Predictors of infertility

Barinova E.R., Aruytin D.G.

1) Medical Institute, Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia; 2) N.E. Bauman City Clinical Hospital No. 29, Moscow City Healthcare Department, Moscow, Russia
Infertility is a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular unprotected sexual life. Infertility tends to become another pandemic of the modern world. According to some estimates, the frequency of infertile marriages ranges 10–25% (from 48 to 180 million). Such couples face adverse consequences for physical and mental health, financial difficulties, a serious social stigma, an increased risk of domestic violence, and instability in marriage. The evaluation of the female factor infertility has been traditionally the driving force in the examination of infertility.
Although men and women are equally susceptible to infertility; however, women bear a greater social burden, especially in the societies where identity and social value are closely related to the ability to give birth to babies. The age-related decline in female fertility is of serious concern; moreover, the decision about pregnancy is frequently made at a later age. Therefore, the study of the causes of infertility development is extremely important and a review of the current studies on this topic seems relevant. This review considers the most common causes of infertility, such as ovulatory dysfunctions, male infertility, tubal diseases, lifestyle (smoking, obesity), environmental factors, abnormalities of the uterus and cervix uteri, as well as endometriosis.
Conclusion: Infertility is a multifactorial disease that requires further investigation and solution of this problem to achieve the main result – to overcome infertility. Despite advances in the modern diagnosis and treatment of infertility, the number of infertile couples is growing every year. Therefore, female patients of any age need a personalized treatment approach. It should be noted that modern trends in medicine are aimed at the prediction and prevention of diseases that can lead to menacing complications, including infertility.

Authors' contributions: Barinova E.K. – writing the text; Aryutin D.G. – editing the text; Aryutin D.G., Barinova E.K. – concept and design.
Conflicts of interest: The authors declare that there is no potential interest conflict requiring disclosure in this article.
Funding: The investigation has not been sponsored.
For citation: Barinova E.K., Aryutin D.G. Predictors of infertility.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (4): 178-183 (in Russian)


