Infertility occurs when you’re not able to become pregnant after
a year of trying or after six months if you’re 35 or older, according to the Mayo
Clinic. Infertility can occur in males and females.
for Disease Control and Prevention (CDC) reports that 12 percent of women
in the United States between the ages of 15 and 44 have problems becoming or
staying pregnant due to male or female infertility.
What Are the Symptoms of Infertility?
The main indication of infertility is not being able to become
pregnant after unprotected intercourse after a year of trying or after six
months if you’re 35 or older.
Women may also experience irregular or absent menstrual periods,
painful periods, or multiple miscarriages.
Men may also have a history of testicular, prostate, or sexual
What Causes Infertility?
Certain steps in the reproductive process must occur to become
- A woman’s ovary must release an egg. This
process is known as ovulation.
- The egg must then travel through the fallopian
tube toward the uterus, or the womb. A man’s sperm must be in the woman’s body
during this specific time. It must also meet and join with the egg as it
travels through the fallopian tubes. This process is known as fertilization.
- The fertilized egg must then reach the uterus.
- At the uterus, the fertilized egg must push its
way inside and implant itself. This is called implantation.
Infertility can occur if there’s a problem with any of these
Infertility in Women
Female infertility is most often the result of problems with
ovulation. Irregular or absent periods can indicate an issue with ovulation.
These problems may occur with hormonal disorders, such as polycystic ovarian
syndrome (PCOS) or primary ovarian insufficiency (POI). POI occurs when a
woman’s ovaries stop working before age 40.
Other causes of infertility in women include:
- uterine fibroids, which are benign growths that
can keep fertilized eggs from implanting properly in the uterine lining
- scar tissue in the pelvis from past surgeries
- scar tissue inside the uterus from
- early menopause
- blocked or scarred fallopian tubes due to
infection or endometriosis
Endometriosis is an often painful condition in which the uterine
tissue that should line the inside of your uterus begins to grow outside of the
uterus. The tissue becomes trapped because it has no place to go. Uterine
tissue inside the uterus sheds each month during the menstrual cycle, but the
trapped tissue can’t shed. The surrounding body tissues become inflamed, and
scar tissue may form inside the fallopian tubes. This can lead to infertility
Infertility in Men
Problems with sperm production and delivery, a low sperm count,
and low motility, or ability of sperm to swim and fertilize the egg, can all
affect male fertility.
A varicocele is a disorder in which the veins draining a man’s
testicles have incompetent or leaky valves. The backflow of blood can enlarge
the blood vessels and can raise the temperature of the testicles. This causes a
low sperm count or abnormal sperm. Testicles are normally slightly below the
core body temperature.
Who Is at Risk for Infertility?
Certain risk factors can make it more difficult for men and women
Women older than 30 and men older than 40 years old are at an
increased risk of infertility. According to the Centers for Disease
Control and Prevention, about 20 percent of women in the United States are
now waiting until their 30s or 40s to have children.
The following lifestyle factors can impair healthy egg and sperm
- heavy alcohol use
- drug use
- being overweight
- being underweight
- exercising excessively
In men, exposure to environmental toxins, such as pesticides, and
exposure to high temperatures, such as in hot tubs, have also been shown to
affect sperm count.
How Is Infertility Diagnosed?
Your doctor will usually start with a physical examination. They’ll
want to discuss your medical and sexual history. If no cause is immediately
evident, additional tests may also be necessary.
In men, your doctor may ask for a semen analysis. This will look
for problems with sperm, including low sperm count or motility issues.
A blood test to examine hormone levels and an ultrasound to look
for certain conditions, such as retrograde ejaculation or ejaculatory duct
obstruction, may also be necessary. In retrograde ejaculation, semen, which is the
white fluid that contains sperm, enters the bladder instead of exiting through
the penis. Sometimes, cysts may form on the ejaculatory ducts, which can block
semen from exiting the duct and traveling to the penis for ejaculation. This is
called ejaculatory duct obstruction.
In women, the first concern is whether there are ovulation
problems. Your doctor may ask you to track your ovulation, or they may check
your ovulation with a blood test.
If ovulation is normal, your doctor may look for other problems
with the ovaries, fallopian tubes, or uterus. They’ll look for these problems
using an X-ray, ultrasound, or laparoscopy.
A laparoscopy is a minimally invasive procedure performed under
general anesthesia. Your doctor will make a small incision under your navel. They’ll
then insert a small camera to look at your fallopian tubes, ovaries, and
uterus. This procedure is helpful in finding endometriosis, scarring, and
fallopian tube blockages or abnormalities.
Not all tests for men or women may be necessary. However,
identifying the cause of an infertility problem can take several months and can
be expensive. The Mayo
Clinic reports that one-third of cases never have a diagnosed, specific
cause of infertility.
What Are the Treatment Options for Infertility?
Fertility drugs help regulate or trigger ovulation, but they can
also increase a woman’s chance of having twins or other multiple births.
Laparoscopic, or minimally invasive surgery, can help open or
repair damaged or blocked fallopian tubes.
Fertility treatments are often combined with artificial
insemination, also known as intrauterine insemination. This involves placing
specially prepared sperm into a woman’s uterus. The sperm may come from a male
partner or an anonymous sperm donor.
In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is a process in which your doctor
retrieves eggs and sperm from a woman and a man, and then combines them in a
laboratory, forming embryos. The doctor then places the embryos inside the
woman’s uterus. Doctors usually recommend IVF when all other treatments have
What Is the Long-Term Outlook?
If you’re having problems becoming or staying pregnant, remember
that you’re not alone. Infertility is a problem that many men and women face.
To help you cope, make sure to find support, consider your options, and manage
your stress during diagnosis and treatment. If you want to have a child, a
growing number of treatment options are available to make this possible.