| Causes | - Abnormal sperm production or function: undescended testicles, genetic defects, health problems such as diabetes or infections such as chlamydia, gonorrhea, mumps or HIV. Enlarged veins in the testes (varicocele).
- Problems with the delivery of sperm: sexual problems (premature ejaculation), genetic diseases (cystic fibrosis), structural problems (blockage in the testicle, damage or injury to the reproductive organs.
- Overexposure to certain environmental factors: pesticides and other chemicals, radiation, cigarette smoking, alcohol, marijuana or taking certain medications, such as antibiotics, antihypertensives, anabolic steroids or others. Frequent exposure to heat, such as in saunas or hot tubs.
- Damage related to cancer and its treatment: radiation or chemotherapy as treatment for cancer.
| - Ovulation disorders: hormonal disorders such as polycystic ovary syndrome, hyperprolactinemia, hyperthyroidism, hypothyroidism. Excessive exercise, eating disorders, injury or tumors.
- Uterine or cervical abnormalities: abnormalities with the opening of the cervix, polyps in the uterus or the shape of the uterus, noncancerous (benign) tumors in the uterine wall (uterine fibroids).
- Fallopian tube damage or blockage: inflammation of the fallopian tube (salpingitis), pelvic inflammatory disease, sexually transmitted infection, or adhesions.
- Endometriosis.
- Primary ovarian insufficiency: early menopause.
- Pelvic adhesions: bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery.
- Cancer and its treatment.
- Medical conditions associated with delayed puberty.
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| Risk factors in both genders | - Age: Woman’s fertility gradually declines with age, especially in her mid-30s, and it drops rapidly after age 37. Men over age 40 may be less fertile than younger men.
- Tobacco use: Smoking tobacco or marijuana by either partner reduces the likelihood of pregnancy.
- Alcohol use: For women, there's no safe level of alcohol use during conception or pregnancy. For men, heavy alcohol use can decrease sperm count and motility.
- Being overweight: An inactive lifestyle and being overweight may increase the risk of infertility. A man’s sperm count may also be affected if he is overweight.
- Being underweight: Women at risk of fertility problems include those with eating disorders, such as anorexia or bulimia, and women who follow a very low calorie or restrictive diet.
- Exercise issues: Insufficient exercise contributes to obesity, which increases the risk of infertility. Less often, ovulation problems may be associated with frequent strenuous, intense exercise in women who are not overweight.
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