Infertility – causes and diagnostics

nfertility is not only a female issue: the causes are distributed equally between men and women with each accounting for 30-40 %. In 15 - 30 % of cases it can be because of both partners. And in 5-10 % there is no recognizable reason. An unfulfilled wish for a child is also a problem which affects both partners equally. Therefore, it is understandable that the search for the reason and the treatment of infertility must always come together.

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Common causes - female partner:
  • Obstruction of / or damage to tubes
  • ovulation disorders
  • hormonal disorders (e.g. Polycystic ovary syndrome)
  • Endometriosis
  • Malfunction of the thyroid gland
  • Malformations of the uterus
  • depletion of the ovarian reserve, poor oocyte quality
  • genetical deviations
  • immunological factors
  • external factors - cigarettes, alcohol or coffee, drugs, chemo- and radiotherapy, etc.

In order to find the cause a minimum of tests has to be done such as: basic hormone status in the beginning of the menstrual cycle (during the bleeding), ultrasound examinations of the pelvic area, assessment of the ovarian reserve, tube occlusion tests, hysteroscopy, eventually immunological and genetic examinations and more.

  • Limited sperm production
  • inflammations and endocrine disorders
  • mechanical obstructions – hydrocele, varicocele
  • external factors - cigarettes, alcohol or coffee, drugs, chemo- and radiotherapy, etc.


The diagnosis for male infertility disorder can only be based on a semen analysis. More than one examinations are recommended because even a healthy male has significant variations in the sperm concentration and quality. The analysis has to include evaluations of the most important parameters such as sample volume, color, pH, viscosity and liquefaction, sperm cell concentration, motility and morfology, presence of agglutinations, leucocytes, bacteria, etc.  

Sometimes although these parameters appear normal still oocyte fertilization and pregnancy cannot occur. In such cases additional tests need to be done such as sperm DNA fragmentation essay and others.


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