Fertility & Infertility

Γονιμότητα & Υπογονιμότητα

Fertility care is defined by prevention, diagnosis and treatment of infertility.

Reproduction is normally achieved through unprotected and systematic sexual intercourse, where depending on the age and reproductive dynamics of the couple, the probability of natural conception ranges at an optimum between 20-37% in the first three months of trying. According to the age of the woman and as an indication, this percentage will form around 20% at 30 years of age, while at 40 years this percentage decreases to only 5%.

Successful reproduction is a complex and multifactorial biological process by which the two genetic materials combine to form a genetically novel organism. The crucial initial stages of the reproductive process require:

The outmost important factor for the successful completion of the above processes is fertility, a dynamic situation with three interconnected levels of organization:

Fertility, apart from the biological procedures, also depends on external factors such as the environment, diet, lifestyle, sexual behavior, frequency of intercourse, cultural-social- and religious beliefs, economic and social status and emotional fluctuations.

Infertility & Causes

Υπογονιμότητα & Αίτια

The causes of infertility can be found in multiple and often combined factors.


Male factor
Tubal factor
Ovarian dysfunction
Unexplained infertility

RCOG, 2004; Bhattacharya et al, 2009; Mascarenhas et al, 2012

Male Infertility

The male infertility is mainly attributed to isolated and combined sperm disorders (oligozoospermia, asthenozoospermia, teratozoospermia), absence of sperm in seminal fluid (azoospermia) and to erectile and ejaculatory dysfunction. Equally important are the functional capacity of sperm and the integrity of the contained genetic material.

The main causes that lead to male infertility are:

Female Infertility

The female reproductive system is a physiologically complex system as in addition to the contribution of the individual’s genetic material (oocyte), it “hosts and nurtures” the interaction of gametes (sperm and ova), fertilization and pregnancy.

The main causes of female infertility are:

Age and lifestyle factors

Fertility decreases over time and this is evident in both females and males. The reproductive cycle has been significantly extended, especially in developed countries due to the pursuit of education and professional stability, which results in many couples choosing to delay childbearing.

In men, testosterone levels decrease progressively after the age of 35, with sperm parameters being negatively affected in terms of volume, concentration, motility and morphology. After the age of 40, there is an increased rate of DNA damage carried by sperm, reduced motility (~ 40%) and sperm viability (~ 50%).

On the female side, even though women are born with a significant supply of eggs, only 400 to 500 of them will eventually mature. With advancing age, the time required to achieve pregnancy increases due to the differentiation of endocrine and reproductive function, with an additional increase in the frequency of aneuploidy occurrence in the ovum.

Lifestyle factors such as body weight, exercise, psychological stress, smoking, alcohol, caffeine, drugs, certain medications, environmental and occupational exposure to radiation, fever, chemicals and harmful factors can have a significant effect on fertility. Some of these behaviors are modifiable and preventative care may prove beneficial. Tailored consultation by an expert can bring about positive changes and improve your chances of getting pregnant.

  1. American Society of Reproductive Medicine. Infertility: An Overview. Patient Information Series 2012 (http://www.fertilityanswers.com/wp-content/uploads/2016/04/infertility-an-overview-booklet.pdf).
  2. World Health Organization (WHO). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018.
  3. Mascarenhas MN, Flaxman SR, Boerma T, et al. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 2012;9(12):e1001356. doi: 10.1371/journal.pmed.1001356 [published Online First: 2012/12/29]
  4. Boivin J, Bunting L, Collins JA, et al. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human reproduction (Oxford, England) 2007;22(6):1506-12. doi: 10.1093/humrep/dem046 [published Online First: 2007/03/23]
  5. Bhattacharya S, Maheshwari A, Mollison J. Factors associated with failed treatment: an analysis of 121,744 women embarking on their first IVF cycles. PLoS One 2013;8(12):e82249.
  6. Mascarenhas MN, Flaxman SR, Boerma T, et al. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 2012;9(12):e1001356.
  7. Practice Committee of the ASRM – American Society for Reproductive Medicine. Report on optimal evaluation of the infertile male. Fertil Steril 2006a; 86: S111-4.