Infertility as a Multifactorial Health Condition: Current Perspectives on Etiology, Pathophysiology, and Emerging Therapeutic Approaches

Abstract

Infertility, a complex and multifactorial health condition, affects a significant proportion of the global population, with profound physiological and psychosocial implications. It is defined as the inability to achieve pregnancy after 12 months or more of regular, unprotected sexual intercourse. The etiology of infertility is diverse, encompassing endocrine disorders, genetic abnormalities, infections, anatomical defects, and environmental or lifestyle factors. In males, common causes include varicocele, hormonal imbalances, and impaired spermatogenesis, while in females, ovulatory dysfunction, tubal obstruction, endometriosis, and polycystic ovary syndrome are predominant contributors. The pathophysiology of infertility reflects disruptions in normal reproductive physiology, often driven by oxidative stress, hormonal dysregulation, or immune-mediated damage. Diagnostic approaches have advanced, incorporating hormonal assays, imaging techniques, semen analysis, and laparoscopy to identify underlying causes in both sexes. The impact of infertility extends beyond reproductive challenges, significantly affecting physical health, emotional well-being, and social relationships. Preventive and therapeutic strategies include pharmaceutical interventions—such as ovulation induction agents, gonadotropins, and emerging assisted reproductive technology approaches—and non-pharmaceutical measures, including lifestyle modifications, nutritional support, and stress reduction. A multidisciplinary approach is essential for effective management. This review synthesizes current insights into infertility’s etiology, pathophysiology, diagnostic pathways, health consequences, and therapeutic strategies, emphasizing the need for individualized, evidence-based care