Scarring from sexually transmitted infections (STIs), injury, or surgery
Smoking
Toxins in the environment
Vasectomy or failure of vasectomy reversal
History of testicular infection from mumps
Healthy couples under age 30 who have sex regularly will have about a 20% per month chance of getting pregnant each month.
A woman is most fertile in her early 20s. The chance a woman can get pregnant begins to decrease around age 35 (and especially after age 40). The age when fertility starts to decline varies from woman to woman.
Infertility problems and miscarriage rates increase significantly after 35 years of age. There are now options for early egg retrieval and storage for women in their 20's. This may help ensure a successful pregnancy if childbearing is delayed until after age 35. This is an expensive option. However, women who know they will need to delay childbearing may consider it.
Exams and Tests
Deciding when to get treated for infertility depends on your age. Health care providers suggest that women under 30 try to get pregnant on their own for 1 year before getting tested for conditions that may cause infertility.
Women over 35 should try to get pregnant for 6 months. If it does not occur within that time, they should talk to their provider.
Infertility testing involves a medical history and physical exam for both partners.
Blood and imaging tests are most often needed. In women, these may include:
Blood tests to check hormone levels, including progesterone and follicle stimulating hormone (FSH)
Home urine ovulation detection kits
Measurement of body temperature every morning to see if the ovaries are releasing eggs (ovulating)
Treatment depends on the cause of infertility. It may involve:
Education and counseling about the condition
Fertility treatments such as taking medicine to induce ovulation, intrauterine insemination (IUI), and in vitro fertilization (IVF)
Medicines to treat infections and clotting disorders
Medicines that help the growth and release of eggs from the ovaries
Couples can increase the chances of becoming pregnant each month by having sex at least every 2 days before and during ovulation.
Ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. Therefore, if a woman gets her period every 28 days the couple should have sex at least every 2 days between the 10th and 18th day after her period starts.
Having sex before ovulation occurs is especially helpful.
Sperm can live inside a woman's body for at least 2 days.
However, a woman's egg can only be fertilized by the sperm within 12 to 24 hours after it is released.
Women who are under or overweight may increase their chances of becoming pregnant by getting to a healthier weight.
Support Groups
More information and support for people with infertility and their families can be found by joining a local support group. You can ask your provider to recommend local groups.
Outlook (Prognosis)
As many as 1 in 5 couples diagnosed with infertility eventually become pregnant without treatment.
Most couples with infertility become pregnant after treatment.
When to Contact a Medical Professional
Contact your provider if you are not able to get pregnant.
Prevention
Preventing STIs, such as gonorrhea and chlamydia, may reduce your risk of infertility.
Maintaining a healthy diet, weight, and lifestyle may increase your chance of getting pregnant and having a healthy pregnancy.
Avoiding the use of lubricants during sex may help improve sperm function.
Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril. 2021;116(5):1255-1265. PMID: 34607703 pubmed.ncbi.nlm.nih.gov/34607703/.
Schlegel PN. Clinical management of male infertility. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 113.
Review Date:
1/1/2023
Reviewed By:
John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Internal review and update on 02/06/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.