What is infertility?


On average, it is estimated that infertility could affect between 48 million couples and 186 million people of fertile age all over the world, according to the current data from the World Health Organization. Infertility is the pathology that prevents pregnancy from being achieved or brought to completion. It affects both men and women to the same extent. We talk to Dr. Elena Santiago about what we know as infertility and sterility.

At Vida Fertility Institute we recommend that you go to your specialist if after a year of unprotected sex you do not achieve pregnancy. Moreover, if you are over 35 years old, it is advisable not to wait more than six months of searching.

But do infertility and sterility mean the same thing?

We often use these two terms synonymously to refer to the impossibility of achieving pregnancy. In reality, they are two different terms that refer to whether or not a pregnancy has already been achieved.

We speak of sterility when patients cannot conceive, while we are referring to infertility when there has already been a pregnancy, but due to some problem it has not been brought to completion, it has been interrupted and a miscarriage has occurred.

How are infertility and sterility diagnosed?

Fertilization of an egg and a spermatozoon is a highly complex process.  Each piece of this puzzle has an important role to play in order to fit together and form an embryo. It must travel through the fallopian tubes to the uterus, where it will be implanted to gestate and evolve until it gives birth to the desired baby.

But let’s go back nine months. If, during one of these delicate stages of the process, an alteration occurs, either in the man or in the woman, the result will not be as expected.. Frustration and discouragement will overtake expectations as a result.

That is why a detailed study of each patient leading to an accurate diagnosis that identifies where the problem lies and what is the way forward with the least number of attempts is so important.

There are different tests that allow us to assess your fertility condition. Initially, and to start the process, we need to know everything that has happened until we came to know each other, that is to say, what we know as medical history. Then we will focus on each one of them.

For the study of the woman we need:

  • Hormonal study in blood to assess: the AMH (anti-müllerian hormone) with which, along with the follicular ultrasound we can reliably know the number of fertile eggs, FSH (follicle stimulating hormone) that promotes egg production and controls the menstrual cycle, LH (luteinizing hormone) controls the maturation of the follicles and, finally, the level of Estradiol (estrogen that identifies the proper functioning of the ovaries.
  • Ultrasound for antral follicle count. With this test we measure how many eggs are present in each ovary.
  • Hysterosalpingography (HSG), a test performed to determine that the fallopian tubes are permeable, that is, that they are not obstructed.

For the study of the man we need:

After having a first approach comes the step for more advanced tests that allow us to assess different aspects such as: genetics, immunology, the state of the endometrium, among others.

What are the main causes of infertility and sterility?

As we have already told you in this article, infertility can be both male and female.

Main causes of male infertility:

  • Low sperm production or poor sperm quality due to: failure of the testicles to descend, genetic defects, diabetes or sexually transmitted disease infections (chlamydia, gonorrhea, mumps or HIV), varicocele (or enlarged veins in the testicles).
  • Ejaculation problems: premature ejaculation, cystic fibrosis, testicular obstruction or injury to the reproductive organs.

Main causes of female infertility:

  • Early menopause or when the ovaries stop functioning before the age of 40.
  • Ovulation disorders such as hormonal disorders, an example of which is due to polycystic ovary syndrome. Excess of prolactin (hormone that stimulates the production of breast milk). Hyperthyroidism or hypothyroidism (excess or deficit of thyroid hormones). In addition, excessive physical exercise, eating disorders or tumors can also affect ovulation.
  • Uterine or cervical anomalies that can obstruct the fallopian tubes and prevent the embryo from implanting in the mother’s uterus (polyps, benign tumors or uterine fibroids).
  • Pelvic adhesions or scars that form after infection, appendicitis, endometriosis or surgery.
  • Damage or blockage of one or both fallopian tubes such as Hydrosalpinx (accumulation of fluid inside the tubes).
  • Endometriosis, or when endometrial tissue grows outside the uterus, affects the function of the ovaries, uterus and fallopian tubes.

There are some common factors of infertility.

  • Infertility caused by cancer and its treatment with radiation or chemotherapy.
  • Environmental factors such as pesticides, chemicals or radiation, as well as unhealthy lifestyles such as smoking, drinking and drug use.

If I already have one child, can I have problems having a second?

Yes, this is known as secondary infertility and it is more common than it seems.

For the most part, the causes may be some of those already described in this article. These may be due to the passage of time and age, or as a result of the first pregnancy, such as a possible pelvic infection or the development of uterine adhesions.

If you have any further questions or would like to speak directly with a fertility specialist, please contact us and we will be happy to help you.

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