Causes - Fertility problems

If your ovaries do not release an egg each month, you may have ovulation problems. Ovulation problems can affect your fertility.

You may have an ovulation problem if you have:

• irregular periods
• period cycles that are shorter or longer than usual
• no periods at all

Causes of ovulation problems include:

• polycystic ovarian syndrome (PCOS)
• early menopause - when your periods stop before age 45
• having excess weight or underweight
• underactive thyroid (hypothyroidism)
• overactive thyroid (hyperthyroidism)
• too much exercise, such as marathon or triathlon training
• making too much of the hormone prolactin

Endometriosis is a condition where tissue similar to the lining of the womb grows in other places. For example, your ovaries or the lining of your tummy.

Endometriosis causes fertility problems for some women. Endometriosis can damage the ovaries and cause adhesions (scarring) in the pelvis or around your fallopian tubes.

Fallopian tubes are the 2 tubes that connect your ovaries to your womb.

Your fallopian tubes can become damaged, blocked or scarred by:

• pelvic inflammatory disease (PID)
• pelvic or abdominal (tummy) surgery
• ectopic pregnancy - you may need to have a tube removed

Surgery to repair your fallopian tubes may help you to become pregnant. But this surgery is not suitable for all women. Your doctor may recommend IVF or other fertility treatments.

Major surgery to your cervix may cause scarring. For example, surgery to remove cancer cells. Scarring can affect your ability to get pregnant.

Treatment such as a large loop excision of the transformation zone (LLETZ) is not likely to cause fertility problems.

Cervical cancer treatment

Health conditions that may affect female fertility include:

• cancer
• inflammatory bowel disease (IBD) such as ulcerative colitis or Crohn's disease
• severe rheumatoid arthritis
• cystic fibrosis

Certain medicines and treatments may also affect your fertility.

These include:

• contraception
• cancer treatments such as radiotherapy and chemotherapy
• anti-psychotic medicines
• large doses of non-steroidal anti-inflammatory drugs (NSAIDs) - such as ibuprofen or aspirin
• some herbal and alternative medicines

Do not stop taking a prescribed medicine without talking to your GP first.

Tell your GP about any non-prescription or herbal medicines you take.

Fibroids are benign (non-cancerous) tumours that grow in the muscle wall of your womb. Depending on their location, they may cause fertility problems.

Fibroids may:

• stop a fertilised egg from attaching to your womb
• block a fallopian tube
• stop sperm from reaching the egg - this is rare

When you're ovulating, mucus in the neck of your womb (the cervix) becomes thinner. Thinner mucus is easier for sperm to swim through.

If there's a problem with your mucus, it can make it harder for the sperm to get into your womb.

Problems with sex for women include:

• vaginismus (not being able to have vaginal sex)
• a loss of sex drive
• pain during sex

If you or your partner have problems with sex, it can be difficult for your relationship. Talk about your problems with your GP as soon as possible.

There are many things that can cause problems with your sperm count or quality.

These include:

• previous cancer treatment
• lifestyle causes
• testicles that did not drop properly as a baby
• issues with your testicles because of surgery, enlarged veins (varicocele) or tumours
• medical conditions such as a thyroid problem or poorly-controlled diabetes
• hormonal problem such as hypogonadism - where you make little or no testosterone
• genetic problems such as Klinefelter syndrome
• your testicles overheating

Problems with sex for men include:

• problems getting an erection (erectile dysfunction)
• ejaculation problems such as retrograde ejaculation (when sperm moves into the bladder instead of outside the penis)
• difficulty having an orgasm

If you or your partner have problems with sex, it can be difficult for your relationship. Talk about your problems with your GP as soon as possible.

Health conditions that may affect male fertility include:

• cancer
• thyroid problems
• poorly controlled diabetes
• cystic fibrosis
• spina bifida
• any chronic illness that impacts your health

Certain medicines and treatments may also affect your fertility.

These include:

• cancer treatments such as radiotherapy and chemotherapy
• anabolic steroids
• testosterone medicines
• some anti-psychotic medicines and antidepressants
• some epilepsy medicines
• some blood pressure medicines
• large doses of non-steroidal anti-inflammatory drugs (NSAIDs) - such as ibuprofen or aspirin
• some herbal and alternative medicines
• some medicines to treat auto-immune disorders

Do not stop taking a prescribed medicine without talking to your GP first.

Tell your GP about any non-prescription or herbal medicines you take.