A grounded overview of the most common factors behind difficulty conceiving.
PCOS, hypothalamic suppression, thyroid disorders, hyperprolactinemia, and premature ovarian insufficiency.
Prior pelvic infection, endometriosis, adhesions from prior surgery, and hydrosalpinx.
Fibroids, polyps, adhesions, adenomyosis, and dysmorphic uterus — many require 3D imaging to diagnose accurately.
Abnormal sperm count, motility, morphology, or DNA fragmentation; varicocele; obstructions; and hormonal issues.
Egg quantity and quality decline with age — the largest single fertility variable for women.
Weight, sleep, alcohol, smoking, chronic stress, and environmental exposures can all matter.
About 15–30% of couples have no clear cause on standard testing. Advanced workup including 3D ultrasound often uncovers contributing factors.
Dr. Patsama Vichinsartvichai, MD, MClinEmbryol, EFOG-EBCOG, EFRM-ESHRE/EBCOG, FACOG is a board-certified reproductive endocrinology & infertility specialist, former head of the Vajira IVF unit at Navamindradhiraj University, and founder of LIFE by Dr. Pat in Bangkok. His published research focuses on the dysmorphic (T-shaped) uterus and uterine-factor infertility.
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