If you and your partner are struggling to have a baby, you’re not alone. In the United States, 10% to 15% of couples are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples.
Infertility may result from an issue with either you or your partner, or a combination of factors that prevent pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.
The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, a woman with infertility may have irregular or absent menstrual periods. In some cases, a man with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function.
When to see a doctor
You probably don’t need to see a doctor about infertility unless you have been trying regularly to get pregnant for at least one year. Women should talk with a doctor earlier, however, if they:
- Are age 35 or older and have been trying to conceive for six months or longer
- Are over age 40
- Have irregular or absent periods
- Have very painful periods
- Have known fertility problems
- Have been diagnosed with endometriosis or pelvic inflammatory disease
- Have had multiple miscarriages
- Have undergone treatment for cancer
Men should talk to a doctor if they have:
- A low sperm count or other problems with sperm
- A history of testicular, prostate or sexual problems
- Undergone treatment for cancer
- Small testicles or swelling in the scrotum
- Others in your family with infertility problems
All of the steps during ovulation and fertilization need to happen correctly in order to get pregnant. Sometimes the issues that cause infertility in couples are present at birth, and sometimes they develop later in life.
Infertility causes can affect one or both partners. In general:
- In about one-third of cases, there is an issue with the man
- In about one-third of cases, there is an issue with the woman
- In the remaining cases, there are issues with both the man and the woman, or no cause can be found
Causes of male infertility
These may include:
- Abnormal sperm production or function due to undescended testicles, genetic defects, health problems such as diabetes, or infections such as chlamydia, gonorrhea, mumps or HIV. Enlarged veins in the testes (varicocele) also can affect the quality of sperm.
- Problems with the delivery of sperm due to sexual problems, such as premature ejaculation; certain genetic diseases, such as cystic fibrosis; structural problems, such as a blockage in the testicle; or damage or injury to the reproductive organs.
- Overexposure to certain environmental factors, such as pesticides and other chemicals, and radiation. Cigarette smoking, alcohol, marijuana, anabolic steroids, and taking medications to treat bacterial infections, high blood pressure and depression also can affect fertility. Frequent exposure to heat, such as in saunas or hot tubs, can raise body temperature and may affect sperm production.
- Damage related to cancer and its treatment, including radiation or chemotherapy. Treatment for cancer can impair sperm production, sometimes severely.