatozoa that interfere with sperm motility.
