Infertility can be linked to a wide range of hormonal, genetic, and anatomical causes. Stress, excess weight, and age add further influence. A diagnosis is not always a verdict. In 70% of cases, treating infertility through surgery, hormonal correction, or assisted reproductive technology (ART) — including surrogacy — brings a positive result, and the couple becomes parents. The path to a solution is always individual, and with the guidance of a specialised agency it becomes clearer and calmer from the very first step.
Female and Male Factors in Infertility
Male and female factors affect the ability to have children in equal measure. That is why a thorough examination of both the woman and the man is needed. In 20% of cases, a disorder is found in each partner. Statistically, the main causes of infertility are:
- Ovulation disorders due to polycystic ovary syndrome (PCOS), inadequate thyroid function, or the premature arrest of oocyte maturation.
- The tubal factor, where the egg cannot reach the uterus because of adhesions and obstruction of the fallopian tubes.
- Pathologies of the uterus and endometrium: congenital anomalies, fibroids, polyps, and endometriosis — factors that hinder the attachment and development of the embryo.
- Impaired spermatogenesis, with a reduced sperm count, reduced motility, altered morphology, or a complete absence of sperm.
- Varicocele, which worsens blood supply and raises the temperature of the testicle, reducing fertility.
- Hormonal imbalances such as a testosterone deficiency in men or hyperprolactinaemia in women.
- Genetic disorders. Y-chromosome microdeletions, with the loss of regions that affect sperm production. Klinefelter syndrome, where a man carries an extra chromosome, leading to substantial impairment of reproductive function.
Diagnostic methods identify the cause of the problem in 80% of cases. In 15–20%, the issue is idiopathic: the couple appears healthy on testing, yet the desired pregnancy does not occur. Researchers believe there are at least three plausible mechanisms whose expression is not yet fully understood.
The first is a reaction of the immune system to sperm, releasing so-called antibodies that promote agglutination and impair the motility of the gametes. The second explanation is a reduced immune tolerance to the embryo. The third mechanism is genetic incompatibility between the partners at the molecular level.
The Effect of Age and Lifestyle on Reproductive Health
Reproductive function depends not only on the presence of a medical diagnosis, but also on age and lifestyle. For example, excess weight with a body mass index above 30 and chronic stress cause a hormonal imbalance, which halts menstruation and reduces both sperm quality and potency. Smoking and alcohol affect the number and viability of the gametes. Combining two factors — obesity and smoking, for instance — lowers the probability of pregnancy by 50%.
The Influence of Age
Fertility follows a clearly defined age-related pattern. In women under 30, the likelihood of conception in each cycle averages 20–25%, while after 40 it is below 10%. This is linked to a decline in the ovarian reserve and in oocyte quality. After the age of 35, the risk of miscarriage and of chromosomal abnormalities in the embryo also doubles.
In men after the age of 40–45, the concentration and motility of sperm decrease, and the level of sperm DNA fragmentation rises, which increases the possibility of genetic mutations in offspring.
The Role of Chronic Conditions
Chronic conditions disrupt the functioning of the whole body, including the reproductive system. Among the factors connected with infertility in couples:
- Diabetes. It causes ovulation disorders in women and erectile dysfunction in men.
- Thyroid conditions lead to an irregular menstrual cycle and to difficulties with implantation and carrying a pregnancy.
- Systemic inflammatory and autoimmune conditions affect the early development of a pregnancy.
Some conditions threaten the health and life of the mother, so although a woman may be able to conceive, doctors advise against carrying a pregnancy. Examples include kidney or heart failure and pulmonary hypertension.
Prevention as a Way to Improve the Chances of Conception
Prevention has a direct effect on reproductive health. It will not resolve medical problems, but it does meaningfully address behavioural factors. Among the important and effective steps:
- planning to have children with age in mind;
- managing body weight;
- giving up smoking and the misuse of alcohol;
- treating TORCH infections;
- regular gynaecological and urological check-ups;
- correcting endocrine disorders at an early stage.
According to international studies, changes to lifestyle can improve fertility indicators by 20–30% where there is no organic cause of infertility in the couple.
Medical and Surgical Treatment of Infertility
When a disorder of hormonal or anatomical origin is identified, the first step is a course of the appropriate corrective medication or a surgical intervention. An individual approach matters. The method is chosen with the patient’s age, state of health, and previous treatment attempts in mind.
Oral and Injectable Therapy
- Hormonal medication. It is prescribed to correct the imbalance of hormones that reduce fertility. It is used in cases of anovulation, hypo- or hyperthyroidism, elevated prolactin production, male hypogonadism, or a disorder of the luteal phase of the cycle.
- Ovulation stimulation — a controlled effect on the ovaries to develop several follicles and increase the likelihood of fertilisation.
Surgery
Where indicated, surgery is offered to correct anatomical defects: obstruction, adhesions, and tumours. For men, the most common operation is varicocelectomy.
After conservative and surgical treatment of infertility, the chance of a natural pregnancy rises to 40%. If the desired result does not follow, ART methods are recommended.
When Assisted Reproductive Technology and Surrogacy Become the Best Option
To have a child in cases of diagnosed infertility that does not respond to conventional treatment, a range of ART methods is used successfully in Ukraine and worldwide:
- In vitro fertilisation (IVF) — the fusion of reproductive cells outside the body.
- Intrauterine insemination — the direct introduction of sperm into the uterus.
- Surrogacy — the carrying of a couple’s embryos by another woman.
Where needed, these methods are complemented by techniques that considerably support conception. Examples include micro-TESE (sperm retrieval in cases of azoospermia) and ICSI (the injection of a sperm directly into the oocyte). In severe, irreversible disorders of gametogenesis, donor sperm or donor eggs are used.
Surrogacy in Ukraine is suitable for couples who have a diagnosis of infertility and have been through at least four unsuccessful IVF attempts. International parents can take part in these programs as well. The fertilisation procedure and the recognition of parenthood are set out in law, and every party is protected by legal contracts. With expert coordination, the process unfolds smoothly and calmly.
In short, one in six people of reproductive age worldwide experiences infertility. Yet timely prevention, a healthy lifestyle, and medical and surgical treatment can help 40% of these couples. A further 30–40% become parents through the various assisted reproductive technologies — which together offers a chance at parenthood to 70–80% of people with a diagnosis of infertility.
