Infertility

What is infertility?

Infertility means not becoming pregnant after having frequent, unprotected sex for one year or longer. If you are age 35 or older, infertility can be diagnosed after six months. Infertility also includes situations where you can get pregnant, but the pregnancy ends in repeated miscarriage or stillbirth.

Infertility is common. It can affect both men and women. Sometimes both partners contribute to the cause.

What causes infertility?

Infertility can happen because of a health issue in you or your partner or a mix of factors. In some cases, no clear cause is found.

Common causes in women include:

• Failure to ovulate, often due to conditions like polycystic ovary syndrome (PCOS)
• Blocked or damaged fallopian tubes (the tubes that carry eggs from the ovaries to the uterus), often caused by past sexually transmitted infections (STIs), pelvic inflammatory disease, or abdominal (belly) surgery
• Conditions affecting the uterus (womb), such as fibroids or endometriosis
• Problems producing eggs, which may occur with aging
• Hormonal imbalances, such as having too much estrogen

Common causes in men include:

• Low sperm count
• Sperm that doesn't move well
• Blocked sperm ducts
• Hormonal imbalances, such as having too much testosterone

Certain lifestyle habits can also raise your risk of infertility. These can include smoking, heavy alcohol use, and being very overweight or underweight. Older age and some health conditions may increase your risk as well.

How is infertility diagnosed?

Your health care provider will ask about your health history and may do a physical exam. Testing is different for women and men. It may include blood tests, imaging tests, and a semen test for men.

How is infertility treated?

Treatment depends on the cause, how long you've been trying to get pregnant, and your age. Some treatments are for men, some are for women, and some involve both partners. Common options include treatment for the underlying cause, medicines, assisted reproductive technology, and surgery.

Infertility can be stressful. Counseling and support groups may help you and your partner cope. Many couples who receive treatment go on to have children.

Can infertility be prevented?

Not all cases of infertility can be prevented, but practicing healthy habits may help lower your risk:

• Quit smoking, or don't start
• Limit alcohol
• Maintain a healthy weight
• Practice safe sex to prevent STIs, except when you're trying to get pregnant

If you're ready to try to get pregnant, see your provider if you are over age 40, have irregular periods, have a history of pelvic inflammatory disease, or have had fertility concerns in the past.

NIH: National Institute of Child Health and Human Development

Questions for your care team

General prompts to help prepare for your appointment.

• How does this information apply to my situation?
• Which symptoms or results need evaluation?
• Which tests are useful, and what can they tell us?
• What care options, benefits, and risks should we discuss?
• When should I seek urgent help, and whom should I call?
• When is follow-up, and how will we know whether the plan is working?