Endometrial polyps are growths found in the uterine cavity. Large polyps or multiple polyps can impact fertility by interfering with the ability of embryo to implant and should be removed. The impact of small or single polyps is more controversial.

Fibroids are noncancerous growths in the uterus. They are very common (approximately 40% of women have them them). However, the presence of fibroids alone doesn’t necessarily cause infertility or predispose a woman to pregnancy loss. Fibroids that distort the uterine cavity have an impact on the ability of an embryo to implant and should be removed surgically. The impact of fibroids located elsewhere in the uterus are controversial and do not always require surgery.

Even after a full fertility work-up, for one in five couples an exact cause of infertility cannot be determined. Unexplained infertility is not the same thing as having no explanation, but rather reflects the fact that the tests performed have been normal. There is always an explanation! Often, in vitro fertilization (IVF) can reveal abnormalities in egg quality, sperm function, or embryo development that would not have been determined from standard testing. Thankfully, even when the cause of infertility is not known, various fertility treatments can eventually lead to delivery of a healthy baby.

There are many different tubes that carry sperm. They can be blocked due to numerous causes, including infections,  trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.

Hereditary disorders, such as Klinefelter’s syndrome (when a male is born with two X chromosomes and one Y chromosome instead of one X and one Y) impacts the normal development of the male reproductive organs.

These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.

Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility.

Certain surgeries may prevent you from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others. In most cases, surgery can be performed to either reverse these blockage or to retrieve sperm directly from the epididymis and testicles.

A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility. Fertility may improve after adopting a gluten-free diet.

Some infections, such as gonorrhea or inflammation of the testicles, can affect sperm production or sperm health or can cause scarring that blocks the passage of sperm.