risk factors


  1. Centers for Disease Control and Prevention. The main statistics of the National Family Growth Survey are listing I. Retrieved 28 April 2020. Available at:
  2. World Health Organization. Infertility. Accessed on 11 July 2022. Available at:
  3. Эседова А.Э., Меджидова А.М. Аденомиоз и бесплодие. Подходы к лечению. РМЖ. Мать и дитя. 2021; 4(2): 110-4. [Esedova A.E., Medzhidova A.M. Adenomyosis and infertility. Management strategies. Russian Journal of Woman and Child Health. 2021; 4(2): 110-4. (in Russian)].
  4. Carson S.A., Kallen A.N. Diagnosis and treatment of infertility: an overview. JAMA. 2021; 326(1): 65-76.
  5. Thoma M., Fledderjohann J., Cox C., Adageba R.K. Biological and social aspects of human infertility: a global perspective. Oxford research encyclopedia of global public health. Published online: 25 March 2021.
  6. Перминова С.Г. Бесплодие у женщин с заболеваниями щитовидной железы: принципы диагностики, тактика ведения. Акушерство и гинекология: новости, мнения, обучение. 2013; 2(2): 18-24. [Perminova S.G. Infertility in women with thyroid diseases: principles of diagnosis, management. Obstetrics and Gynecology: News, Opinions, Training. 2013; 2(2): 18-24.(in Russian)].
  7. Tide H.J., Miss M.L., Costello M.F., Dokras A., Levin J., Moran L. et al. Recommendations of the international evidence-based guidelines for the assessment and treatment of polycystic ovary syndrome. Fertil. Infertil. 2018; 110(3): 364-79.
  8. Назаренко Т.А. Синдром поликистозных яичников. Современные подходы к диагностике и лечению бесплодия. МЕДпресс-информ; 2005. 207с. [Nazarenko T.A. Polycystic ovarian syndrome. Modern approaches to diagnosis and treatment of infertility. MED press-inform; 2005. 207p. (in Russian)].
  9. Киракосян К.Э., Назаренко Т.А., Краснопольская К.В. Гиперандрогенные состояния в структуре репродуктивных нарушений у женщин армянской национальности. Проблемы репродукции. 2012; 5: 45 9. [Kirakosian K.É., Nazarenko T.A., Krasnopol'skaia K.V. The features of hyperandrogenism in women of Armenian nationality. Russian Journal of Human Reproduction. 2012; (5): 45 9. (in Russian)].
  10. Boutari C., Pappas P.D., Mintziori G., Nigdelis M.P., Athanasiadis L., Goulis D.G., Mantzoros C.S. The effect of underweight on female and male reproduction. Metabolism. 2020; 107: 154229.
  11. Farquhar C.M., Bhattacharya S., Repping S., Mastenbroek S., Kamath M.S., Marjoribanks J., Boivin J. Female subfertility. Nat. Rev. Dis. Primers. 2019; 5(1): Article 7.
  12. Tal R., Seifer D.B. Ovarian reserve testing: a user’s guide. Am. J. Obstet. Gynecol. 2017; 217(2): 129-40.
  13. Practice Committee of the American Society for Reproductive Medicine. Role of tubal surgery in the era of assisted reproductive technology: a committee opinion. Fertil. Steril. 2015; 103(6): e37-e43.
  14. Дубровина С.О., Ардинцева О.А., Машкина Е.В. Современные представления о роли полиморфизма генов NOD в патогенезе трубного бесплодия у пациенток с перенесенной хламидийной инфекцией. Вопросы практической кольпоскопии. Генитальные инфекции. 2022; 1: 78-81. [Dubrovina S.O., Ardintseva O.A., Mashkina E.V. Modern concepts of the role of nod gene polymorphism in the pathogenesis of tube infertility in patients with a past chlamydia infection. Colposcopy Issues & Genital Infections. 2022; (1): 78-81. https://dx/
  15. Singh N., Sumina G., Mittal S. Genital tuberculosis: the main cause of infertility in women seeking assisted conception in Northern India. Arch. Gynecol. Obstet. 2008; 278(4): 325-7. https://dx/
  16. Fang F., Bai Y., Zhang Y., Faramand A. Oil- and water-based contrast for hysterosalpingography in infertile women: a systematic review and meta-analysis of randomized controlled trials. Fertil. Steril. 2018; 110(1): 153160.e3.
  17. Dreyer K., van Rijswijk J., Mijatovic V., Goddijn M., Verhoeve H.R.,van Rooij I.A.J. et al. Oil- or water-based contrast for hysterosalpingography in infertile women. N. Engl. J. Med. 2017; 376(21): 2043-52.
  18. Maheux-Lacroix S., Boutin A., Moore L., Bergeron M-E., Bujold E., Laberge P. et al. Hysterosalpingosonography for the diagnosis of tubal occlusion in subfertile women: a systematic review with meta-analysis. Hum. Reprod. 2014; 29(5): 953-63. 02.
  19. Tan J., Tannus S., Taskin O., Kan A., Albert A.I., Bedaivi M.A. The effect of unilateral tubal blockade diagnosed by hysterosalpingogram on the clinical frequency of pregnancy in intrauterine fertilization cycles: a systematic review and meta-analysis. BJOG. 2019; 126(2): 227-35.
  20. Melo P., Georgiou E.X., Johnson N., van Voorst S.F., Strandell A. et al. Surgical treatment of tubal disease in women for the purpose of in vitro fertilization. Cochrane Database Syst. Rev. 2020; 10(10): CD002125.
