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What are the types of infertility?

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6 fertility expert(s) answered this question

Answer from: Guillermo Quea Campos

Gynaecologist, Specialist in Reproductive Medicine
Pronatal Fertility Clinics
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The types of infertility they are nothing more than diagnosis given to a couple knowing if they previously got pregnant or not. We have two types of infertility: primary infertility and secondary infertility. Primary is the one when the couple that never achieved pregnancy and the Secondary: being those who had previous pregnancy.

Answer from: Wael Saab, MRCOG, Bsc

Gynaecologist, Deputy Clinical Director at CRGH, Associate Professor at UCL
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When it comes to classifying infertility, there are different ways to classify infertility or fertility issues. One of the definition is: people who suffer from primary infertility which are ladies or men who has never achieved a pregnancy so, men who have never their partners did not achieve a pregnancy or they did not father a pregnancy and the same for women – they did not conceive or they did not have any children before and their secondary infertility which is a lady who has been pregnant before whether that pregnancy resulted in a live birth or a miscarriage and they are struggling to get pregnant again. This is one of the ways to divide infertility as primary and secondary.

There are other ways to classify fertility issues. Another way that can be classified is dividing them as male factor infertility, female factor infertility and unexplained. When we mention female factor infertility, that means there’s a female cause for the fertility problem. A male factor infertility – a male problem causing the infertility and when we mention unexplained – that doesn’t mean that there’s no reason but that means unfortunately with what we have in our hands at the moment, we are not finding a cause for the infertility. Again you will find them in different studies quoting different percentages. I always try to keep things simple: approximately 40% of infertility is related to a female factor, 40% is related to a male factor and 20% is unexplained and the treatment will depend on what is the cause. If it’s a female a factor infertility, we take into account: is it a problem with the eggs, is it a problem with the tubes, is it a problem with the uterus and the treatment will be tailored accordingly and when it comes to the male factor infertility, we have to check: is it the how good or how bad are the semen parameters to see what kind of treatment will be offered because treatment is offered, if we are going to also simplify treatment on an algorithm from the simplest to the most complex. The simplest will be only asking couple to time intercourse properly and support them with some hormones, the second treatment is what we refer to as insemination, where we give ladies some medications and on a specific day we process the sperm and inject it inside the uterus and the third step in the ladder of the treatment: will be IVF which is a more medically intrusive treatment where we stimulate ovaries, we take eggs out, we mix eggs and the sperm in the lab and we put embryos inside the uterus. What treatment is offered to what patient will depend on the history, will depend on the cause of infertility too.

Answer from: Malini Uppal, MBBS, DGO Diploma Prenatal Genetics and Foetal Medicine

Gynaecologist, Medical Director and PR to HFEA
GENNET City Fertility
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With fertility for women there are two types of fertility, or sub fertility as we like to call it. One is primary where a woman has never conceived, has never been pregnant and the other one is secondary meaning you may have had a pregnancy that may have led to a miscarriage or a successful live birth and after having one child you are trying to conceive and unable to do so again. So there are two different types, classified into two subsections.

Answer from: James Nicopoullos, MD

Gynaecologist, Consultant Gynaecologist and Clinical Director of Lister Fertility
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I think that in essence, the vast majority, not the vast majority – the commonest thing we find frustrating theories about 30% of cases are idiopathic or unexplained, where you investigated everything and there’s still no obvious cause. In about 25% percent of cases the infertility is predominantly because of a male factor problem: sperm count, sperm motilities, the way the sperm looks or some issue directly causing it about 25% of cases. In another 25% of cases, it is a very subtle sperm factor that may have been having a minor effect but 25% of cases it is mainly sperm related. In about 20% of cases, there’s some issue with ovulation that is impacting fertility. Commonest of which is polycystic ovaries but a number of other factors that come in there. In about 15 % of cases there’s a tubal factor – block tubes causing the problem and then perhaps 5 to 10% of other cases, there’s some other gynaecological problem like endometriosis that may be impacted on the outcome.

Answer from: Raj Mathur, MD

Gynaecologist, Chair of the British Fertility Society, Consultant at Manchester University NHS Foundation Trust
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You could say that infertility has two types. You could have primary infertility where the couple have never previously conceived or could have secondary infertility in which they’ve conceived pregnancy, sometimes even couples who’ve had a baby, can very distressingly develop secondary infertility later on. So that’s the kind of broad classification of infertility and then you have different causes of infertility: on the male side, the female side and sometimes unexplained infertility which is another quite common entity.

Answer from: Radwan Faraj, MD

Gynaecologist, Gynaecology and Reproductive Medicine
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Types of infertility can be classified as primary and secondary. In primary infertility; the couples have not been able to conceive in their relationship. In secondary infertility, they have been able to conceive. Either the woman had a baby before, or a woman had been unsuccessful with the pregnancy like having a miscarriage, an ectopic pregnancy, or termination of pregnancy. That means she has been able to conceive. This gives me some reassurance because that means she has managed to ovulate, she has patent fallopian tubes, and the sperms are okay to get her pregnant. So we look at them differently from the management point of view.

Regarding causes of infertility; this can be classified into male factor, female factor, combined factors, and unexplained infertility. So malefactors are mainly related to the sperm production, quality of the sperm, number of the sperm. If there is erectile dysfunction or psychological factors. Regarding the female factors; it can be divided as ovulatory; which is the most common cause of around 30%. And the most common cause is Polycystic Ovarian Syndrome. Other ovulation problems are using certain drugs, and also overweight women will struggle so if you have a body mass index more than 30, or even a much lower body mass index of less than 18; this also will lead to suppression of ovulation absent periods.

Regarding the tubal factor, there could be so many conditions including chlamydia, which may affect the tubal block, including conditions like endometriosis which may also affect adhesions around the tubes of the ovaries. And also absent tubes or absent uterus or absent vagina; this is congenital. The woman is usually born with these conditions.

Regarding the unexplained factors; which is we’ve done all the tests for the couple and we cannot find the cause, this is seen in around 20% of the cases and management is usually with assisted conception.
So in a nutshell, these are the causes for infertility.

About this question:

What are general types of infertility and what are medical definitions of them?

Infertility can be divided in several subcategories. We can categorise by the gender : male or female infertility; We can also differ in primary and secondary infertility type. There is also so called idiopathic infertility.

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