Infertility is a condition where you can’t get pregnant after one year of trying to conceive. Causes of infertility can include ovulatory disorders, endometriosis, low sperm count or low testosterone. The risk of infertility increases as you age. Many treatment options are available for people with infertility.
Infertility is a condition of your reproductive system that causes people to be unable to get pregnant (conceive). Infertility can affect anyone and has many causes. Getting pregnant involves several steps:
A pregnancy can’t occur if anything in this process doesn’t happen.
If you’re younger than 35, your healthcare provider may diagnose infertility after one year (12 months) of trying to conceive. Trying to conceive is defined as having regular, unprotected sex. If you’re 35 or older, your provider may diagnose infertility after six months of regular, unprotected sex.
Infertility is more common than you might think. Fortunately, there are many treatment options available for people who wish to begin or expand their family.
Types of infertility include:
Infertility affects men and people assigned male at birth (AMAB) and women and people assigned female (AFAB) at birth equally. Infertility is very common. In the United States, 1 in 5 women between 15 and 49 years old struggle with primary infertility and about 1 in 20 women struggle with secondary infertility. Approximately 48 million couples live with infertility around the world.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
The main sign of infertility is being unable to get pregnant after six months or one year of regular, unprotected sex. You may not have any other symptoms. But some people may show physical symptoms such as:
There are many causes of infertility, and sometimes, there isn’t a simple answer as to why you’re not getting pregnant. Only a healthcare provider can determine the cause and find the best treatment for you.
While causes of infertility vary, studies show that:
Twenty-five percent of infertile couples have more than one factor that contributes to their infertility.
Some causes of infertility affect just one partner, while others affect both partners. Risk factors for infertility include:
Ovulation disorders are the most common cause of infertility in people with ovaries. Ovulation is the process in which your ovary releases an egg to meet sperm for fertilization.
These factors can contribute to female infertility:
The most common cause of male infertility involves problems with the shape, movement (motility) or amount (low sperm count) of sperm.
Other causes of male infertility include:
First, your healthcare provider will get your full medical and sexual history.
Fertility for people with a uterus involves ovulating healthy eggs. This means your brain has to send hormonal signals to your ovary to release an egg to travel from your ovary, through your fallopian tube and to your uterine lining. Fertility testing involves detecting an issue with any of these processes.
These tests can also help diagnose or rule out problems:
Diagnosing infertility in people with a penis typically involves making sure a person ejaculates healthy sperm. Most fertility tests look for problems with sperm.
These tests can help diagnose or rule out problems:
Treatment for infertility depends mostly on the cause and your goals. Your age, how long you’ve been trying to conceive and your personal preferences are factors in deciding on a treatment. Sometimes, one person needs treatment, but other times, treatment involves both partners.
In most cases, people and couples with infertility have a high chance of pregnancy. Things like medication, surgery or assisted reproductive technology (ART) can help. Often, lifestyle changes or improving the frequency and timing of intercourse can improve your chances of pregnancy. Treatment can also include a combination of methods.
Treatments for infertility in women and people assigned female at birth include:
Providers may make suggestions on how you can improve your odds of conceiving. These may include things like:
Treatments for infertility if you have a penis or testes include:
Some couples need more help conceiving using assisted reproductive technology (ART). ART is any fertility treatment that involves a healthcare provider handling the sperm or egg. To increase pregnancy odds, you can take medications to stimulate ovulation before trying one of these options:
Complications of infertility treatment include:
Yes, but it depends on the cause. In 85% to 90% of cases, lifestyle modification, medication, ART or surgery can treat infertility and allow a person to conceive.
You can take these steps to protect your fertility, especially while trying to conceive:
Approximately 9 out of 10 couples get pregnant after undergoing fertility treatments. Success rates vary depending on the cause of infertility, the couple’s ages and other factors.
Infertility has emotional, physical, financial and psychological side effects. Don’t forget to practice self-care and be patient with yourself and your partner throughout the process. Infertility isn’t easy, so surround yourself with supportive people or consider joining an online support group. Sometimes, sharing your feelings with people who understand what you’re going through can be helpful.
Health insurance policies vary, so you should always check with your insurance provider. Most insurers cover medically necessary procedures, such as surgeries to treat endometriosis and uterine fibroids. Some policies cover fertility procedures like IUI, but may not cover ovulation-stimulating medications or IVF.
Certain states have laws that require employers to provide infertility coverage as part of their health insurance policy for employees. As of June 2022, The National Infertility Association (Resolve) states:
If you live or work in a state that has an infertility coverage law in place and want to know your coverage details, you should contact your employer.
People who are under the age of 35 and who aren’t pregnant after one year of trying should see a healthcare provider. You should seek help sooner (after six months of trying) if you’re 35 to 39 years old. If you’re 40 or older, you should seek evaluation after fewer than six months of trying. Your chances of getting pregnant decrease with age. For example, a 25-year-old female has a 25% to 30% chance of getting pregnant each menstrual cycle. By the time you reach 40, your chances are less than 5% each cycle.
Regardless of sex, you should seek help early if you have a risk factor or medical condition that affects fertility. Seek prompt evaluation if you have a history of risk factors for premature ovarian failure, severe endometriosis, or known or suspected uterine/tubal disease.
You may want to ask your healthcare provider:
Chlamydia causes about 4 million infections each year in the U.S. Untreated chlamydia is a risk factor for infertility because it leads to pelvic inflammatory disease (PID). PID is an infection that can permanently damage your fallopian tubes, uterus or ovaries.
No. Studies show that using birth control doesn’t harm your future fertility.
Endometriosis is a risk factor for infertility. About 30% to 50% of people with endometriosis will experience infertility.
A note from Cleveland Clinic
Infertility poses many challenges and can feel soul-crushing if you’re wanting to start or expand your family. It can affect your relationships and emotional health. Infertility treatments can also be costly and strain finances. If you’re not getting pregnant despite your best efforts, it may be time to contact a healthcare provider. They can determine if there’s a cause and then discuss possible treatment options with you. Most couples eventually get pregnant, but some turn to reproductive technologies or adoption.
Last reviewed by a Cleveland Clinic medical professional on 04/19/2023.
Learn more about our editorial process.