Iatro­genic causes of infer­tility

Various medical procedures or operations can cause infertility.

Chemotherapy and radio­therapy

This includes all chemotherapy given as treatment for malignant tumours (carcinomas). Chemotherapy and radiotherapy, mainly to the lower pelvis, can destroy the function of the ovaries and testes, so that they no longer produce eggs or sperm respectively.
This leads to insufficiency of the gonads (ovaries, testes) and a hypergonadotrophic state (raised FSH and LH). The production of steroid hormones in the ovaries (or testes) falls, and as a result the brain and the pituitary gland release the hormones that control them (gonadotrophins). Through this compensatory reaction, the body tries to produce the missing hormones, but this is not possible because the testes and ovaries have already been destroyed.
Chemotherapy can also bring on premature menopause. To preserve eggs, sperm and tissue before chemotherapy or radiotherapy, read about cryopreservation.

Surgery

Operations in which ovarian tissue is removed, e.g. to remove a tumour or large endometriosis cysts, can cause ovarian insufficiency. An “aggressive” curettage (scraping) of the uterine cavity that destroys the basal layer of the endometrium can also significantly reduce fertility.

Tubal ligation

This operation, which a woman chooses herself as a method of contraception, leads to sterility because the fallopian tubes are cut.