Infertility can commonly be a result of at least one of the three main aspects of fertility – release of eggs (ovulation), health of the fallopian tubes or healthy sperm. Dr Metawa is experienced in investigating and managing all aspects of infertility. At your consultation Dr Metawa will discuss your circumstance and best available options.

Infertility Causes

Common Causes of Infertility

Ovulation disorders – usually associated with absent or irregular periods. For example:

  • Polycystic ovarian syndrome (PCOS)
  • Raised levels of prolactin (hormone that stimulates milk production)
  • Abnormal thyroid function (gland that controls hormone levels)
  • Hypothalamic causes (stress, exercise, weight loss)

Fallopian tube – blockage or damage. The fallopian tubes are delicate and can easily become blocked by:

  • Infection (salpingitis – inflammation of the fallopian tubes)
  • Adhesions from surgery (appendix or ovarian), or
  • Endometriosis and other conditions (endometriosis – abnormal tissue growth outside the uterus)


Uterine fibroid — Submucosal or an intracavitary
Uterine abnormities — interfering with normal implantation of fertilized egg. Uterine congenital anomalies, Endometrial polyps, and internal uterine adhesions.
Luteal phase defect — inadequate production of progesterone, which is necessaryfor making the endometrium receptive to implantation.


Cervical Factors — Normal midcycle cervical mucus facilitates the transport of sperm. Congenital malformations and trauma to the cervix (including surgery) may result in sever narrowing and inability of the cervix to produce normal mucus, thereby impairing fertility.

Immune Factors

Male factor – sperm quality. Up to 50% of infertility in couples is due to sperm quality. This can easily be tested with a sperm count (semen analysis).

Any surgical or invasive procedure carries risks.
Before proceeding, you should seek  a second opinion from an appropriately qualified health practitioner.