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Infertility Causes

Mechanical infertility

    Investigation of mechanical infertility is indicated when the clinical interview raises the suspicion of mechanic difficulty or in case of repeated failures in fertility treatments.

 The egg coming from the ovary and the sperm coming from the vagina meet at the fallopian tube. Obstruction of the tubes or adhesions between the fallopian tubes and ovaries might interfere with this important encounter. Importantly, one patent fallopian tube is sufficed for this conception. If both tubes are obstructed IVF is indicated. Hysterosalpingography (HSG) and Hystero-Echovist are both efficient procedures to investigate the patency of the fallopian tubes.    

 A uterine lining (endometrium) of at least 6mm thick is essential for proper implantation of the embryo coming from the fallopian tube. Any uterine lesions, such as adhesions, polyp, fibroid or partition might interfere with proper implantation or even cause a later miscarriage. Hysteroscopy is the test of choice for evaluating the uterine cavity.

 In rare cases cervical lesions from surgical procedures in the cervix (especially for malignancy) can prevent the sperm from reaching its final destiny.

 A history of former miscarriages, repeated curettages, pelvic inflammatory disease (PID) or operation in the pelvic area raised in the clinical interview might direct towards a mechanical problem and investigation of mechanical infertility might be indicated. Investigation of the uterine cavity and fallopian tubes can be done in a variety of procedures: Hysterosalpingography (HSG), Hystero-Echovist, hysteroscopy, laproscopy or some combination of those.

 Even when there is no specific suspicion but fertility treatments fail repeatedly, investigation of mechanical infertility should be performed. Moreover, hysteroscopy is performed routinely as part of IVF.

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