Infertility

What is infertility?

Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile.

Pregnancy is the result of a process that has many steps. To get pregnant:

  • A woman's body must release an egg from one of her ovaries (ovulation).
  • The egg must go through a fallopian tube toward the uterus (womb).
  • A man's sperm must join with (fertilize) the egg along the way.
  • The fertilized egg must attach to the inside of the uterus (implantation).

Infertility can happen if there are problems with any of these steps.

Is infertility a common problem?

Yes. About 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention (CDC).

Is infertility just a woman's problem?

No, infertility is not always a woman's problem. Both women and men can have problems that cause infertility. About one-third of infertility cases are caused by women's problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture of male and female problems or by unknown problems.

What causes infertility in men?

Infertility in men is most often caused by:

  • A problem called varicocele (VAIR-ih-koh-seel). This happens when the veins on a man's testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm.
  • Other factors that cause a man to make too few sperm or none at all.
  • Movement of the sperm. This may be caused by the shape of the sperm. Sometimes injuries or other damage to the reproductive system block the sperm.

Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.

What increases a man's risk of infertility?

A man's sperm can be changed by his overall health and lifestyle. Some things that may reduce the health or number of sperm include:

  • Heavy alcohol use
  • Drugs
  • Smoking cigarettes
  • Age
  • Environmental toxins, including pesticides and lead
  • Health problems such as mumps, serious conditions like kidney disease, or hormone problems
  • Medicines
  • Radiation treatment and chemotherapy for cancer

What causes infertility in women?

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman's ovaries stop working normally before she is 40. POI is not the same as early menopause.

Less common causes of fertility problems in women include:

  • Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
  • Physical problems with the uterus
  • Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.

What things increase a woman's risk of infertility?

Many things can change a woman's ability to have a baby. These include:

  • Age
  • Smoking
  • Excess alcohol use
  • Stress
  • Poor diet
  • Athletic training
  • Being overweight or underweight
  • Sexually transmitted infections (STIs)
  • Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency

How long should women try to get pregnant before calling their doctors?

Most experts suggest at least one year. Women 35 or older should see their doctors after six months of trying. A woman's chances of having a baby decrease rapidly every year after the age of 30.

Some health problems also increase the risk of infertility. So, women should talk to their doctors if they have:

  • Irregular periods or no menstrual periods
  • Very painful periods
  • Endometriosis
  • Pelvic inflammatory disease
  • More than one miscarriage

It is a good idea for any woman to talk to a doctor before trying to get pregnant. Doctors can help you get your body ready for a healthy baby. They can also answer questions on fertility and give tips on conceiving.

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Content source: Office of Women's Health
Content last updated July 1, 2009

Reviewed by athealth on February 5, 2014.