Causes - Fertility problems

If your ovaries don't release an egg each month, you may have ovulation problems. This 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

Ovulation problems can be caused by:

• polycystic ovarian syndrome (PCOS)
• early menopause - when your periods stop before the age of 45
• being underweight or overweight
• thyroid problems - such as an underactive thyroid (hypothyroidism) or 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 starts to grow in other places, such as your ovaries or the lining of your tummy.

This can damage the ovaries and cause adhesions (scarring) in the pelvis and around your fallopian tubes. This may cause fertility problems in some women. But not all women with endometriosis will have fertility problems.

Fallopian tubes are the two tubes connecting your ovaries to your womb.

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

• pelvic inflammatory disease (PID)
• pelvic or abdominal (tummy) surgery
• an 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. You may be advised about IVF or other fertility treatments.

Major surgery to your cervix may cause scarring. This may affect your ability to get pregnant.

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

LLETZ

Cervical cancer surgery

Health conditions that may affect your fertility include:

• cancer
• inflammatory bowel disease (IBD) such as ulcerative colitis and 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 your prescribed medicine without talking to your GP first.

Speak to your GP if you are taking any medicines you bought without a prescription or herbal remedies.

Fibroids are benign (not harmful) tumours that grow in the muscle wall of your womb. Depending on their location, they may cause fertility problems in some women.

They 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. This lets sperm swim through it more easily.

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
• smoking
• alcohol
• drug use, including performance enhancing steroids
• current or past sexually transmitted infections (STIs), such as gonorrhoea and chlamydia
• 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:

• erectile dysfunction (impotence)
• 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 your fertility if you're a man include:

• cancer
• thyroid problem
• 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
• performance enhancing steroids
• testosterone medicines
• some anti-depressants and anti-psychotic medicines
• 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 used for treating auto-immune disorders

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

Speak to your GP if you are taking any medicines you bought without a prescription or herbal remedies.