  21. Урюпина К.В., Куценко И.И., Кравцова Е.И., Кудлай Ю.В., Кравцов И.И. Эндометриальный фактор бесплодия у пациенток позднего репродуктивного возраста (обзор). Кубанский научный медицинский вестник. 2020; 27(6): 149-63. [Uryupina K.V., Kutsenko I.I., Kravtsova E.I., Kudlai J.V.,Kravtsov I.I. Endometrial Infertility in Patients of Late Reproducti ve age (a review). Kuban Scientifc Medical Bulletin. 2020; 27(6): 149-63.(in Russian)].
  22. Аксененко А.А., Гус А.И., Мишиева Н.Г. Аденомиоз и бесплодие. Акушерство и гинекология. 2021; 4: 41-7. [Aksenenko A.A., Gus A.I., Mishieva N.G. Adenomyosis and infertility. Obstetrics and Gynecology. 2021; (4): 41-7.(in Russian)].
  23. Yan L., Ding L., Tang R., Chen Z.-J. Effect of adenomyosis on in vitro fertilization/intracytoplasmic sperm injection outcomes in infertity. Gynecol. Obstet. Invest. 2014; 77(1): 14-8.
  24. Bittencourt C.A., Dos Santos Simões R., Bernardo W.M., Fuchs L.F.P., Soares Júnior J.M., Pastore A.R., Baracat E.C. Accuracy of saline contrast sonohysterography in detection of endometrial polyps and submucosal leiomyomas in women of reproductive age with abnormal uterine bleeding: systematic review and meta-analysis. Ultrasound Obstet. Gynecol. 2017; 50(1): 32-9.
  25. Оразов М.Р., Михалева Л.М., Исмаилзаде С.Я. Факторы риска реализаций внутриматочных адгезий у женщин репродуктивного возраста. Медицинский вестник Юга России. 2022; 13(2): 86-90.
  26. Fujimoto V.Y., Miller J.H., Klein N.A., Soules M.R. Congenital cervical atresia: report of seven cases and review of the literature. Am. J. Obstet. Gynecol. 1997; 177(6): 1419-25.
  27. Bosteels J., van Wessel S., Weyers S., Broekmans F.J., D'Hooghe T.M., Bongers M.Y., Mol B.W.J. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database Syst. Rev. 2018; 12(12): CD009461.
  28. Gleason J.L., Shenasa E.D., Toma M.E. Self-assessment of infertility, metabolic dysfunction and cardiovascular events: a cross-analysis among U.S. women. Fertil. Steril. 2019; 111(1): 138-46.
  29. Stentz N.C., Koelper N., Barnhart K.T., Sammel M.D., Senapati S. Infertility and mortality. Am. J. Obstet. Gynecol. 2020; 222(3): 251.e1-251.e10.
  30. Brännström M., Johannesson L., Bokström H., Kvarnström N., Mölne J.,Dahm-Kähler P. et al. Live birth after uterus transplantation. Lancet. 2015; 385(9968): 607-16.
  31. Eisenberg D., Andraus V., Barateli Karelii Mendes L.R, Ducatti L., Song A., Tanigawa R. et al. Live births after uterus transplantation from a deceased donor to a recipient with uterine infertility. Lancet. 2019; 392(10165): 2697-704.
  32. Каширова Т.В., Фадеев В.В., Перминова С.Г., Назаренко Т.А., Корнеева И.Е., Лесникова С.В., Ибрагимова М.Х. Особенности репродуктивной функции у женщин с болезнью Грейвса. Клиническая и экспериментальная тиреодология. 2009; 5(2): 52-7. [Kashirova T.V., Fadeyev V.V., Perminova S.G., Nazarenko T.A., Korneyeva I.E., Lesnikova S.V., Ibragimova M.Ch. Reproductive Function in Women with Graves’ Disease. Clinical and Experimental Thyroidology. 2009; 5(2): 52-7. (in Russian)].
  33. Перминова С.Г. Бесплодие у женщин с аутоиммунной патологией щитовидной железы особенности реализации репродуктивной функции в программах вспомогательных репродуктивных технологий. Медицинский cовет. 2012; 7: 40-4. [Perminova S.G. Infertility in women with autoimmune thyroid pathology, peculiarities of realization of reproductive function in programs of assisted reproductive technologies. Medical Council. 2012; (7): 40-4. (in Russian)].
  34. Перминова С.Г. Особенности овариального резерва у женщин с бесплодием и аутоиммунным тиреоидитом. Акушерство и гинекология. 2012; 1: 60-3. [Perminova S.G. The ovarian reserve in women with infertility and autoimmune thyroiditis. Obstetrics and Gynecology. 2012; (1): 60-3.(in Russian)].
  35. Сметник А.А., Сазонова А.И. Влияние щитовидной железы и ее патологии на репродуктивную функцию женщин. Акушерство и гинекология. 2019; 3: 46-52. [Smetnik A.A., Sazonova A.I. The impact of the thyroid and its disease on female reproductive function. Obstetrics and Gynecology. 2019; (3): 46-52. (in Russian)].

Received 15.03.2023

Accepted 17.04.2023

About the Authors

Ebecha K. Barinova, graduate student of the Department of Obstetrics and Gynecology with a course of perinatology, RUDN University, +7(926)695-40-73,,, 117198, Russia, Moscow, Miklukho-Maklaya str., 8.
Dmitry G. Aryutin, Ph.D., Head of the Gynecological Department, N.E. Bauman City Clinical Hospital No. 29, Moscow Healthcare Department; Associate Professor at the Department of Obstetrics and Gynecology with a course of perinatology, RUDN University, +7(903)772-95-38,,, 111020, Russia, Moscow, Hospital sqr., 2.

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.