Infertility
The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, women with infertility may have irregular or absent menstrual periods. In some cases, men with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function.
Women should talk with a care provider 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 health care provider 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
Fertilization and implantation
During fertilization, the sperm and egg unite in one of the fallopian tubes to form a zygote. Then the zygote travels down the fallopian tube, where it becomes a morula. Once it reaches the uterus, the morula becomes a blastocyst. The blastocyst then burrows into the uterine lining — a process called implantation.
Male reproductive system
The male reproductive system makes, stores and moves sperm. Testicles produce sperm. Fluid from the seminal vesicles and prostate gland combine with sperm to make semen. The penis ejaculates semen during sexual intercourse.
Female reproductive system
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.
Causes of female infertility may include:
- Ovulation disorders, which affect the release of eggs from the ovaries. These include hormonal disorders such as polycystic ovary syndrome. Hyperprolactinemia, a condition in which you have too much prolactin — the hormone that stimulates breast milk production — also may interfere with ovulation. Either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism) can affect the menstrual cycle or cause infertility. Other underlying causes may include too much exercise, eating disorders or tumors.
- Uterine or cervical abnormalities, including abnormalities with the cervix, polyps in the uterus or the shape of the uterus. Noncancerous (benign) tumors in the uterine wall (uterine fibroids) may cause infertility by blocking the fallopian tubes or stopping a fertilized egg from implanting in the uterus.
- Fallopian tube damage or blockage, often caused by inflammation of the fallopian tube (salpingitis). This can result from pelvic inflammatory disease, which is usually caused by a sexually transmitted infection, endometriosis or adhesions.
- Endometriosis, which occurs when endometrial tissue grows outside of the uterus, may affect the function of the ovaries, uterus and fallopian tubes.
- Primary ovarian insufficiency (early menopause), when the ovaries stop working and menstruation ends before age 40. Although the cause is often unknown, certain factors are associated with early menopause, including immune system diseases, certain genetic conditions such as Turner syndrome or carriers of Fragile X syndrome, and radiation or chemotherapy treatment.
- Pelvic adhesions, bands of scar tissue that bind organs that can form after pelvic infection, appendicitis, endometriosis or abdominal or pelvic surgery.
- Cancer and its treatment. Certain cancers — particularly reproductive cancers — often impair female fertility. Both radiation and chemotherapy may affect fertility.
