Common Signs That Suggest Evaluation

Inability to conceive after 12 months of regular unprotected intercourse (or after 6 months if woman is over 35)
Irregular or absent menstrual cycles
Painful periods or pelvic pain
Recurrent pregnancy loss or multiple miscarriages
History of pelvic infections, sexually transmitted infections, or pelvic surgery
Known male factor issues: low sperm count, poor motility, or abnormal morphology

Major Causes

Male factor: low sperm count, poor motility, abnormal shape, or sperm transport problems
Ovulatory disorders: PCOS, premature ovarian insufficiency, hormonal imbalances
Tubal factors: blocked or damaged fallopian tubes from infection or surgery
Uterine factors: fibroids, polyps, congenital uterine anomalies
Endometriosis affecting ovarian or tubal function
Age-related decline in ovarian reserve
Unexplained infertility when tests are normal but pregnancy does not occur

Treatment is tailored to the diagnosed cause and the couple’s preferences, and may include one or more of the following:

Lifestyle interventions: weight optimisation, smoking cessation, alcohol limitation, and stress reduction
Medications to induce or regulate ovulation (e.g., clomiphene, letrozole, gonadotropins)
Correction of tubal or uterine problems by minimally invasive surgery (laparoscopy/hysteroscopy)
Treatment of male factor infertility (medical therapy or surgical sperm retrieval when indicated)
Intrauterine insemination (IUI) for selected cases
Assisted reproductive techniques (ART) such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI)
Use of donor sperm, donor eggs, or surrogacy when appropriate
Emotional support and counselling throughout evaluation and treatment

Not all causes of infertility are preventable, but certain steps can reduce risks and preserve fertility:

Seek early evaluation if trying to conceive for 12 months (or 6 months if over 35)
Maintain a healthy weight and balanced diet
Avoid smoking, excessive alcohol, and recreational drugs
Protect against sexually transmitted infections and treat infections promptly
Consider fertility preservation (egg/sperm freezing) if delaying pregnancy for medical or personal reasons
Regular health check-ups and early treatment of conditions like PCOS or thyroid disorders