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Infertility- An Overview

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Infertility- An Overview

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There could be many reasons as to why one is unable to conceive. This article discusses all the possible causes and treatments for male and female infertility.

Medically reviewed by

Dr. Sameer Kumar

Published At August 13, 2019
Reviewed AtAugust 4, 2023


Infertility is when a couple cannot conceive a child or get pregnant even after having unprotected sexual intercourse for a year. And women over 35 years old are considered infertile if they are not able to get pregnant after trying for 6 months. It also includes women who conceive but are not able to carry the pregnancy to term.

The two types of infertility in women are:

  1. Primary Infertility - It is when a woman has never been able to get pregnant.

  2. Secondary Infertility - It is when a woman has had a baby previously.

Not only a woman, but a man can also be infertile. Of all the cases, one-third is caused by male infertility, one-third by female infertility, and the remaining third can be due to unknown causes.

What Are the Causes of Male Infertility?

In men, infertility generally results from:

  1. Low Sperm Count - When the sperm count is under 15 million.

  2. Abnormal Sperm Shape - Abnormal shape can make it difficult for the sperm to move and fertilize an egg.

  3. Low Sperm Motility - Sperm with low motility cannot swim and reach the fallopian tube to fertilize the egg.

The changes in the sperm count, quality, and motility are affected by the following factors:

  • Smoking.

  • Old age.

  • Alcoholism.

  • Obesity.

  • Infection, cancer, or surgery of testes.

  • Undescended testes.

  • Varicocele.

  • Varicose veins in the scrotum.

  • Blocked ejaculatory ducts.

  • Hypogonadism.

  • Low testosterone.

  • Overheated testicles.

  • Exposure to environmental irritants like pesticides, toxins, and heavy metals.

  • Klinefelter’s syndrome.

  • Inflammation of testicles during mumps.

  • Hypospadias (Instead of at the tips, the urethral opening is under the penis).

  • Cystic fibrosis (can result in obstructed or missing vas deferens).

  • Diabetes.

  • Cushing’s syndrome.

  • Thyroid problem.

  • Anemia.

  • Radiation therapy.

  • Chemotherapy.

  • Drug abuse.

  • Stress and anxiety.

  • Certain drugs (Tricyclic antidepressants, anabolic steroids, calcium channel blockers, Sulfasalazine).

What Are the Signs of Male Infertility?

The common signs of male infertility are:

  • Decreased libido or sexual desire.

  • Pain or swelling in testicles.

  • Erectile dysfunction (problem in maintaining an erection).

  • Premature ejaculation.

  • Firm and small testes.

What Are the Causes of Female Infertility?

Infertility in women results when one of the following biological processes is affected:

  1. The process by which a mature egg is released from the ovary (Ovulation).

  2. The process where the sperm fertilizes the mature egg in the fallopian tube (Fertilization).

  3. And the process by which the fertilized egg gets attached to the wall of the uterus (Implantation).

The factors that can affect these processes are:

  • Age more than 35 years.

  • Smoking.

  • Alcoholism.

  • Obesity.

  • Sexually transmitted infections.

  • Eating disorders.

  • Too much or too little exercise.

  • Stress and anxiety.

  • Exposure to environmental irritants like pesticides, toxins, and heavy metals.

  • Premature ovarian failure.

  • Polycystic ovarian syndrome (PCOS).

  • Damaged or underdeveloped egg.

  • Hyperprolactinemia.

  • AIDS.

  • Cancer.

  • Thyroid diseases.

  • Damage or scarring of the fallopian tubes during pelvic surgery.

  • Fibroids.

  • Uterine polyp.

  • High cholesterol levels.

  • Endometriosis.

  • Blocked fallopian tube.

  • Chemotherapy.

  • Radiation therapy.

  • Long-term use of NSAIDs.

  • Drug abuse.

What Are the Signs of Female Infertility?

The signs of female infertility include:

  • Irregular periods.

  • Heavy menstrual bleeding.

