Infertility means not being able to get pregnant after 12 months of regular, unprotected sex — or after 6 months if the woman is 35 or older. It affects many couples and can be due to issues in the female reproductive system, the male reproductive system, or both. In some cases, no clear cause is found, but help is still available.
Female Factors
In women, infertility is often related to problems with ovulation, blocked fallopian tubes, or changes in the uterus.
- Ovulation problems: This means the ovary isn’t releasing an egg each month. Hormonal imbalances or conditions like polycystic ovary syndrome (PCOS) are common causes. These can affect how the brain signals the ovaries to release an egg.
- Blocked or damaged fallopian tubes: The fallopian tubes carry the egg from the ovary to the uterus. If they are blocked due to past infections (like pelvic inflammatory disease), endometriosis, or surgery, the egg and sperm can’t meet.
- Uterine issues: Growths such as fibroids or polyps in the uterus can affect implantation. Age also plays a role—egg quality and quantity naturally decrease over time, especially after age 35.
Male Factors
In men, infertility usually involves problems with the sperm.
- Sperm problems: These include low sperm count, poor movement (motility), or unusual shape, which can affect the sperm’s ability to reach and fertilize the egg.
- Blockages or medical conditions: Varicocele (enlarged veins in the scrotum), infections, or blockages in the sperm ducts can interfere with sperm delivery.
- Lifestyle and health: Smoking, heavy alcohol use, frequent heat exposure (like hot tubs), and certain medications can lower sperm quality. Hormone imbalances and chronic illnesses can also contribute.
Combined or Unexplained Causes
In many couples, both partners may have factors that affect fertility. Sometimes, all tests come back normal, but pregnancy still doesn’t happen. This is called unexplained infertility, and it accounts for about 10–20% of cases. Even in these situations, many couples go on to conceive with treatment.
When to See a Fertility Specialist
- If you’re under 35 and haven’t gotten pregnant after 12 months of trying.
- If you’re 35 or older and haven’t conceived after 6 months.
- Right away if you have very irregular periods, known sperm problems, a history of pelvic infections, or multiple miscarriages.
The good news: Many causes of infertility are treatable. Depending on the situation, treatment may include lifestyle changes, medication, procedures like intrauterine insemination (IUI), or assisted reproductive technologies like IVF.
If you’re concerned about fertility, talk to your doctor or a fertility specialist. The earlier you evaluate, the more options you may have.
