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What Is Infertility? Understanding the Causes, Types and When to Seek Help

Dream Baby banner for “What Is Infertility?” featuring a South Asian couple in a calm, warm setting, with the subtitle “Understanding the causes, types and when to seek help.”

What Is Infertility?

Trying to have a baby can be an exciting time, but when pregnancy doesn't happen as expected, it can also bring uncertainty, worry and many questions.

Infertility is a medical condition that can affect both women and men. It is not simply a problem that belongs to one partner, and in some cases the reason for difficulty conceiving cannot be identified.

According to the World Health Organization (WHO), infertility is defined as the failure to achieve a pregnancy after 12 months or more of regular, unprotected sexual intercourse. World Health Organization

Infertility may result from problems affecting the female reproductive system, the male reproductive system, both partners, or from factors that cannot be identified even after evaluation. World Health Organization

The good news is that infertility does not automatically mean that pregnancy is impossible. There are different approaches to investigating and treating infertility, depending on the individual circumstances.

What Does Infertility Mean?

In simple terms, infertility means that pregnancy has not occurred despite regular unprotected sexual intercourse over a period of time.

The clinical definition used by WHO is 12 months or more without achieving pregnancy. World Health Organization

However, the time at which someone should seek medical advice does not necessarily have to be exactly 12 months in every situation. A person's age, medical history, reproductive history and other circumstances can affect when an evaluation may be appropriate. WHO's guidance recognises that fertility care may sometimes need to begin before a full year has passed, depending on the individual circumstances. IRIS

This is one reason it is important not to rely solely on a calendar when deciding whether to speak with a fertility specialist.

Can Infertility Affect Both Women and Men?

Yes.

Infertility can involve:

  • Female factors
  • Male factors
  • Both male and female factors
  • Unexplained factors

WHO identifies a range of possible causes affecting both the female and male reproductive systems. World Health Organization

For example, female infertility may be associated with problems involving the ovaries, fallopian tubes, uterus or reproductive hormones.

Male infertility may be associated with problems involving sperm production, sperm movement or sperm function, blockages in the reproductive tract, or hormonal problems. World Health Organization

This is why both partners may need to be evaluated when a couple is having difficulty conceiving.

What Causes Infertility?

There isn't one single cause of infertility.

Some possible causes include:

Female factors

These may include:

  • Problems with ovulation
  • Polycystic ovary syndrome (PCOS)
  • Endometriosis
  • Blocked or damaged fallopian tubes
  • Problems affecting the uterus
  • Fibroids
  • Reduced ovarian reserve
  • Age-related changes in fertility

Male factors

These may include:

  • Low sperm count
  • Poor sperm movement (motility)
  • Abnormal sperm shape (morphology)
  • Problems with sperm production
  • Blockages affecting sperm transport
  • Hormonal problems
  • Certain conditions affecting the testicles

There can also be lifestyle and environmental factors that affect fertility. WHO notes associations between infertility and factors including smoking, excessive alcohol consumption, obesity and exposure to some environmental pollutants. World Health Organization

However, having a particular risk factor does not necessarily mean that someone is infertile. Fertility is individual, and a proper medical assessment is needed to understand what may be affecting conception.

What Is Unexplained Infertility?

Sometimes fertility tests do not identify an obvious reason why pregnancy has not occurred.

This is known as unexplained infertility.

It does not mean that the problem is imaginary or that there is no possible explanation. Rather, it means that the available evaluation has not identified a clear cause.

Unexplained infertility is important enough that we have a separate Dream Baby article planned specifically for this topic.

👉 Read next: Unexplained Infertility

What Is Primary Infertility?

Primary infertility generally refers to difficulty achieving a first pregnancy.

In other words, a person or couple has not previously achieved a pregnancy.

WHO distinguishes primary infertility from secondary infertility. World Health Organization

What Is Secondary Infertility?

Secondary infertility refers to difficulty becoming pregnant after a previous pregnancy has occurred.

This can sometimes be confusing because a person may have conceived naturally in the past and later experience difficulty conceiving again.

Previous fertility does not necessarily guarantee future fertility. Changes in age, reproductive health, sperm health and other factors can influence fertility over time.

We'll explore this in much more detail in our article:

👉 Primary vs SecondaryInfertility

When Should You See a Fertility Specialist?

