Fertility Screening Specialists in Central London

London Pregnancy Clinic is a diagnostic imaging screening centre; as such, we do not offer any treatments at our clinic. Instead, we specialise in screening and understanding the potential causes of infertility. Additionally, our consultant gynaecologists can advise you on the results of your fertility screening and on the causes of both male and female infertility.

Every year, we assist hundreds of our patients at various stages of their fertility journeys and treatments, whether during initial fertility assessments, in collaboration with overseas clinics for fertility treatments, or in the later stages with pregnancy scanning.

Female infertility can be influenced by a variety of factors. The main causes include:

Ovulatory Disorders: This is one of the most common causes. Problems with ovulation often lead to irregular, infrequent, or absent menstrual cycles. Conditions like polycystic ovary syndrome (PCOS), primary ovarian insufficiency (POI), and hyperprolactinemia can influence ovulation.

Tubal Blockage or Damage: Fallopian tubes can become blocked or damaged, preventing sperm from reaching the ovum or the fertilized egg from reaching the uterus. Causes can include pelvic inflammatory disease, sexually transmitted infections, or previous surgeries in the area.

Endometriosis: This is a condition where tissue similar to the lining inside the uterus, called endometrium, starts to grow outside the uterus. This can cause ovarian cysts (endometriomas) and scar tissue, potentially affecting fertility.

Uterine or Cervical Abnormalities: Abnormalities with the opening of the cervix, the shape or cavity of the uterus, or the presence of benign tumours in the uterine wall (fibroids) can cause infertility.

Premature menopause (premature ovarian insufficiency): Some women reach menopause before the age of 40 (menopause before 45 is termed early menopause), which means their ovaries stop producing normal amounts of eggs and oestrogen.

Pelvic Adhesions: Bands of scar tissue that can form after surgeries or infections can bind organs and potentially affect fertility.

Thyroid Problems: Disorders of the thyroid, either hyperthyroidism (too much thyroid hormone) or hypothyroidism (too little thyroid hormone), can interrupt menstrual cycles and cause infertility.

Cancer and Cancer Treatments: Certain cancers, especially reproductive cancers, and treatments (like chemotherapy and radiation) can severely impair female fertility.

Other Causes: These include medical conditions such as Cushing’s syndrome, sickle cell disease, kidney disease, celiac disease, diabetes, and autoimmune diseases. Lifestyle factors like excessive alcohol or drug use, smoking, age, obesity, and extreme weight loss can also influence fertility.

It’s worth noting that sometimes, despite investigations, the cause of infertility remains unexplained. For a comprehensive understanding and diagnosis, it’s crucial for individuals or couples to consult with a reproductive specialist or gynaecologist.

Male infertility can result from a range of factors related to sperm production, delivery, and other underlying conditions. The main causes include:

Varicocele: This is an enlargement of the veins within the scrotum and is one of the most common reversible causes of male infertility. It can impair sperm production and function.

Ejaculation Disorders: This includes conditions like retrograde ejaculation (sperm enters the bladder instead of emerging through the penis), anejaculation (a man cannot ejaculate), and aspermia (absence of semen).

Tubal Blockages: Obstructions, either congenital or as a result of surgeries, can block the sperm’s passage. This includes conditions like congenital bilateral absence of the vas deferens (CBAVD).

Infections: These can interfere with sperm health or sperm production. Examples include epididymitis, orchitis, and some sexually transmitted infections, including gonorrhea, chlamydia, and HIV.

Hormonal Imbalances: Testosterone deficiencies or other hormonal problems can affect sperm production. This can be due to conditions like hypogonadism or tumours.

Genetic Disorders: Examples include Klinefelter’s syndrome, Y-chromosome microdeletions, and cystic fibrosis.

Erectile Dysfunction: Difficulty with erections or other sexual problems can prevent successful intercourse and, consequently, conception.

Environmental and Lifestyle Factors: Exposure to certain environmental factors such as pesticides, heavy metals, and radiation, as well as frequent exposure to heat (like in saunas or hot tubs), can reduce sperm production or function. Similarly, drug use, tobacco smoking, excessive alcohol consumption, certain medications, and obesity can negatively impact sperm quality.

Medications and Treatments: Some medications, such as those for hypertension, depression, or cancer, can impair sperm production. Treatments like radiation and chemotherapy can also adversely impact male fertility.

Undescended Testicles: This condition, where one or both of the testicles do not descend into the scrotum during fetal development, can affect fertility.

Immune System Disorders: In some cases, men produce anti-sperm antibodies that attack their own sperm, leading to infertility.

Testicular Trauma or Surgery: Injuries or surgeries to the testicles or nearby structures can impact sperm production or delivery.

It’s important to highlight that in some cases, the exact cause of male infertility remains unidentified. As with female infertility, consultation with a urologist or fertility specialist is vital for proper diagnosis and guidance.

Based on UK figures from the National Institute for Health and Care Excellence (NICE Clinical Guideline 156), the main contributing factors to infertility break down approximately as follows. These proportions are approximate and vary between populations, and categories can overlap because a cause may be found in both partners:

Female Factors: On the female side, the most common identifiable causes are ovulatory disorders (around 25% of cases), tubal damage (around 20%) and uterine or peritoneal disorders such as endometriosis (around 10%).

Male Factors: A male factor contributes to around 30% of infertility cases, which can involve sperm production issues, ejaculation disorders, structural abnormalities and other conditions.

Both Partners: In about 40% of cases a contributing factor is found in both the man and the woman.

Unexplained Causes: In around 25% of cases (about 1 in 4), no cause is identified in either partner after standard investigations. This is known as unexplained infertility.

These are population-level estimates and an individual's situation can only be established through appropriate assessment. For a full evaluation, it is important to consult a reproductive specialist or gynaecologist.