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Female Infertility

Infertility means that you're unable to conceive, or become pregnant, after having regular, unprotected sex for a certain amount of time.

Surgery can help some causes of infertility, while other causes require medications.

Looking for Female Infertility Care?

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  • Women's Health

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On this page:

  • What Is Infertility?
  • What Are the Symptoms of Infertility?
  • How Do You Diagnose Infertility?
  • How Do You Treat Infertility?

What Is Infertility?  

Infertility is a couple’s inability to get pregnant despite having unprotected sex. Doctors consider a couple infertile if they're unable to conceive within one year, or six months if you’re 35 or older.

According to the National Institutes of Health (NIH), after one year of unprotected sex, between 12% to 15% of couples are unable to conceive. After two years, 10% of couples still haven't had a live birth.

Typically, 40% to 60% of generally healthy couples who are younger than 30 will conceive in the first three months of trying. Fertility declines with age in both men and women, but the effects of age are much greater in women.

In your 30s, you're about half as fertile as you were in your early 20s, and your chance of conceiving declines significantly after age 35. Male fertility also declines with age, but more gradually.

Fertility is a complex issue, and being able to conceive involves:

  • Healthy sperm production.
  • Healthy egg production.
  • Fallopian tubes that aren’t blocked, allowing the sperm and egg to connect.
  • The ability of a sperm to fertilize the egg.
  • The ability of the fertilized egg to implant in the uterus and stay implanted.
  • Adequate quality of the embryo.

Problems in any of these areas may lead to infertility. One partner can be infertile, and it can also be a combination of both partners.

Although there are many causes for infertility, the direct cause isn't always clear. Not knowing the cause makes treating it feel aimless, but the good news is that there are successful options.

What is secondary infertility?

Secondary infertility is the inability to conceive or carry a baby to term after having given birth previously. It's treated in the same ways as infertility in couples who've not given birth.

How common is infertility? 

About 9% of men and 12% of women of reproductive age in the U.S. face challenges getting pregnant. As more people wait longer to start their families, more couples are likely to face infertility.

How infertility breaks down between partners:

  • In about a third of infertile couples, the cause is with the man.
  • In a third of infertile couples, the cause is with the woman.
  • In a third of infertile couples, the cause can't be identified or is an issue with both partners.

What are the types of infertility? 

There are two types of infertility:

  • Female infertility.
  • Male infertility.  

What causes infertility?

Causes of female infertility

Some reasons for female fertility problems include:

  • Ovulatory disorders
  • Age
  • Tubal abnormalities
  • Uterine abnormalities
  • Endometriosis
  • Other medical issues

Causes of male infertility

Many things can lead to male infertility, including:

  • Antibodies.
  • Environmental factors, such as certain chemicals.
  • Spending long periods of time in hot tubs.
  • Varioceles (a collection of varicose veins in the scrotum).

Are miscarriages related to infertility?

Miscarriage and infertility are distinct but possibly related problems. Having multiple miscarriages can indicate or lead to infertility in women.

In both cases, couples face the possibility that they may not be able to have biological children together. Both also involve a great deal of emotional pain and sometimes physical pain. Even infertile couples who achieve successful live births have higher rates of postpartum depression.

What are infertility risk factors and complications?  

Infertility risk factors 

Potential risk factors for women include:

  • Age.
  • Having had multiple miscarriages.
  • Hormonal imbalances.
  • Chronic diseases.
  • Tubal damage.
  • Uterine polyps or adhesions.

Potential risk factors for men include:

  • Prostatitis.
  • Sexually transmitted infections (STIs).
  • Genital infection.
  • Exposure to hazardous conditions or chemicals.
  • Heavy alcohol consumption.
  • Smoking cigarettes or marijuana and being around their smoke.

Complications of infertility

Couples dealing with infertility can experience a plethora of emotions, such as anger, sadness, and guilt; suffer from depression and anxiety; and have issues with low self-confidence and self-esteem.

They may also have financial stress as they figure out how to pay for IVF and other assisted reproductive technology (ART) services. 

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What Are the Signs and Symptoms of Infertility? 

The main symptom of infertility is not being able to get pregnant when you and your partner are having regular, unprotected sex.

When should I see a doctor about my infertility symptoms? 

If you haven’t conceived within a year, or within six months if you’re 35 or older, it’s time to seek help from a doctor.

If you're 40 or older, an evaluation is recommended before you try to get pregnant.

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How Do You Diagnose Infertility  

Diagnosing female infertility

Your doctor:

  • Will take a complete medical history and do a physical exam.
  • Will take blood to check the hormones being released and look for any abnormalities.
  • May order several imaging tests to look at your uterus, fallopian tubes, and how many follicles are developing.

Diagnosing male infertility

Semen analysis is one of the most important tools for diagnosing male infertility.

Once sperm are ejaculated, they must be capable of swimming in the cervical mucus through the cervix and vagina into the uterus. Conditions and abnormalities that impede this process may lead to male infertility.

A trained andrologist performs the semen analysis and looks at several factors, such as:

  • Motility.
  • Density.
  • Morphology (the size and shape of the sperm).
  • Volume.
  • Progression.
  • Viscosity.
  • Presence of round cells.
  • Antibodies.

A unique aspect of sperm production is that the analyzed sperm are sperm that were developed three months before. The quantity and quality of the sperm depend on factors that were present three months ago. These factors may or may not have changed or may still be present.

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How Do You Treat Infertility?  

Treatments for infertility and to help you conceive depend largely on the reason for infertility.

Some treatment plans include:

  • Drug therapy.
  • Intrauterine insemination (IUI), a form of micro-assisted fertilization.
  • Ovulation medication.
  • Surgery.
  • Assisted reproductive technology (ART) that assists in reproduction, such as in vitro fertilization (IVF).

Treating male infertility

Treatments may include:

  • Determining the source of infertility.
  • Preparing sperm for IUI.
  • Surgically repairing a varicocele.
  • Using the combined ARTs of IVF with intracytoplasmic sperm injection (ICSI).

Treating female infertility

Treatments may include medications to:

  • Assist with ovulation.
  • Stimulate follicle development to help create more than one mature egg each month.

The most successful method for many women is IVF. The use of IVF treatment has increased steadily since 1978, when the first baby was born in the U.K. through IVF.

The International Committee for Monitoring Assisted Reproductive Technologies estimates that at least 12 million babies have been born worldwide through IVF and other ARTs since 1978. In 2021, 86,146 infants — 2.3% of all infants born in the U.S. — were conceived using ART.

What is in vitro fertilization (IVF)?

IVF is one treatment option for infertility that increases the chance of pregnancy. In this procedure, the eggs (oocytes) are fertilized with sperm outside of the body. Then, the embryos are placed back into the uterus to achieve pregnancy.

Additionally, if a man has a very low sperm count or other abnormal semen issues, doctors may recommend IVF with ICSI. This can increase the chance of pregnancy in cases where spontaneous pregnancy is unlikely.

How effective is IVF?

Successful pregnancy through IVF depends on several factors, including a woman’s age and the reason for infertility.

In general, success rates for women:

  • Under 35 years old can range from 35% to 50% per IVF cycle.
  • 40 or older are more modest, around 10% per IVF cycle.

By UPMC Editorial Staff. Last reviewed on 2024-09-05.

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