Scarring from sexually transmitted infections, injury, or surgery
Too little or too much hormones
Use of certain drugs, such as cimetidine, spironolactone, and nitrofurantoin
Vasectomy, or failure of vasectomy reversal
In healthy couples under age 30 who have sex regularly, the chance of getting pregnant is about 25 - 30% per month.
A woman's peak fertility occurs in her early 20s. After age 35 (and especially 40), the chance that a woman can get pregnant drops considerably. The age when fertility starts to decline is different from woman to woman.
Signs and tests
When you should get treated for infertility depends on your age. Doctors often suggest that women under 30 should try to get pregnant on their own for 1 year before getting tested.
Infertility testing involves a complete medical history and physical examination of both partners.
Blood and imaging tests will be done. In women, this may include:
Blood tests to check hormone levels, including progesterone and follicle stimulating hormone
Taking body temperature first thing in the morning to check if the ovaries are releasing eggs
Medicines to treat infections and clotting disorders
Medicines that help the woman grow and release eggs from the ovaries
You can increase your chances of becoming pregnant each month by having sex at least every 3 days before and during ovulation. It is especially important to do so before ovulation occurs. Sperm can live inside a woman's body for at least 3 days. However, a woman's egg can only be fertilized by the sperm for a few hours after it is released.
Ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. If a woman gets her period every 28 days, the couple should have sex at least every 3 days between the 10th and 18th day after the period starts.
If you are under- or overweight, getting to a healthier weight may increase your chance of getting pregnant.
Sharing with others who have similar fertility challenges can help you not feel alone. Ask your health care provider to recommend local groups. Or check the internet for resources.
As many as 1 in 5 couples diagnosed with infertility eventually become pregnant without treatment.
More than half of couples with infertility become pregnant after treatment, not including advanced techniques such as in vitro fertiliziation (IVF).
Calling your health care provider
Call for an appointment with your health care provider if you are unable to get pregnant.
Preventing sexually transmitted infections (STIs), such as gonorrhea and chlamydia, may reduce your risk of infertility.
Maintaining a healthy diet, weight, and lifestyle may increase your chance of getting pregnant and having a healthy pregnancy.
American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012;98:302-307.
American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril. 2012;98:294-301.
Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 17.
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.