Infertility Support Group

General factors: Diabetes mellitus, Thyroid disorders, Adrenal disease; Significant liver, kidney disease; Psychological factors

Hypothalamic-pituitary factors: Kallmann syndrome, Hypothalamic dysfunction, Hyperprolactinemia, Hypopituitarism

Ovarian factors: Polycystic ovary syndrome, Anovulation, Diminished ovarian reserve; Luteal dysfunction; Premature menopause; Gonadal dysgenesis (Turner syndrome); Ovarian neoplasm

Tubal/peritoneal factors: Endometriosis; Pelvic adhesions; Pelvic inflammatory disease (PID, usually due to chlamydia); Tubal occlusion

Uterine factors: Uterine malformations; Uterine fibroids (leiomyoma); Asherman's Syndrome

Cervical factors: Cervical stenosis; Antisperm antibodies; Insufficent cervical mucus (for the travel and survival of sperm)

Vaginal factors; Vaginismus; Vaginal obstruction

Genetic factors: Various intersexed conditions, such as androgen insensitivity syndrome

Healthy couples in their mid-20s having regular sex have a one-in-four chance of getting pregnant in any given month. This is called "Fecundity".

Factors relating to male infertility include:

• Pretesticular causes
  • Endocrine problems, i.e. diabetes mellitus, thyroid disorders
  • Hypothalamic disorders, i.e. Kallmann syndrome
  • Hyperprolactinemia
  • Hypopituitarism
  • Hypogonadism due to various causes
  • Psychological factors
  • Drugs, alcohol
• Testicular factors
  • Genetic defects on the Y chromosome, including Y chromosome microdeletions
  • Abnormal set of chromosomes, including Klinefelter syndrome
  • Neoplasm, e.g. seminoma
  • Idiopathic failure
  • Cryptorchidism
  • Varicocele
  • Trauma
  • Hydrocele
  • Mumps
• Posttesticular causes
  • Vas deferens obstruction
  • Infection, e.g. prostatitis
  • Retrograde ejaculation
  • Hypospadias
  • Impotence

Some causes of male infertility can be determined by analysis of the ejaculate, which contains the sperm. The analysis includes counting the number of sperm and measuring their motility under a microscope: Producing few sperm, oligospermia, or no sperm, azoospermia, or a sample of sperm that is normal in number but shows poor motility, or asthenozoospermia.

In the majority of cases of male infertility and low sperm quality, no clear cause can be identified with current diagnostic methods. It has been speculated that random mutations of the Y chromosome may be an important factor. As the human Y chromosome is passed directly from father to son, it is not protected against accumulating copying errors, whereas other chromosomes are error corrected by recombining genetic information from mother and father. This may leave natural selection as the primary repair mechanism for the Y chromosome. Microdeletions in the Y chromosome have been found at a much higher rate in infertile men than in fertile controls and the correlation found may still go up as improved genetic testing techniques for the Y chromosome are developed. (Existing test kits for Y chromosome microdeletions with PCR markers cover only a tiny fraction of the chromosome's 23 million base pairs and therefore very likely still miss most mutations. The gold standard test for genetic mutation, namely complete DNA sequencing of a patient's Y chromosome, is still far too expensive for use in epidemiologic research or even clinical diagnostics.)