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Infertility

Inability to conceive; Unable to get pregnant

Infertility means you cannot get pregnant (conceive).

There are 2 types of infertility:

Images

Pelvic laparoscopy
Female reproductive anatomy
Male reproductive anatomy
Primary infertility
Sperm

Causes

Many medical conditions can cause infertility. It may be due to problems in the woman, man, or both.

FEMALE INFERTILITY

Female infertility may occur when:

Female infertility may be caused by:

MALE INFERTILITY

Male infertility may be due to:

Male infertility can be caused by:

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:

Tests in men may include:

Treatment

Treatment depends on the cause of infertility. It may involve:

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.

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.

Related Information

Retrograde ejaculation
Semen analysis
Cervix
Pelvic inflammatory disease (PID)
Orchitis
Epididymitis
Varicocele
Abnormal uterine bleeding
In vitro fertilization (IVF)
Ovarian hyperstimulation syndrome

References

American Society for Reproductive Medicine website. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part 1 (2021). www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-auaasrm-guideline-part-i-2020/. Accessed February 6, 2024.

Catherino WH. Reproductive endocrinology and infertility. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 218.

Fauser BCJM, Broekmans FJ. Female infertility: evaluation and management. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 123.

Lobo RA. Infertility: etiology, diagnostic evaluation, management, prognosis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 40.

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.

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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.

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