Infertility is defined as an attempt to conceive (with frequent sexual intercourse) for at least a year without success. Female infertility, male infertility, or a combination of the two affects millions of couples in the United States. It is estimated that 10 to 18 percent of couples have difficulty getting pregnant or having a successful delivery.

Infertility results from female factors in about one third of the cases and from male factors in about one third of the cases. The cause is either unknown or, in other cases, a combination of male and female factors.

The main symptom of infertility is the inability to get pregnant. Too long (35 days or more), too short (less than 21 days), irregular, or absent menstrual cycles can mean that you are not ovulating. There may be no other outward sign or symptom.

The reasons
Female reproductive organs
Female Reproductive System Open the Fertilization and Implantation pop-up dialog
Fertilization and Implantation Open the popup dialog
Fertilization and implantation

Each of these factors are important in getting pregnant:

You need to ovulate. In order to get pregnant, your ovaries need to produce and release an egg, a process known as ovulation. Your doctor can help assess your menstrual cycles and confirm ovulation.
Your partner needs sperm. For most couples, this is not a problem unless your partner has a history of illness or surgery. Your doctor may do some simple tests to assess the health of your partner’s semen.

Risk factors
Certain factors can increase your risk of infertility, including:

Age. The quality and quantity of a woman’s eggs decrease with age. In the mid-1930s, the rate of follicle loss accelerated, resulting in fewer and poor quality eggs. This makes conception difficult and increases the risk of miscarriage.
Smoke. Smoking not only damages the cervix and fallopian tubes, it also increases the risk of miscarriage and an ectopic pregnancy. It is also believed to age your ovaries and deplete your eggs prematurely. Quit smoking before starting fertility treatment.

For women planning to get pregnant soon or in the future, these tips can help optimize fertility:

Maintain a normal weight. Overweight and underweight women are at increased risk of ovulatory disorders. If you need to lose weight, exercise moderately. Exhausting and strenuous exercise for more than five hours per week has been linked to decreased ovulation.
Stop smoking. Tobacco has several negative effects on fertility, not to mention your overall health and the health of the fetus. If you smoke and plan to get pregnant, stop now.

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