What is the cause of infertility (inability to conceive)?

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Differential Diagnosis for Trouble Getting Pregnant

Single Most Likely Diagnosis

  • Unexplained Infertility: This is the most common diagnosis, accounting for approximately 20-30% of infertility cases. It is often diagnosed after a thorough evaluation of both partners, including semen analysis, ovulation testing, and assessment of tubal patency, and no identifiable cause is found.

Other Likely Diagnoses

  • Ovulatory Disorders: Issues such as polycystic ovary syndrome (PCOS), thyroid dysfunction, or hyperprolactinemia can disrupt ovulation, making it difficult to conceive.
  • Male Factor Infertility: Low sperm count, poor sperm motility, or abnormal sperm morphology can significantly impact fertility.
  • Tubal Damage or Blockage: Conditions like endometriosis, pelvic inflammatory disease, or previous surgeries can cause scarring or blockage of the fallopian tubes, preventing fertilization.
  • Endometriosis: This condition, where tissue similar to the lining of the uterus grows outside the uterus, can lead to inflammation, scarring, and adhesions that may obstruct ovulation or fertilization.

Do Not Miss Diagnoses

  • Genetic Disorders: Certain genetic conditions, such as cystic fibrosis or fragile X syndrome, can affect fertility and have significant implications for the health of the offspring.
  • Infections and Sexually Transmitted Infections (STIs): Untreated infections like chlamydia or gonorrhea can cause permanent damage to the reproductive organs, leading to infertility.
  • Cancer or Tumors: Certain types of cancer, such as cervical or testicular cancer, can impact fertility, and early detection is crucial for effective treatment.

Rare Diagnoses

  • Premature Ovarian Failure (POF): A condition where the ovaries stop functioning and ovulation ceases before the age of 40.
  • Uterine Abnormalities: Congenital or acquired anomalies of the uterus, such as a unicornuate uterus or Asherman's syndrome, can affect implantation and fertility.
  • Immunological Disorders: Conditions like antiphospholipid syndrome or autoimmune disorders can increase the risk of recurrent miscarriage and infertility.
  • Environmental and Occupational Factors: Exposure to certain toxins, such as pesticides or heavy metals, can impact fertility in both men and women.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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