Infertility means you cannot get pregnant (conceive).
There are 2 types of infertility:
Primary infertility refers to couples who have not become pregnant after at least 1 year having sex without using birth control methods.
Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable to do so.
Many medical conditions can cause infertility. It may be due to conditions in the woman, man, or both.
FEMALE INFERTILITY
Female infertility may occur when:
A fertilized egg or embryo does not survive once it attaches to the lining of the womb (uterus).
The fertilized egg does not attach to the lining of the uterus.
The eggs cannot move from the ovaries to the womb.
The ovaries have problems producing healthy eggs.
Female infertility may be caused by:
, such as antiphospholipid syndrome (APS)
Birth defects that affect the reproductive tract
Cancer or tumor
Clotting disorders
Drinking too much alcohol
Exercising too much
Eating disorders or poor nutrition
Growths (such as fibroids or polyps) in the uterus and cervix
Medicines such as chemotherapy drugs
Failure to ovulate
Being overweight or underweight
Older age
and
(PCOS)
Pelvic infection resulting in scarring or swelling of fallopian tubes (hydrosalpinx) or
(PID)
Scarring from sexually transmitted infection, abdominal surgery, or endometriosis
Smoking
Surgery to prevent pregnancy (tubal ligation) or failure of tubal ligation reversal (reanastomosis)
Thyroid disease
MALE INFERTILITY
Male infertility may be due to:
Decreased number of sperm
Blockage that prevents the sperm from being released
Defects in the sperm
Male infertility can be caused by:
Birth defects
Cancer treatments, including chemotherapy and radiation
Exposure to high heat for prolonged periods
Heavy use of alcohol, marijuana, or cocaine
Benign pituitary tumor (causing high blood level of prolactin)
Diabetes (uncontrolled)
Hypogonadism causing low levels of the male hormone testosterone
Infection
Medicines such as cimetidine, spironolactone, and nitrofurantoin
Obesity
Older age
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% 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.
Deciding when to get evaluated and 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)
FSH and clomid challenge test
Antimullerian hormone testing (AMH)
(HSG) to look for blockages in the fallopian tubes
Pelvic ultrasound to check egg quality and evaluate the uterus
Blood tests to detect a prior chlamydia infection (which can cause fallopian tube damage)
Tests in men may include:
Exam of the testes and penis
Ultrasound of the male genitals (sometimes done)
Blood tests to check hormone levels
(rarely done)
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
(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.
The process of undergoing evaluation and treatment of infertility is stressful for most couples. Emotional stressors may induce depression, anger, anxiety, and marital discord between couples.
More information and support for people with infertility and their families can be found by joining a local
. You can ask your provider to recommend local groups.
As many as 1 in 5 couples diagnosed with infertility eventually become pregnant without treatment.
Most couples with infertility become pregnant after treatment.
Contact your provider if you are not able to get pregnant.
Preventing STIs, such as gonorrhea and chlamydia, may reduce your risk of infertility.
Maintaining a healthy diet, weight, and lifestyle may increase your chances of getting pregnant and having a healthy pregnancy.
Avoiding the use of lubricants during sex may help improve sperm function.
Inability to conceive; Unable to get pregnant
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. Accessed March 21, 2025.
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.
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Updated by: Peter J. Chen, MD, FACOG, Associate Professor of OBGYN at Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.