Causes of male infertility may be a violation of spermatogenesis, as a consequence of an inflammatory disease, trauma, infectious diseases in childhood (especially mumps), urogenital infections (gonorrhea), the presence of cryptorchidism, varicocele, and intoxication with alcohol or chemical agents. Of great importance in the development of infertility in men is herpes simplex virus and chlamydial infection, in which sperm can carry the infection into the female genital organs. Infertility also occurs with debilitating diseases of the liver, kidneys, lungs, endocrine pathology (diabetes mellitus, Itenko-Cushing's disease).
Sometimes infertility occurs as a result of the sensitization of a woman to a certain male sperm.
In the case when there are changes in the spermogram, a man is referred to a sexopathologist or andrologist.
If all the parameters of the spermogram are normal, then a woman's examination begins.
The main causes of infertility in women are:
- Violations of ovogenesis and absence of ovulation - 35-40%;
- Pipe factors -20-30%;
- Diseases of the genital organs - 15-25%;
- Immunological causes - 2%.
Diagnostics of female infertility lies, first of all, in qualitative collection of anamnesis (age, profession, influence of harmful factors in production, the transferred diseases, bad habits). Tactically determine the psychosexual conditions of life, childbearing function, meaning that the primary infertility is often due to infantilism, and the secondary is the consequence of the transferred inflammatory processes.
More often than not, the cause of female infertility is endocrine diseases associated with impaired ovogenesis and the process of ovulation. Infertility affects women with various forms of hyperpolaktinemia, hyperandrogenism, and polycystic ovary syndrome. A large number of cases of infertility is the result of violations of the endocrine function of the ovaries, moreover, these disorders can be both primary and secondary, the consequence of the transferred inflammation. In the ovaries, cyclic processes are disrupted, anovulation or slowing of the maturation of the follicle with an inferior luteal phase occurs. With infertility of the endocrine origin, irregularities in the menstrual cycle are often observed: amenorrhea - complete absence of menstruation, hypomenstrual syndrome - discharge during menstruation very scarce and uterine bleeding.
The causes of peritoneal infertility are adhesive processes in the small pelvis, which cause the inflexion of the tubes while maintaining their patency. Tubal infertility is due to anatomical and functional disorders in the fallopian tubes.
Obstruction of the fallopian tubes often occurs after gonorrheal salpingitis, although it may also be a consequence of a nonspecific inflammatory process. Inflammatory processes can cause not only tubal obstruction, but also dystrophic changes in its wall, a violation of the peristalsis of the tube. Of great importance in the emergence of infertility are abortions, as it causes inflammatory processes in the mucous membrane of the uterus with subsequent dystrophic changes that prevent the implantation of the egg.
Also, infertility can occur as a result of inflammation of the cervix uteri - endocervicitis. It prevents the advancement of spermatozoa into the uterine cavity.
Immunological form of infertility is due to the emergence of antisperm antibodies in a man or a woman, is rare. Its frequency is 2% among all forms of infertility. Among all couples with an unexplained cause of infertility, a subsequent examination of 20-25% reveals antibodies to sperm. More often antispermanye antibodies are formed in men than in women. The cause of this may be vasectomy, testicular damage in orchites, injuries, genital infections. With this form of infertility, the most effective method is intrauterine insemination.
The majority of women with infertility have various disorders of the psychoemotional sphere: a feeling of inferiority, loneliness, a tense expectation of another menstruation and hysterical conditions at the beginning of it. The complex of these symptoms is the so-called "pregnancy expectation syndrome". Great stress for a married couple is the need for examination and further implementation of the doctor's recommendations and the rhythm of sexual life, the definition of the period of ovulation in a woman with functional tests and the use of this particular time for conception. Sometimes the insistent request of a woman in intimacy at certain times can lead to a functional failure of the man and other impairments of potency. Especially adversely affects the state of potency diagnosis of sperm pathology. This news leads to impotence in more than half of men, and the frequency of its occurrence depends on the reaction of the spouse.
For a woman, the necessity of subordinating sexual life to the results of tests of functional diagnostics is also a stressful situation, to which not only the psyche reacts, but also the organs of the genital tract, in particular the fallopian tubes. Their spasm, antiperistaltic may arise, which even violates the passableness of the sex cells even if they pass through the tubes. Therefore, sometimes a woman's great desire to become pregnant becomes her enemy. Many cases have been described when a long-awaited pregnancy occurred after a woman decided to completely stop treatment, stopped measuring basal temperature and monitored the time of expected ovulation. This also happens when a married couple loses hope for their own children and adopts a child.