WHO defines Infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.” Infertility may arise from male factors, female factors, or a combination of both.

Female fertility normally peaks at age 24 and diminishes after 30, with pregnancy occurring rarely after age 50. A female is most fertile within 24 hours of ovulation. Male fertility peaks usually at age 25 and declines after age 40 (Tamparo et al, 2011).

According to Center for Disease Control (CDC), about 6% of married women 15–44 years of age in the United States are unable to get pregnant after one year of unprotected sex (infertility). Also, about 12% of women 15–44 years of age in the United States have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status (impaired fecundity).


Types of infertility

Primary infertility- This is when a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. That is, women whose pregnancy spontaneously miscarries, or whose pregnancy result in a still born child, without ever having had a live birth is known to be primarily infertile.

Secondary infertility- This is when a woman is unable to bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to a live birth, she would be classified as having secondary infertility. That is, women who repeatedly spontaneously miscarry or whose pregnancy results in a stillbirth, or following a previous pregnancy or a previous ability to do so, are then not unable to carry a pregnancy to a live birth would present with secondarily infertile.



Symptoms of infertility

Infertility symptoms in women can be:

  • Changes in the menstrual cycle andovulation (a symptom of a disease related to infertility).
  • Abnormal periods (Bleeding is heavier or lighter than usual) or Irregular periods (The number of days in between each period varies each month).
  • Painful periods (Back pain,pelvic pain, and cramping may happen).

Some symptoms can occur as a result of hormonal disorder. In this case, symptoms can also include:

  • Skinchanges, including more acne
  • Changes insex drive and desire
  • Darkhair growth on the lips, chest, and chin
  • Loss ofhair or thinning hair
  • Weightgain
  • Milky white discharge from nipples unrelated tobreastfeeding
  • Pain duringsex

Infertility Symptoms in Men can be:

Infertility symptoms in men can be vague and may go unnoticed until a man tries to have a baby.

Symptoms depend on what is causing the infertility. They can include:

  • Changes in hair growth
  • Changes in sexual desire
  • Pain, lump, or swelling in the testicles
  • Problems with erections and ejaculation
  • Small, firm testicles


Causes of infertility

Infertility in men (as a result of impaired sperm quality, quantity, or both) may be due to the following:

  • Testicular failure or dysfunction
  • Infection
  • Injury
  • Environmental toxin exposures especially to pesticides and lead
  • Anatomic variances
  • Chromosomal abnormalities,
  • Systemic diseases
  • Sperm antibodies.
  • Smoking
  • alcohol use,
  • obesity
  • older age
  • Medical conditions such as diabetes, cystic fibrosis, trauma,
  • Treatment with chemotherapy or radiation.


Women infertility can be caused by:

  • ovulation disorders
  • uterine abnormalities
  • tubal obstruction/disease
  • peritoneal factors
  • Cervical factors
  • previous use of contraception
  • previous pregnancies and outcomes
  • Pelvic infections
  • Medication use
  • Occupational exposures
  • Substance abuse
  • Alcohol intake
  • Obesity or physical inactivity
  • Tobacco use
  • Previous surgery on reproductive organs.
  • Menopause
  • Advancement in age

The frequency and timing of intercourse, and the use of lubricants or other products that may impair fertility by both couples, can also lead to infertility.

Prevention of infertility

Some fertility problems are related to lifestyle or other health conditions. The following tips will help protect your fertility:

  • Avoid tobacco (cigarettes) and marijuana. They reduce sperm count and fertility.
  • Avoid exposure to harmful chemicals and toxins.
  • Avoid excessive alcohol use. It may damage eggs or sperm.
  • Limit your sex partners and use condoms to reduce the risk of getting sexually transmitted infection (STI). Untreated STIs can damage the reproductive system and cause infertility.
  • Maintain a healthy body weight that is close to the ideal for your height. It will reduce the possibility of hormone imbalances. This is very important for men as well as for women.



Diagnosis of infertility

This involves:

  • First, collecting a medical and sexual history from both partners.
  • Then, initial evaluation which usually includes a semen analysis, a tubal evaluation, and ovarian reserve testing. The results of these tests help determine the best fertility treatment.


Treatment of infertility

Specific treatments are recommended for infertility based on:

  • The factors contributing to the infertility.
  • The duration of the infertility.
  • The age of the female.
  • The couple’s treatment preference after counseling about success rates, risks, and benefits of each treatment option.

Infertility can be treated with:

  1. medicine
  2. surgery
  3. Intra-uterine insemination or assisted reproductive technology.

Many times these treatments are combined.

We advise women less than 35 years of age who have been trying to get pregnant without success for a year to see their Doctor. While, women who are 35years and older, should see their doctor after six months of trying. This is because infertility tests take long time.

Article by: eDokita Team


  1. Tamparo, Carol; Lewis, Marcia (2011).Diseases of the Human Body. Philadelphia, PA: F.A. Davis Company. p. 459. ISBN 9780803625051.
  2. Tammy J. Lindsay, Kirsten R. Vitrikas. ‘Evaluation and Treatment of Infertility’. American Family Physician. Volume 91, number 5.
  3. Alaina B. Jose-Miller, Jennifer W. Boyden, and Keith A. Frey. ‘Infertility’. American Family Physician. Volume 75, number 6.
  4. Center for Disease Control. Reproductive Health: What is infertility? 2016. Web
  5. Christian Nordqvist. Infertility: Causes and Diagnosis. Medical News Today. 2016. Web
  6. Sexual and Reproductive Health: Infertility definitions and terminology
  7. Understanding Infertility: Symptoms. 2016. Web.


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