If you have been trying to conceive without success, it may be appropriate to speak with a doctor or fertility specialist.

For many couples, an infertility evaluation is considered after 12 months of regular unprotected intercourse without pregnancy. World Health Organization

However, you may need to seek advice sooner depending on factors such as:

  • Your age
  • Irregular or absent periods
  • A known reproductive or medical condition
  • Previous pelvic or reproductive surgery
  • Previous fertility problems
  • Concerns about sperm health
  • Previous cancer treatment or other treatments that may affect fertility
  • Other concerns about your reproductive health

A doctor can help determine whether testing is appropriate and what investigations may be useful.

👉 Read next: When Should You See a Fertility Specialist?

Can Infertility Be Treated?

In many cases, there are treatment options that may help improve the chances of pregnancy.

Treatment depends on what is causing the difficulty conceiving, the age and health of the individuals involved, how long they have been trying, and other factors.

Depending on the circumstances, fertility care may include:

  • Treatment to help with ovulation
  • Surgery in some situations
  • Intrauterine insemination (IUI)
  • In vitro fertilisation (IVF)
  • Intracytoplasmic sperm injection (ICSI)
  • Other forms of medically assisted reproduction

Not everyone needs IVF, and the most appropriate approach varies from person to person.

WHO's 2025 infertility guideline provides evidence-based recommendations covering prevention, diagnosis and treatment of infertility. World Health Organization

Does Infertility Mean You Can Never Have a Baby?

No.

A diagnosis of infertility does not automatically mean that pregnancy is impossible.

It means that there is a medical difficulty affecting conception that may require evaluation and, depending on the circumstances, treatment.

Some people become pregnant without fertility treatment, while others may need medical assistance.

The important thing is to understand what may be affecting fertility and what options are appropriate for your individual situation.

Infertility is Not Something to Blame Yourself for

One of the most important things to understand about infertility is that it is not necessarily anyone's fault.

Both men and women can experience infertility, and there may be several contributing factors. In some cases, no clear cause is found.

Infertility can also have a significant emotional and psychological impact. WHO notes that infertility can be associated with distress, stigma, anxiety, depression and other psychosocial difficulties. World Health Organization

If you are experiencing difficulty conceiving, seeking appropriate medical advice is a positive step — not something to feel ashamed about.

Frequently Asked Questions

How long does it take to be considered infertile?

WHO defines infertility as failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. World Health Organization

However, some people may benefit from an earlier evaluation depending on their age, medical history or other circumstances.

Can men be infertile?

Yes. Male factors can contribute to infertility, including problems involving sperm production, sperm count, movement or function. WorldHealth Organization

Can women be infertile?

Yes. Female infertility can be associated with problems involving ovulation, the fallopian tubes, uterus, ovaries and reproductive hormones, among other factors. WorldHealth Organization

Can infertility be unexplained?

Yes. Sometimes medical evaluation does not identify a clear cause. This is known as unexplained infertility.

Does infertility mean IVF is necessary?

No. IVF is only one of several possible fertility treatments. The appropriate approach depends on the individual's or couple's circumstances and the cause of infertility.

Should both partners be tested?

Because infertility can involve male factors, female factors, both, or unexplained factors, evaluation may involve both partners. A doctor can advise which tests are appropriate.

Where to Go Next

If you're trying to understand why pregnancy has not happened, these Dream Baby articles may help:

Causes of Infertility

Learn about the different factors that can affect fertility in women and men.

Primary vs Secondary Infertility

Understand the difference between difficulty achieving a first pregnancy and difficulty conceiving after a previous pregnancy.

Unexplained Infertility

Find out what it means when fertility tests don't identify an obvious cause.

When Should You See a Fertility Specialist?

Learn when it may be appropriate to seek professional help.

What Happens at a Fertility Consultation?

Find out what you can expect at a first fertility appointment.

A note from Dream Baby

The information on Dream Baby is provided for general educational purposes. It is not intended to diagnose infertility or replace advice from a qualified healthcare professional. Fertility concerns are individual, and anyone experiencing difficulty conceiving should discuss their circumstances with an appropriately qualified medical professional.

Medical review: This article has not yet been medically reviewed by a Dream Baby doctor. We will add genuine medical review as Dream Baby develops its medical advisory network.

Sources

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