Infec­tions and medicines

Inflammation of the cervix (cervicitis), of the lining of the uterus (endometritis) and of the fallopian tubes (salpingitis) is among the most serious causes of infertility. The microorganisms responsible are chlamydia, mycoplasma, ureaplasma, gonococcus and herpes. After the infection, healthy tissue in the cervical canal and the uterine cavity is replaced by scar tissue.
Scar tissue forming in the fallopian tubes is a common cause of infertility, because it blocks them. In this case, the tubes are not only blocked but also less able to play their part in conception, because their ciliated lining (epithelium), which helps move the fertilised egg towards the uterine cavity, has been destroyed.
In addition, the risk of an ectopic (tubal) pregnancy is considerably increased.
These infections are treated with antibiotics. If the fallopian tubes are blocked, in vitro fertilisation (IVF) is the better option, unless the blockage is at the far end of the tube, in which case the tube can be opened laparoscopically.

Medicines

Certain medicines reduce fertility, such as antidepressants, blood pressure medicines (antihypertensives), neuroleptics and antacids. The reason is that they cause a rise in prolactin (a hormone of the pituitary gland), which blocks the release of gonadotrophins and reduces the production of sex hormones. This disrupts the development and maturation of the egg in the ovaries. The passage of sperm is also hindered.