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What is infertility?

Infertility is when you have trouble getting pregnant or staying pregnant. Fertility problems can happen in people of all genders, and can have many causes.

Infertility is common.

Some people have a hard time getting pregnant or staying pregnant. You’re generally diagnosed with infertility if you don’t get pregnant after 1 year or more of trying, or if you have multiple miscarriages. There are treatments for many kinds of infertility, and many people go on to have a healthy pregnancy and a child.

Fertility isn't just a “woman’s problem” or an issue with age. Lots of things can lead to infertility, and it can affect people of all sexes and ages. When a couple has a hard time getting pregnant, either person (or both people) is equally likely to be the cause. That’s why both people are usually tested for infertility if a couple is having trouble getting pregnant.

What causes infertility?

There are lots of possible causes of infertility. Seeing a doctor that specializes in infertility can help you figure out what’s causing your fertility problems and find the best treatments for you. Sometimes there’s no known reason for infertility — this is called unexplained infertility. Unexplained infertility can be really frustrating, but there are still usually treatment options that you can try.

Causes of infertility in cis women

Some common reasons for infertility in cis women include:

  • untreated chlamydia or gonorrhea

  • not ovulating (not releasing eggs from your ovaries)

  • your fallopian tubes are blocked so sperm can’t get to your egg

  • poor egg quality

  • the shape of your uterus makes it hard for a fertilized egg to implant

  • endometriosis

  • uterine fibroids

Causes of infertility in cis men

The most common causes of infertility in cis men include:

  • untreated chlamydia or gonorrhea

  • low sperm count (not having enough sperm in your semen)

  • poor sperm motility (when sperm doesn’t swim well enough to reach an egg)

  • sperm that aren’t formed correctly

  • semen that’s too thick for sperm to easily move around in it

  • no sperm in your semen

Having too much or too little of some of the hormones that help your body make sperm can also lead to sperm-related problems that cause infertility.

Infertility can also be caused by a problem with ejaculation. If the tubes inside your penis or testicles are blocked, you may have a hard time ejaculating, or nothing comes out when you have an orgasm. Sometimes, ejaculation can send semen backward from your prostate into your bladder, instead of out of your penis.

If you’re trans and using hormones

Gender affirming hormone treatments and surgeries can lead to infertility, but they don’t always lead to infertility. If you want to get pregnant, talk with your doctor or nurse about your fertility options. If you don’t want to get pregnant, use birth control.

What might increase my risk of infertility?

There are certain health and lifestyle factors that can increase your chances of having fertility problems. They include:

  • being older than 35 (for women)

  • being very overweight or underweight

  • chemotherapy or radiation

  • lots of exposure to environmental toxins, like lead or pesticides

  • excessive drug or alcohol use

  • smoking cigarettes

  • not getting recommended testing for chlamydia/gonorrhea

  • a history of pelvic inflammatory disease (PID)

  • injury to the scrotum and testes

  • overheated testicles (from wearing clothing that’s too tight, or swimming or bathing in hot water often and recently)

  • having an undescended testicle

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