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Mr Parijat Bhattacharjee, Private Consultant Gynaecologist, Harrow, Brentford, Northwood, London, UK / Media / Videos » Infertility - Causes | Risk | Treatment

Infertility - Causes | Risk | Treatment

Infertility - Causes | Risk | Treatment
Posted on: 03-Jul-2026

This video, titled "Infertility - Causes | Risk | Treatment" by Gynae Consultant, provides a comprehensive overview of human fertility statistics, the medical criteria for a delayed fertility evaluation, male and female causes, the biological impacts of age, and available treatment options.

General Fertility and Evaluation

  • The Chance Factor: Humans are naturally less fertile than many other species. In a normal cycle, a couple has roughly a 1 in 6 chance of conceiving. Delay is often just a matter of luck or chance.
  • When to Seek Help: Couples are advised to consult a doctor if they haven't conceived after one year of regular, unprotected intercourse (every 2–3 days). However, those over 35 years of age should seek clinical guidance earlier.

Distribution of Causes

Fertility challenges are shared across partners:

  • Male Factors: Responsible for roughly 25% of cases.
  • Combined/Unexplained Factors: Account for 25% to 30%.
  • Ovulation Issues: Responsible for about one-third of female-specific cases.
  • Structural Female Factors: Comprise 10% to 15% of cases.

Causes in Detail

Male Factors

  • Lifestyle: Smoking and substance abuse negatively impact sperm count and quality.
  • Physical and Surgical Factors: Past testicular infections (such as mumps), trauma to the genitalia, previous hernia surgeries, or the use of anabolic steroids for muscle building can significantly impair sperm health.

Female Factors

  • Ovulation Disorders: Polycystic Ovary Syndrome (PCOS) is the most common cause. Linked to insulin resistance, its symptoms often worsen with weight gain. Other disruptions include early menopause or the side effects of certain psychiatric and anti-nausea medications.
  • Structural/Pelvic Issues: Localized uterine growths like fibroids or polyps can distort the womb. Conditions such as endometriosis, pelvic infections, or previous surgeries can cause pelvic scarring that blocks or damages the fallopian tubes.

The Impact of Age on Fertility

Women are born with a finite ovarian reserve. By age 35, the remaining egg count drops drastically, accelerating toward a critical low around age 40. Beyond quantity, the quality of the eggs declines with age. This decline reduces the likelihood of natural conception and heightens the medical risks of miscarriage and chromosomal conditions, such as Down syndrome.

Management and Treatments

  • Lifestyle Interventions: Many couples successfully conceive without intensive medical procedures. Simple adjustments—such as smoking cessation and weight management for both partners—alongside giving the process more time, are often highly effective.
  • Medication & Monitoring: For minor ovulation problems, simple medications taken under outpatient monitoring can successfully stimulate egg release.
  • Surgical Interventions: Structural impediments like fibroids, polyps, endometriosis, or pelvic scarring can be treated via day-case keyhole surgery. Damaged or fluid-filled fallopian tubes may be surgically addressed or removed to optimize the odds of success before moving to advanced therapies.
  • Assisted Reproductive Technology (ART): While IVF is not required for every couple, it remains a highly effective, revolutionary treatment option for cases involving severe male factor infertility, structural blockages, or advanced maternal age (over 35).