If you’re having trouble getting pregnant, we understand it can be upsetting and frustrating, especially when you don’t know what’s behind it. Here are the common causes of fertility problems, with suggestions for next steps you can take.
We recognise sex and gender are complex. Because we share fertility advice, we use 'women' and 'female' on this page to refer to the person who would carry a pregnancy.
The simplest definition of fertility is when you’re able to make a baby within one year of regular unprotected sex.
Sometimes it can take longer, which doesn’t always mean you’re infertile.
Fertility exists on a spectrum:
Optimal fertility - there are little to no delays in getting pregnant
Subfertility - it takes longer but is still possible naturally or with fertility treatment
Infertility - pregnancy is unlikely without fertility treatment and or donor eggs/sperm
There are two types of infertility:
Primary infertility – where you’ve never had a pregnancy before and are unable to get pregnant now
Secondary infertility – where you’ve had one or more pregnancies in the past but are unable to get pregnant now
Secondary infertility is more likely to be caused by recent conditions or lifestyle factors, instead of a condition you were born with.
You’re born with all your eggs, which means that as you age, so do they.
This is why getting older is the most common reason for female infertility.
In your thirties, your fertility starts to reduce until, eventually, you're no longer fertile (around age 45).
At the end of this process is menopause, when your periods stop.
Ovulation is when you release an egg, 12 - 16 days before your period.
Infertility is often related to ovulation problems, which can be caused by:
Ovulation might stop completely, or it can become irregular (not every month).
The fallopian tubes are how the egg travels from the ovaries to the womb, so it can be fertilised by sperm.
Conditions that scar or damage the tubes or womb can cause infertility.
Pelvic or cervical surgery such as a C-section
Fibroids - non-cancerous growths in the womb
Pelvic inflammatory disease - an infection caused by STIs
This can sometimes be reversed with surgery.
Medicines and treatments that can affect female fertility include:
Chemotherapy or radiotherapy to treat cancer
Long-term or high doses of NSAIDs like ibuprofen and aspirin
Spironolactone (aka Aldactone), a medicine for fluid retention that can temporarily reduce fertility
Illegal drugs may also affect fertility.
A fertility assessment and consultation can give the answers you’re looking for. Have your questions answered by an expert, with fertility tests and treatments tailored to you.
If you’ve been trying to get pregnant for over a year, a fertility test can help you understand your reproductive health so you can plan your next steps.
In certain cases, you might need to a specialist sooner.
Learn more about when to see a specialist and how they can help below.
For 1 in 4 couples, the cause of infertility is unknown.
This can be difficult news, leaving you feeling helpless about what to do next.
But it doesn’t mean giving up on your fertility journey.
At TFP Fertility UK, we help many people with unexplained infertility to become parents.
We offer a choice of specialist fertility treatments to suit you and counselling to support you at any point in your journey.
When it comes to infertility, tests and treatment, there can be a lot to take in. Talk to our friendly experts face-to-face at one of our in-person or online events, and get your fertility questions answered.
The main sign of infertility is not being able to get pregnant within a year of having unprotected sex every 2-3 days.
You might not have any other signs any symptoms, as it depends on the cause.
Other signs of female infertility can include:
Irregular or missed periods
There are many reasons why periods can stop.
You should see your GP if you miss three periods in a row.
The most common reasons for missed or stopped periods are:
Sudden weight loss
Too much exercise
Taking the contraceptive pill
Polycystic ovary syndrome (PCOS)
Contraception does not permanently affect your fertility.
Once you stop taking it, your fertility will eventually return, unless you have reached menopause.
It can take time for your cycle or your fertility to come back after taking contraception.
Our specialists can advise you on how long this might be, as it depends on the type of contraception and how long you took it.
Having an abortion or miscarriage does not affect your fertility unless you get a complication like an infection.
If you’re worried about pregnancy or fertility after a miscarriage or procedure, speak to one of our expert team for confidential advice and support.
Infections known to cause infertility include:
Pelvic inflammatory disease
If left untreated, these infections can damage the female and male reproductive organs.
STIs don’t always cause symptoms, which is why it’s important to get tested if you’ve had unprotected sex.
Not all STIs cause infertility. Herpes and HPV are not linked to infertility.
As with most health-related concerns, infertility is likely to have a genetic influence.
But for most people, it’s impossible to say for sure whether infertility is caused by their genetics unless they have a specific condition.
Genetic conditions known to cause female infertility include:
Turner syndrome (rare)
Fragile X syndrome (uncommon)
Kallmann syndrome (very rare)
If you’re worried about a genetic condition affecting your fertility, speak to a specialist.
While smoking is a well-known factor in reduced fertility, there’s less research on vaping.
It’s too soon to say what its long-term effects could be.
So far, it’s not thought to cause infertility.
Vapes are free from tobacco and many other chemicals that are in cigarettes.
But they still contain nicotine, which affects fertility, along with other substances with unknown effects.
So, while vaping may be an alternative to smoking cigarettes, we recommend staying free from all nicotine-based products.