Inability to have children (infertility) describes when a couple does not achieve pregnancy after a period of regular, unprotected intercourse. Causes may involve factors associated with people assigned female or male at birth; a professional evaluation helps identify appropriate next steps and referrals.
Infertility is commonly defined as the inability to conceive after about one year of regular unprotected sex, though earlier assessment may be appropriate for those over age 35 or with known reproductive issues. The condition can affect both partners and has physical and emotional impacts; timely information and support are important.
Causes can be female-related (ovulation problems, blocked fallopian tubes, endometriosis, hormonal imbalances), male-related (low sperm count or motility, varicocele, genetic or environmental factors) or combined. Chronic health conditions, some medications, obesity, smoking and heavy alcohol use also influence fertility.
The first step is a medical history and physical exam for both partners. Typical tests include semen analysis, hormonal blood tests, pelvic ultrasound, and imaging to check fallopian tube patency when indicated. Genetic testing and additional specialized studies are ordered based on initial findings and clinical judgement.
Primary care or family medicine and gynecology are common first contacts. Urology or andrology can assess male factors; endocrinology helps with hormonal issues; genetics counselling may be useful when inherited conditions are suspected. Infertility itself is not usually urgent, but seek immediate medical care for severe pelvic pain, high fever, or heavy vaginal bleeding.
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