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Causes for Infertility

Fertility is a complex process influenced by many interacting factors. At the Centre for Infertility Solutions (CIS), we recognise that each individual’s fertility journey is unique and may involve medical, genetic, hormonal, or immune-related considerations.

Our role is to help identify possible contributing factors and guide patients toward appropriate investigations and treatment pathways, under the care of Dr Nick Lolatgis and our multidisciplinary team.

Causes for Infertility
Polycystic Ovarian Syndrome (PCOS)

What Is PCOS?
Polycystic Ovarian Syndrome (PCOS) is a common hormonal condition that affects people of reproductive age. Depending on population and diagnostic criteria, it may occur in up to one in five women, and is more frequently identified among those experiencing fertility challenges. PCOS is characterised by hormonal and ovulatory irregularities, which can lead to changes in menstrual cycles and, in some cases, difficulty with conception.
The condition can also be associated with metabolic or dermatological features, such as insulin resistance, acne, or excess hair growth.

A simple way to understand embryo implantation is through the “Seed and Soil” analogy.
Just as a healthy plant requires a good seed placed in fertile soil, successful implantation depends on both a genetically normal embryo (the seed) and a receptive uterine lining (the soil).
Both factors must be favourable and work in harmony to support early embryo development.

The uterus is made up of a thick layer of smooth muscle called the myometrium, which surrounds the thin inner lining known as the endometrium — the site of embryo implantation and pregnancy support.
In some individuals, benign (non-cancerous) growths can develop within the muscle layer of the uterus. These are known as fibroids or leiomyomata.
Fibroids are relatively common, affecting an estimated 20% to 40% of people of reproductive age. Their size, number, and location can vary, and while many cause no symptoms, some may be associated with menstrual or reproductive concerns.

Ovulatory factors refer to conditions that affect the release of eggs (ovulation) or the hormonal balance required to support implantation.
In some cases, infertility may be related to irregular or absent ovulation, which can occur when eggs are not released consistently or when progesterone levels are insufficient to prepare the uterine lining for potential implantation.
Changes in the menstrual cycle — such as absent or irregular periods — can sometimes indicate ovulatory irregularities, which are best assessed through medical evaluation and appropriate testing.

Pelvic Inflammatory Disease (PID) refers to inflammation or infection that affects pelvic organs such as the uterus, fallopian tubes, ovaries, and the surrounding peritoneal tissue.
PID typically develops when bacteria travel from the vagina or cervix into the upper reproductive tract. This can occur following sexually transmitted infections or, less commonly, from contamination spreading from nearby inflamed structures.
Prompt diagnosis and management are important to reduce the risk of complications. Evaluation and treatment should always occur under the guidance of a qualified healthcare professional.

A woman is born with all the eggs she will ever have, and this number gradually declines throughout life. Once menstruation begins, multiple eggs are recruited each month, but typically only one is released during ovulation. Over time, this process continues until menopause, when most eggs have been depleted and ovulation ceases.
As the number and quality of remaining eggs (ovarian reserve) decline, it may become more difficult to achieve pregnancy. The rate of decline and its effect on fertility vary between individuals and are influenced by age, genetics, and other health factors.

Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterine cavity, often on pelvic structures such as the ovaries, fallopian tubes, or peritoneum.
In its early stages, endometriosis may not cause visible anatomical changes or distortion of pelvic structures, and ovulation is often unaffected. The condition can vary widely in its extent and symptoms, and diagnosis should be made through appropriate clinical evaluation and specialist assessment.

Endometriosis is a condition in which tissue similar to the lining of the uterus (endometrium) grows on pelvic structures outside the uterine cavity, such as the ovaries, fallopian tubes, or peritoneum.
In early stages, there is often minimal or no visible anatomical change, and the condition may not significantly affect ovulation or egg release. Symptoms and severity can vary widely, and diagnosis or management should always occur under the guidance of a qualified healthcare professional.

Although infertility is often thought of as a predominantly female issue, male factors contribute to approximately half of all infertility cases.
Male infertility can arise from a range of causes, including sperm production, function, or delivery issues, as well as hormonal, genetic, or lifestyle factors. Many underlying causes can be identified and managed through appropriate evaluation, lifestyle modification, or medical and specialist care.