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General Causes of Infertility

The chart below outlines the most common causes, typical treatments and the percentages of couples who go on to become pregnant. Percentages are variable since multiple problems can exist in a couple, and percentages improve greatly with collaborative treatments between conventional and traditional Chinese medical treatments. The information is very general and not necessarily applicable to any one individual.

DO NOT USE THIS INFORMATION TO SELF-DIAGNOSE. CONSULT A HEALTH CARE PROFESSIONAL BEFORE MAKING ANY HEALTH CARE DECISIONS.

Condition	Definition	Possible symptoms	Possible solutions	Success rates
FEMALE -- About 35-40 per cent of all fertility problems
Endometriosis	In this condition endometrial tissue (the uterine lining that sheds with each monthly period) grows outside the uterus. This is a major cause of infertility in women.	Painful menstrual periods, irregular or heavy bleeding and possibly, repeated miscarriages.	Conventional: Laparoscopic surgery to remove abnormal tissue or unblock tubes and assisted conception treatments. Traditional Chinese Medicine (TCM): Acupuncture and/or Herbal treatments to promote healing, help with scar tissue.	Surgery: 40-60 per cent conceive within 18 months after surgery. IVF: usual expected success rates TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
Ovulation problems	Any condition that prevents the release of a mature egg from an ovary. Ovulation is a complex event in which hormonal signals and physical events are linked in a delicate balance. Ovulation can be seriously affected by abnormalities of the thyroid gland, over-production of prolactin, excessive male hormone (androgens), and physical stress, psychological stress and extreme lifestyle changes.	Absent or infrequent periods and excessively heavy or light bleeding.	Conventional: Ovulation-stimulating drugs such as clomiphene, follicle-stimulating hormones, human chorionic gonadotrophin (HCG) and in vitro fertilisation (IVF) using these drugs. TCM: Acupuncture and/or Herbal treatments to help balance hormones, regulate the cycle and promote the release of an egg.	70 per cent ovulate and of those, 20-60 per cent get pregnant using conventional medical techniques. TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
Poor egg quality	Eggs that become damaged or develop chromosomal abnormalities cannot sustain a pregnancy. This problem is often age-related. Egg quality declines significantly in the late 30s and early 40s.	None.	Conventional: Egg donation or surrogacy. TCM: Acupuncture and/or Herbal treatments to improve supporting systems and tissues.	43 per cent of women who have a fertilised donor egg implanted become pregnant. TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
Polycystic ovary syndrome	Patients whose ovaries contain many small cysts have hormone imbalances and do not ovulate regularly.	Irregular menstrual periods, excessive hair growth, acne and weight gain.	Conventional: Ovulation-stimulating drugs such as clomiphene, follicle-stimulating hormones, and IVF. TCM: Acupuncture and/or Herbal treatment to help regulate hormones and the cycle, reduce inflammation and scarring, and promote healing.	70 per cent who take fertility drugs ovulate and of those, half go on to conceive within six to nine months. Unfortunately, one in five of those pregnancies miscarries. TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
Female tube blockages	Blocked or damaged fallopian tubes prevent eggs from getting to the uterus and sperm from getting to the egg. Leading causes include pelvic inflammatory disease, sexually transmitted diseases such as chlamydia, and previous sterilisation surgery.	None.	Conventional: Laparoscopic surgery to open tubes, if possible (small area of blockage). If surgery fails, in vitro fertilisation is an option. TCM: Acupuncture and/or Herbal treatments can help with incomplete blockages and certain blockages with specific causes. Helps reduce swelling, promote healing and reduce scaring.	Conception rates vary widely -- from a low of 10 per cent to a high of 70 per cent -- depending on the severity of the blockage and the amount of scar tissue that develops after surgery. IVF: usual success rates. TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
MALE -- About 35-40 per cent of all fertility problems
Male tube blockages	Any obstructions in the vas deferens or epididymis (the tubes that transport fertile sperm). Varicoceles (varicose veins) in the testicles are the most common cause of male tube blockages. Sexually transmitted diseases, such as chlamydia or gonorrhoea, are also linked to tube blockage problems.	None.	Conventional: Surgery to repair the varicoceles or other obstruction. TCM: Acupuncture and/or Herbal treatments to reduce swelling and inflammation, and to promote healing	About 40 per cent are able to impregnate their partner within a year of surgery, most within six to nine months. TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
Sperm problems	Low or no sperm counts, poor sperm motility (the ability to move), and abnormally-shaped sperm can all cause infertility.	None.	Conventional: Fertility drugs may boost sperm production. Other options include artificial insemination with donor sperm and injecting sperm directly into the egg (intracytoplasmic sperm injection). TCM: Acupuncture and/or Herbal treatments to balance hormones, increase sperm production and quality.	Fertility drugs: About 25 per cent are able to impregnate a partner. Artificial insemination: 5-20 per cent of women become pregnant per cycle. Sperm injection: About 15 per cent of women get pregnant per attempt. TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
Sperm allergy	Fewer than 10 per cent of infertile women and men have immune reactions to sperm, which cause them to produce antibodies that kill sperm cells. In men, this is most common after a vasectomy. This diagnosis is controversial.	None.	Conventional: Sperm washing and intrauterine insemination, assisted conception treatments. Immunosuppressive drugs, such as cortisone and prednisone, are sometimes used but many doctors don't recommend them. TCM: Acupuncture and/or Herbal treatments to balance hormones and the immune system, desensitization to sperm and promote ideal conditions for fertilization.	Success rates of 20-40 per cent per cycle have been reported for all these treatments, but these figures are considered controversial. TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
Unexplained and combination -- About 20-35 per cent of all fertility problems
Unexplained infertility	This catch-all term is used when doctors cannot find a cause for infertility after a full series of tests and assessments. Some experts think being significantly over- or underweight, exercising excessively and even environmental toxins may be contributing factors but no direct links have been confirmed.	None.	Conventional: Beyond timed intercourse, there is no specific treatment. Some couples try fertility drugs and assisted conception procedures such as in vitro fertilisation, which have usual success rates. TCM: Very rarely would a patient of TCM be diagnosied with unexplained infertility. The causes of infertility, according to TCM, are very different from conventional medical causes. Acupuncture and/or Herbal treatments are the normal course of action.	How long the couple has been infertile is important. Couples with unexplained infertility who have been trying for less than five years have about a 15-30 per cent chance of becoming pregnant in a given year. After five years, fewer than 10 per cent become pregnant without treatment. TCM: results vary with treatment adherence, patient age, and choice of treatments (TCM alone or in combination with other treatments)
Combination infertility	Couples who have both male and female infertility problems, or when one partner has more than one fertility problem.	Symptoms vary, depending on causes.	Once all infertility causes are determined, appropriate treatments follow. TCM: Both partners should attend to be assessed and have a treatment plan created if necessary.	Rates vary, depending on infertility causes.

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