Infertility is defined as: the inability of a couple to conceive after one year of intercourse without contraception. Infertility is seen in ten to fifteen percent of couples. The causes of infertility can be male or female or both. About 40% of infertility problems are related to men, 40% are related to women and about 10% are related to both. In about 10% of couples, the cause of infertility is not known. In other words, in these couples, both people have no problems according to the available tests, but they do not have children for unknown reasons. During the last two decades, great strides have been made in the diagnosis and treatment of infertility, and about 65% of infertile couples have had children using existing methods. **Causes of infertility in women** **1) Ovulation disorder** Ovulation disorder is the main cause of infertility in women. So that 39% of the causes of female infertility are related to this issue. Without ovulation, fertilization does not take place and therefore the woman does not get pregnant. Some women may not ovulate, or they may ovulate irregularly, and therefore they may not have menstrual periods, or their menstrual periods may be scanty and irregular, and even some women have ovulation disorders despite having regular periods. **2) disorder in uterine tubes** In some women, the fallopian tubes are completely or partially closed. As a result, the sperm does not reach the egg. Closed fallopian tubes can be due to infection, endometriosis or adhesions after surgery. These tubes may also close after an ectopic pregnancy. In developing countries compared to developed countries, due to the prevalence of infectious diseases of the reproductive system, the rate of fallopian tube disorders is higher. In general, 30% of the causes of infertility in women are related to disorders in the fallopian tubes. **3) Endometriosis** Endometriosis is a condition in which the lining of the uterus (endometrium) grows and extends beyond the uterus and covers the fallopian tubes and even closes them, causing disruption in ovulation. Endometriosis is the cause of 13% of infertility cases and about 70% of women with endometriosis are infertile. **4) Disturbance of the cervix or uterus** Abnormalities of the cervix can cause infertility, including problems related to body structure, cervical and uterine infections, or inappropriate quality of uterine secretions. On the other hand, malignant tumors of the uterus or some scars on the uterine wall cause infertility. **5) Problems with the body's immune system** Problems related to the body's immune system and immunological factors play an important role in causing infertility. It is difficult to diagnose and treat such patients. In some women, a substance called antibody is secreted against the male sperm, which destroys the sperms and deactivates them, or even causes spontaneous abortion in some pregnancies. Causes of infertility in men **1) disorders related to sperm** Normally, sperm is produced in a man's testicles and is released during ejaculation. If there is a disorder in the following cases, the chance of conception is reduced and the man is considered infertile. Low sperm count Immaturity of sperm Abnormal sperm shape Inability to move sperm properly Factors that have a negative effect on the number, shape, maturity and movement of sperm include: Infectious diseases: Infectious diseases with inflammatory conditions such as mumps cause genital tract infection or inflammation and loss of testicles in men. About 25% of men who get mumps after puberty become infertile. Hormonal disorders Hormonal disorders cause about 2-5% of infertility problems in men. Improper production of FSH and LH hormones affect the production of masculinity hormone or testosterone and sperm production. Problems related to the body's immune system In the body of some men, a substance called antibody is produced against their own sperm, which causes the reduction of sperm movement or their sticking together. **2) Abnormalities related to body structure** Some factors, such as the closure of the sperm exit tubes (defrons, epididymis) cause infertility in men. The closing of the sperm exit tubes can be due to congenital causes, genetic defects, infections or inflammations of the urinary-genital system. Of course, previous surgeries can also block these tubes. Among other factors of male infertility is varicocele. In this case, the veins inside the scrotum dilate and sperm quality decreases. **3) other factors** Other factors such as impotence or premature ejaculation can also cause infertility in men. **Genetic causes of infertility** The causes of infertility, ranging from hormonal problems and obesity to the abnormality of sex cells (eggs and sperm), can all be influenced by genetic factors. For example, the tendency to obesity, getting an infection and even the need to perform a surgery that leads to infertility can all be related to genetic factors, even if they are small. Today, studies on specific genes in humans and laboratory models have revealed to some extent the effect of genetic factors on infertility. Some genetic factors affect male infertility, while some other factors affect both sexes or only women. For example, chromosomal translocations can affect both men and women, but Klinefelter's syndrome, in which the combination of sex chromosomes is XXY, is only for men, and Turner's syndrome, in which the patient only has an X sex chromosome, is only for women. **Unknown Factors** Sometimes, after a careful medical examination, a couple may be diagnosed as completely healthy, but they cannot conceive for unknown reasons. Although usually after two years, a large number of these couples have children, but some of them do not have children even after three years without using contraceptive methods, in which case they should be treated. #### Dr. Siddiqa Akhan Tabib **Surgeon and specialist in gynecology, childbirth and infertility** **Office:** Valiasr Street, below Vali Asr Square, Voldi Street, No. 21, 1st floor Set time Tel: 021-88938793 ###### Dr. Akhwan Tabib, Dr. Akhwan, Gynecologist, Gynecologist, Gynecologist, Valiasr Street, Gynecologist, Valiasr Square, Dr. Sediqah Akhwan, Dr. Sediqah Akhwan, Doctor, Dr. Siddiqa Akhwan, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist, Gynecologist,