  • Absence of periods.

  • Reduced sexual desire.

  • Skin changes.

  • Thinning hair.

  • Weight gain.

  • Increased facial and body hair.

  • Painful sex.

How Is Infertility in Men Diagnosed?

If a couple has been trying for almost a year and are experiencing any of the above signs, it is best to get evaluated by a doctor. If the doctor suspects infertility, then they might run some tests on the individual and their partner to find the exact cause.

The doctor will take a complete medical history and will ask about the overall health, sexual history, and other risk factors. The doctor will also check the genitals for abnormalities. After this, the doctor might ask the individual to perform the following tests:

  • Semen Analysis -The color, quality, quantity, and motility of sperm is checked. Presence of blood or infection is also checked in the semen.

  • Blood Test - To check the levels of testosterone.

  • Ultrasound - To check for retrograde ejaculation and obstruction in the ejaculatory duct.

  • Urine Test - To rule out chlamydia infection.

  • Genetic Testing - To rule out genetic abnormalities.

How Is Infertility in Women Diagnosed?

For women, fertility begins to decrease after 30 years of age. If one is younger than 35, then they can consult a doctor after one year of trying to get pregnant, and if one is 35 or older, it is advisable to visit a doctor after six months of trying.

The doctor will ask about the medical history, previous illnesses, sexual history, menstrual cycle, and any other factor that could affect one's fertility. The following test is then performed:

  • Pelvic Examination - The pelvic area is checked to look for pelvic inflammatory disease, fibroids, or endometriosis.

  • Blood Test - The doctor will ask the individual to check if they are ovulating every month with the help of ovulation kit or blood test.

  • Ultrasound - To examine the ovaries and uterus.

  • Hysterosalpingography - To check if the fallopian tube is patent.

  • Laparoscopy - Any abnormality in the uterus, fallopian tube, or endometriosis can be diagnosed.

  • Ovarian Reserve Testing- To determine the capacity of ovaries to produce egg cells.

  • Genetic Testing - To rule out genetic abnormalities.

  • Thyroid function test.

  • Test to rule out sexually transmitted infections.

What Are the Treatment Options for Infertility?

The treatment options for both men and women depends on the following factors:

  1. Cause.

  2. Age.

  3. Overall health.

  4. How long you have been trying to conceive.

  5. Personal preference.

On the first visit, the doctor will suggest increasing the frequency of sexual intercourse during ovulation. If one is still not able to conceive, then the other treatment options are suggested.

For Men:

Depending on the cause, the various treatment options are:

  • Lifestyle Changes - Regular exercise, reducing weight, avoiding smoking and alcohol, and increased frequency of sexual intercourse.

  • Medicines - Testicular function and sperm count can be increased with some medications. Ask a doctor for the names of the medicine.

  • Surgery - Surgery is indicated for removing varicose veins in varicocele and for blocked epididymis.

  • Sperm Retrieval - In cases of blocked ejaculatory duct and retrograde ejaculation, sperm can be directly taken from the testes or bladder and injected into an egg.

For Women:

The treatment options for women are:

  • Fertility Drugs - If the woman is infertile due to ovulation disorders, then fertility drugs are used. Consult a doctor about these drugs, as it can help regulate and induce ovulation. Depending on the cause, the different fertility drugs used are:

    • Clomifene.

    • Metformin.

    • Human menopausal gonadotropin (hMG).

    • Follicle-stimulating hormone.

    • Human chorionic gonadotropin.

    • Gonadotropin-releasing hormone.

    • Bromocriptine.

  • Surgery - If the fallopian tubes are blocked or scarred, or to treat endometriosis.

Assisted Reproductive Technology (ART):

Procedures that handle egg and sperm and are used to treat infertility are called ART. The methods included are:

  • Intrauterine Insemination (IUI) -When the woman is ovulating, sperm are injected into the uterus, so they can fertilize the released egg. Done when in unknown causes of infertility or when the sperm count or motility is low.

