- MEDICINE ATHENS MED4WOMAN ATHENS
- MEDICINE VOLOS MED4WOMAN VOLOS
Obstetrician - Gynaecologist
Doctor of Medicine, University of Athens Medical School
Panagiotis Polyzos, Gynaecologist Obstetrician, is active at the Institute of Life - IVF Unit of Iaso Maternity Hospital.
The most common cause of infertility is damage to the fallopian tubes, which may present as either obstruction or dysfunction. The primary contributor is a history of tubal infections.
Severe endometriosis is another condition that causes adhesions in the reproductive organs, distorting and impairing their normal function.
Even mild endometriosis can prevent conception through multiple mechanisms, such as ovulatory dysfunction, impaired transport of sperm, eggs, or embryos to the fallopian tubes, and difficulties with embryo implantation in the uterus.
Η laparoscopy provides valuable information on whether surgical correction is feasible or if in vitro fertilization (IVF) is needed.
Ovulation disorders are initially treated medically, but if pregnancy does not occur despite efforts, IVF becomes the appropriate solution, particularly when reproductive time is limited.
Female infertility of unknown origin is defined when pregnancy does not occur despite a normal basic diagnostic workup. In these cases, the issue may lie at a microscopic level, and IVF can help diagnose or bypass it.
Since time is a crucial factor in fertility, women over the age of 40 require immediate treatment to achieve pregnancy, even if everything appears normal.
Another potential but less clearly understood cause of infertility is immunological infertility. IVF can often overcome immunological barriers by providing medication to protect embryos during implantation.
If a woman is no longer producing eggs or does not have functioning ovaries, IVF can offer a solution through egg donation from a woman under 35 years old. Similarly, when repeated insemination cycles with donor sperm have failed, IVF is the preferred treatment option.
Advances in cytogenetics allow for embryo biopsy, where the removal of a single cell from an eight-cell embryo can provide genetic information. Through IVF, it is now possible to assess an embryo’s chromosomal health and sex—important in preventing the transfer of embryos affected by sex-linked genetic disorders or chromosomal translocations.
The causes of male infertility are numerous and varied. The most frequent cause is idiopathic infertility, meaning that although anatomy, hormones, and sexual function appear normal, the testicles do not produce healthy, fertile sperm.
According to the World Health Organization reference limits (2021), semen is considered normal with a concentration of at least 16 million sperm per ml, progressive motility of 30% or more and at least 4% normal forms. For details on semen analysis and treatments, see the article on male infertility.
Another common cause is varicocele, a collection of varicose veins in the scrotum. The abnormal dilation of these veins raises testicular temperature, which can be harmful to sperm production (even a one-degree increase in scrotal temperature can be damaging).
Male infertility may also result from blockage in the reproductive tract. Infection or trauma can cause scarring that obstructs the epididymis—the organ where sperm mature before ejaculation.
Hernia surgery, previous vasectomy, and cystic fibrosis can also block the spermatic ducts. Additionally, the prostate may develop a cyst or stone that obstructs the passage of sperm into the urethra during ejaculation.
Occupational, environmental, and psychological factors—such as high stress levels, sleep disturbances, recreational drug use, smoking, excessive alcohol consumption, lubricants, toxins, growth hormones in foods, chemical or heat exposure, and prolonged use of hot tubs or warm baths—can also contribute to male infertility.
In the most severe cases of male infertility, such as genetic abnormalities (e.g., Klinefelter syndrome) or when the cause is unknown, there may be a complete absence of sperm in the ejaculate (azoospermia).
Infertility is the inability of a couple to achieve pregnancy after 12 months of regular unprotected intercourse. When the woman is over 35, testing begins after 6 months. It is classified as primary, when there has never been a pregnancy, and secondary, when the couple already has a child or a previous pregnancy and has difficulty conceiving again.
It affects about one in six couples. Broadly, one third of cases are due to the woman, one third to the man and the rest to a combination of factors or a cause that cannot be identified. This is why both partners are always tested, at the same time.
The basic work-up is usually completed within one cycle:
Treatment is chosen according to the cause, the woman's age and how long the couple has been trying. We start with the simplest option that has realistic chances:
Lifestyle matters too: weight, smoking and alcohol affect both partners. Read how lifestyle affects female fertility.
The most common causes of female infertility include fallopian tube damage, endometriosis, ovulation disorders, and unexplained infertility.
The most common causes of male infertility infertility include idiopathic infertility, varicocele, infections, trauma, obstructive or non-obstructive azoospermia, and environmental factors such as stress, toxins, and heat exposure.
Infertility may be irreversible in cases of severe genetic abnormalities or a complete absence of eggs or sperm.
A couple should seek medical evaluation if pregnancy has not occurred after one year of regular, unprotected intercourse — or sooner if the woman is over the age of 35.
The basic work-up of the couple is usually completed within one menstrual cycle, that is, in about 4 to 6 weeks.
That all basic tests are normal and yet pregnancy is not achieved. It affects about 10 to 15% of couples and is treatable, usually with intrauterine insemination or IVF.
Yes, it is the most important factor. Fertility declines gradually after 32 and faster after 37, because the number and quality of eggs decrease.
