Causes of Infertility in Men and Women

If you've been asking, "Why am I not getting pregnant?" or searching for the definitive infertility definition, you are not alone. Infertility is a complex, often silent struggle shared by approximately 15% of couples worldwide. It is a diagnosis that requires deep understanding, comprehensive testing, and targeted treatment.

This article provides a comprehensive overview of the infertility meaning, the various causes of infertility in women and men, the warning signs you can't get pregnant, and the available infertility treatment options.

What Is Infertility?

Infertility means the inability to conceive after one year of regular, unprotected sex — or after six months if the woman is over 35. 

Types of Infertility

• Primary infertility: No prior successful pregnancies.
• Secondary infertility: Difficulty conceiving after at least one previous pregnancy.
• Unexplained infertility: Normal results on all tests, but conception still doesn’t occur.

Since infertility affects both partners, evaluations typically involve both men and women. About 25% of cases remain unexplained even after complete testing.

Causes of Infertility in Women

Female infertility accounts for about one-third of all infertility cases. The leading causes include ovulatory disorders, structural problems, and uterine or hormonal issues.

Ovulatory and Hormonal Disorders

A woman must ovulate — release an egg — for pregnancy to occur. Disruptions to this cycle can make conception difficult.

• Polycystic Ovary Syndrome (PCOS): Causes irregular ovulation, hormonal imbalance, and elevated androgens.
• Thyroid Disorders: Both hypo- and hyperthyroidism affect reproductive hormones.
• Premature Ovarian Insufficiency (POI): The ovaries stop functioning properly before age 40, reducing egg supply and hormone production.

Tubal and Pelvic Factors

Roughly 25–35% of infertility cases in women result from fallopian tube or pelvic complications.

• Pelvic Inflammatory Disease (PID): A frequent result of untreated sexually transmitted infections like chlamydia or gonorrhea, leading to scarring and blocked tube.
• Endometriosis: When uterine-like tissue grows outside the uterus, inflammation and scarring reduce fertility.
• Uterine Issues: Fibroids or adhesions from past surgeries (e.g., D&C, C-section) can prevent implantation or distort the uterus.

Common Symptoms of Infertility in Women

• Irregular or missed periods
• Painful or heavy menstrual cycles
• Chronic pelvic pain
• History of STIs, PID, or ectopic pregnancy

Any of these signs may warrant early fertility evaluation.

Causes of Infertility in Men

Male infertility often stems from sperm abnormalities, blockages, or testicular disorders.

Sperm Quality and Production

Semen analysis checks sperm count, movement, and shape. Common findings include:

• Low sperm count (oligozoospermia) or no sperm (azoospermia)
• Poor motility (asthenozoospermia)
• Abnormal morphology (teratozoospermia)

These can result from infections (mumps orchitis, STIs), chronic illnesses (obesity, diabetes), or exposure to toxins, drugs, or chemotherapy).

Varicocele and Obstructive Causes

• Varicocele: Enlarged veins in the scrotum raise testicular temperature, damaging sperm. Found in about 15% of men and up to 40% of infertile men.
• Ejaculatory Duct Obstruction: Congenital or acquired blockages that prevent sperm release, sometimes corrected through surgery.

Lifestyle and Environmental Risk Factors

Certain lifestyle habits can influence fertility in both men and women.

Weight and Hormonal Balance

Both obesity and being underweight can disrupt hormones, affecting ovulation and sperm production.

Substance Use

• Smoking: Reduces sperm motility and egg quality.
• Alcohol: Heavy use decreases fertility potential in both sexes.
• Recreational Drugs: Marijuana, cocaine, and opioids impair reproductive hormones.

Environmental Exposures

• High Heat: Prolonged hot tub or sauna use lowers sperm count.
• Endocrine-Disrupting Chemicals (EDCs): Found in plastics (BPA), pesticides, and phthalates; these interfere with hormones.

What Is Secondary Infertility

Secondary infertility occurs when couples struggle to conceive after already having one or more children.

Common Causes of Secondary Infertility

• Age-related egg decline
• Uterine scarring from prior surgeries
• Weight changes or new health conditions
• New infections or hormonal disorders

Since biological factors change over time, new evaluations are essential when conception becomes difficult after prior success.

Unexplained Infertility

In about 15% to 30% of cases, doctors diagnose unexplained infertility — where all tests appear normal.

Possible Underlying Reasons

• Subtle sperm or egg defects not detected by standard tests
• Implantation problems
• Minor hormonal irregularities

Even without a clear cause, treatments such as ovulation induction, IUI (intrauterine insemination), or IVF (in vitro fertilization) often improve the chances of pregnancy.

Emotional Impact of Infertility

Infertility can be emotionally draining. Up to 60% of couples report anxiety or depression during fertility treatment.

Coping Strategies

• Seek counseling or therapy specializing in fertility-related stress.
• Join infertility support groups.
• Practice mindfulness and stress-reduction techniques.
• Communicate openly with your partner.

Emotional well-being plays a major role in coping with fertility challenges and navigating treatment.

Infertility Treatments and Medical Options

Once diagnosed, infertility treatment is tailored to the cause.

• Lifestyle modifications: Weight management, quitting smoking, and limiting alcohol.
• Surgery: To correct blockages, remove fibroids, or treat endometriosis.
• Assisted Reproductive Technologies (ART): IUI, IVF, or ICSI (intracytoplasmic sperm injection).
• Medications: Don’t let infertility silence your dreams of parenthood.

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Frequently Asked Questions (FAQs)

What Are The Early Signs Of Infertility?

For women, irregular or absent periods and pelvic pain are common clues. In men, low libido, difficulty ejaculating, or changes in semen volume may suggest a problem.

How Can I Check If I’m Fertile?

Doctors use blood tests, ultrasound scans, and semen analysis to evaluate fertility. Home ovulation kits can also help track cycles.

Can Stress Cause Infertility?

Stress doesn’t directly cause infertility, but chronic stress may disrupt hormones and reduce the likelihood of conception.

Can Infertility Be Treated Naturally?

Lifestyle changes—such as balanced nutrition, weight control, quitting smoking, and reducing alcohol—can enhance fertility. However, medical guidance is vital if conception doesn’t occur within a year.

When Should I See A Doctor For Infertility?

Seek medical advice after 12 months of trying (or 6 months if over 35) or sooner if there are known reproductive health issues.