  • In-Vitro Fertilization (IVF)- Eggs and sperm are collected and fertilized outside in a petri dish, and the fertilized eggs are placed in the uterus for implantation.

  • Intracytoplasmic Sperm Injection (ICSI) - During IVF, only a single sperm is injected into an egg.

  • Sperm Donation - In IVF, sperm is collected from a donor.

  • Egg Donation - During IVF, eggs can be received from a donor.

  • Gestational Carrier- The embryo made from a couple's sperm and egg is placed in the uterus of a surrogate.

  • Assisted Hatching - It is done when IVF is not successful or in older women. This procedure helps the embryo to implant or get attached to the wall of the uterus by making a small hole in the outer membrane of the embryo.

Natural Treatments for Infertility:

Natural treatment options are:

  • Acupuncture - The insertion of small and thin needles into various points of the body.

  • Yoga - It includes breathing techniques to promote relaxation and decrease stress and anxiety.

  • Aromatherapy - It used essential oils to reduce stress and promote fertility.

  • Diet - Avoid refined carbohydrates, trans fats, and processed foods. Consume a high-fiber diet and plant protein.

  • Vitamins - Zinc, folate, vitamin C and E, and iron promote fertility.


Infertility is a condition when a couple is unable to achieve pregnancy even after 12 months of unprotected intercourse. Infertility affects millions of people worldwide. It can happen due to various issues in either the male or female reproductive systems. Sometimes, it may not be possible to explain the causes of infertility. There are a lot of options available for couples who wish to have a child but are not able to conceive. If one has been unsuccessful even after trying for more than a year, it is best to consult a doctor. One can also consult experienced and professionally trained infertility doctors online.

Frequently Asked Questions


What Does Infertility Mean?

Infertility refers to the condition where there is a difficulty for a couple to achieve pregnancy. Infertility is known to occur in both males and females. The inability to conceive or get pregnant even after having unprotected sex for more than a year is known as infertility.


What Are the Causes of Infertility in Males?

The main causes of infertility in males are diabetes, obesity, and sexually transmitted diseases like gonorrhea. Genetic reasons might contribute to infertility in some patients. Conditions like varicocele, which have enlarged veins in the testes, can also cause infertility because of the negative influence on the production of sperms.


How Can You Tell If a Woman Is Infertile?

We can identify whether a woman is fertile or not by looking for a few signs. They are:
- Heavy bleeding during pregnancy.
- Pain during sexual intercourse.
- Irregular menstrual periods.
- Obesity.
- Medical conditions like polycystic ovarian disease and endometriosis.
- The female partner not getting pregnant after having unprotected sexual intercourse for more than one year.


How Common Is Infertility?

Reports have mentioned that the infertility rate is high in the U.S. Approximately 12% of the American population is affected by infertility. About ten people out of 100 are known to be suffering from infertility conditions. This might be due to the changes in lifestyle and food habits.


How Can I Test My Fertility at Home?

Ovulation kits and follicle-stimulating hormone test kits are available in medical shops. It can be used to detect ovulation days. It is performed by collecting urine samples. The directions for usage will be mentioned in the kit. After collecting the urine drops, the test kit is placed on a flat surface. It will provide clear results.


Can Infertility Be Cured?

The cause of the infertility condition should be sorted out first. This will aid in choosing ideal treatment options. If the cause is due to pathological conditions, then it is necessary to get medical treatment for those health issues. The most promising treatment option is in vitro fertilization method. If the reason for infertility is a psychological reason, then the patient requires psychological counseling.


Which Is the Best Time to Get Pregnant?

In males, there is no particular time that is considered suitable for pregnancy. The woman contributes to a greater part in terms of conceiving. The woman has to be on her ovulation period. The 14 days before the beginning of the menstrual period is considered the high fertile period. It is applicable for women who are having a regular period cycle of 28 days. Having sexual intercourse without any protection will increase the chance of conceiving.


Which Is the Best Fertility Drug?

