Male and Female Causes of Infertility Explained

Infertility is not one person's problem. The World Health Organization defines it as failing to achieve a pregnancy after 12 months or more of regular unprotected sex, and it can stem from the man, the woman, both, or no cause that can be found.

WHO estimates that about 1 in 6 people of reproductive age experience infertility in their lifetime. This guide explains the common causes in both partners, the usual tests, and the treatment options.

Infertility Is a Couple's Issue

Many families still assume the cause lies with the woman. In fact, the NIH's NICHD says male problems are just as likely as female ones, and that often several factors from both partners overlap. The NHS adds that in about a quarter of cases no cause is found. That is why both partners should be assessed together, and why blame helps no one.

Common Female Causes

WHO and the NHS list these:

• Ovulation problems: irregular or absent ovulation, often linked to hormonal conditions such as PCOS; see understanding PCOS
• Blocked or damaged fallopian tubes: linked to untreated infections, pelvic surgery or complications after delivery or abortion; see pelvic inflammatory disease
• Endometriosis: see painful periods and endometriosis
• Womb conditions: fibroids or a septate womb (a wall of tissue inside the womb); see uterine fibroids
• Hormonal imbalances from other endocrine (gland) disorders

Common Male Causes

According to WHO and the NHS, male infertility often relates to the quality or delivery of sperm:

• Low sperm count or poor-quality semen
• Abnormal shape or movement of sperm
• Blockages in the tubes that carry sperm, often due to injury or infection
• Hormonal disorders
• Problems of the testicles, such as varicoceles (enlarged veins) or damage from treatments like chemotherapy

Many men feel shy about semen testing. It is a simple, painless test and an essential first step.

Factors That Affect Both Partners

The NHS and WHO list smoking, heavy alcohol use, being overweight or underweight, certain sexually transmitted infections such as chlamydia, exposure to some pesticides, solvents and metals, and stress as factors that can lower fertility. Age is listed as a factor too, which is why the timing of seeking help differs by age.

• Stop smoking and keep alcohol low
• Aim for a healthy weight, with balanced meals and regular activity
• Get infections diagnosed and treated early
• Avoid unnecessary exposure to chemicals at work and at home
• Try to manage stress, and sleep well

Tip: To time intercourse well, track the fertile window with our ovulation calculator. It gives an estimate, not a guarantee, and irregular cycles may need medical advice.

When to Seek Help

The NHS advises seeing a doctor after a year of trying without success, and sooner if the woman is 36 or over or if you already know of a possible problem, such as irregular periods, pelvic infection, endometriosis or a past surgery. Guidelines vary between countries, so ask your doctor what suits your situation. Read more in when couples should seek medical help.

Tests You May Be Offered

The NHS describes these common tests:

• Semen analysis for the man: checks sperm count and movement
• Blood tests for the woman: including a hormone level that shows whether ovulation is happening
• Ultrasound scan: looks at the ovaries and womb for conditions such as fibroids, and can suggest tube blockage
• Hysterosalpingogram (HSG): an X-ray with dye to check whether the tubes are open
• Laparoscopy: a keyhole procedure used only when a problem is likely; see laparoscopy and hysteroscopy
• Infection tests: such as chlamydia, which can affect fertility

When to be cautious: Do not start fertility medicines, supplements or herbal remedies on your own, or take them because a friend did. The right treatment depends on the cause, and the wrong one can delay a diagnosis.

Treatment Options Overview

Your doctor chooses treatment based on the cause. The NHS describes:

• Medicines that your doctor may prescribe to help ovulation
• Surgery, for example to treat endometriosis, repair tubes or remove scar tissue
• Assisted conception, such as IUI (placing prepared sperm into the womb) or IVF; see IUI vs IVF

WHO adds that assisted reproduction is out of reach for many people in low- and middle-income countries, so asking early about options, costs and realistic expectations matters. Treatment of male factors depends on the cause, and your doctor will explain what is possible.

Our infertility and reproductive care speciality includes IUI, IVF and fertility counselling.

Looking After Your Emotions

Waiting month after month is tiring. Many couples feel sadness, guilt or pressure from family. Talk to each other, set limits on how much outside advice you accept, and consider counselling. You do not have to go through it alone.

Myths and Facts

• Myth: Infertility is always the woman’s fault. Fact: Male and female problems are equally likely, and often both partners contribute.
• Myth: If tests show nothing wrong, there is no hope. Fact: In about a quarter of couples no cause is found, and treatment can still be planned.
• Myth: Everyone needs IVF. Fact: Options range from medicines for ovulation to surgery and IUI, depending on the cause.

What to Expect at the Clinic

The first visit is mostly a conversation. Expect questions about how long you have been trying, your periods, past infections or surgery, medicines, work, smoking and alcohol. Both partners are usually advised to attend. Tests are then planned in a sensible order, starting with the simplest, so you are not asked to do everything at once. Bring any old reports or scans.

When to See a Doctor

• You have tried for 12 months without success
• The woman is 36 or over
• Periods are irregular, very painful or absent
• Either partner has had pelvic infection, surgery, testicular problems or cancer treatment
• You have had repeated miscarriages
• You feel unsure and want to understand your fertility

Talk to a doctor

Book an appointment at Chaitanya Hospital, Kadapa (near RTC Bus Stand, Simhapuri Colony), or call +91 944 103 0587. Teleconsultation is also available if you would like to start with a conversation from home. This article is for general awareness and is not a substitute for a doctor's advice.