The best drug for fertility in women is Clomiphene citrate. This drug will not require prescriptions from a doctor. It is known to regulate ovulation in women. This is also known to trigger ovulation. In people who are suffering from polycystic ovarian disease, doctors prescribe Metformin for decreasing the resistance to insulin. This will, in turn, elevate the chances of getting pregnant.


What Are the Signs of Infertility in Males?

The signs of infertility in men are:
- Problems with sexual function. It might include ejaculating a minimal quantity of semen.
- Ejaculation difficulty, difficulty in maintaining an erection, and decreased sexual desire.
- Recurrent respiratory infections.
- Swelling or a lump in the testicle area.
- Pain in the testicle area.
- Inability to smell.
- Decreased body or facial hair or other signs of a hormonal or chromosomal abnormality.
- Abnormal breast growth (gynecomastia).
- Low sperm count. The total sperm count of less than 39 million per ejaculation or less than 15 million sperm per milliliter is considered infertile.


Does Endometriosis Cause Infertility?

The condition of endometriosis has a direct influence on the fertility of women. Endometriosis causes inflammation in the pelvis or impairment in the implantation process. This can contribute to infertility. In such conditions, the egg’s quality is altered, and there will be an imbalance in the hormones. In some patients, the immunity function is known to be reduced due to endometriosis.


Does Gonorrhea Cause Infertility?

Gonorrhea is a sexually transmitted disease. It is known to affect the reproductive organs due to conditions such as pelvic inflammatory disease that has been caused due to the infections with gonorrhea. It also causes problems in the fallopian tube. In severe complications, gonorrhea will end up causing infertility in women.


How Do Doctors Diagnose Infertility Problems?

The doctors use different diagnostic tools to diagnose infertility problems. They are:
- Ovulation testing.
- Ovarian reserve testing.
- Hysterosalpingography.
- Imaging tests.


Can I Get Fertility Pills Over the Counter?

The effective drug that is given for infertility is Clomid. This drug is available over the counter and will not require any prescription from the doctor. It is better to get checked with the doctor to get a complete idea of your infertility issue.


Does Fertility Pills Work?

Fertility pills are known to function like a naturally occurring hormone. It will act like follicle-stimulating hormone and luteinizing hormone. The working of these pills is known to stimulate the process of ovulation in women. It will trigger another egg production or another quality egg to be produced.


What Vitamins Help Women's Fertility?

Many vitamins can help to increase fertility in women; they are:
- Folic Acid.
- Vitamin E.
- Vitamin D.
- Fish Oil.
- Coenzyme Q10 (CoQ10).
- Selenium.


Can Turmeric Cure Infertility?

Many types of research suggest that turmeric is known to be beneficial for overcoming conditions such as endometriosis, polycystic ovarian disease, and other fertility disorders. Turmeric is rich in antioxidants, but there is no scientific proof for its effects on fertility. You should discuss with your doctor to identify which food items would be suitable for you.


Is Yogurt Good for Fertility?

There is a common misunderstanding that low-fat milk products like yogurt will help you maintain a healthy weight. It might be partially correct. But, when it comes to fertility, yogurt is known to be a supporting ingredient. Yogurt can elevate the levels of fertility in the long-run. It is good to choose yogurt once a day.


Is Infertility Permanent in Males?

The infertility condition becomes permanent only in a few male patients. In most of the cases, it is treatable. There are many natural remedies for infertility in men. Acupuncture and yoga are known to be effective. Drinking green tea regularly can enhance your fertility. Vitamin supplementation can promote fertility. Above all, a positive attitude is required.


What Foods Increase Male Fertility?

By eating healthy foods, sperm count can be increased naturally. Foods that can help enhance sperm count are eggs, dark chocolate, goji berries, garlic, bananas, spinach, walnuts, oysters, pomegranate, walnuts, zinc-rich food, pumpkin seed, etc
Dr. Sameer Kumar
Dr. Sameer Kumar

Obstetrics and Gynecology


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