If you’re having trouble getting pregnant, 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.
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
1 in 7 couples in the UK struggle to get pregnant, which can be related to their eggs, their sperm, or both.
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.
Sperm is considered low quality when there are:
Low numbers or no sperm in the semen (azoospermia or oligospermia)
Sperm that do not swim properly, making it hard for them to reach an egg
Sperm with an abnormal shape, size or appearance
Learn more about male fertility, including how to improve sperm quality.
Damage to your testicles can stop you from making healthy sperm.
This can be from:
Infections such as STIs
Cancer or tumours
Congenital conditions (something you were born with)
Injury or scrotal injury
It’s not always obvious from looking at them if there’s a problem with your testicles.
The tubes that sperm travels through can become blocked, stopping it from leaving the testicles.
Tubes can be blocked due to:
Surgery of the bladder, urethra or prostate
Problems with the way the tubes have developed
Medicines and drugs that can affect male fertility include:
Chemotherapy or radiotherapy to treat cancer
Anabolic steroids, which are synthetic hormones for medical or personal use
Some herbal remedies - cottonseed extract (Gossypol) or Thunder God vine extract (Tripterygium wilfordii)
Sulfasalazine (aka Azulfidine) – an anti-inflammatory medicine that can temporarily reduce sperm
Illegal drugs may also affect fertility.
Your lifestyle plays an important part in your overall fertility, including:
Weight - being above or below your healthy weight
Smoking - harmful chemicals impact egg production
Alcohol - affects sperm quality
Extreme stress - can reduce sperm production or ovulation
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.
You might also consider a fertility assessment if:
You’re over 35 and have been trying for 6 months
You’re over 40 and want to start trying
You have a condition that can affect fertility
Your periods have stopped or are irregular
If you’re worried about your fertility or are struggling to get pregnant, a fertility assessment and consultation with a specialist can give you the answers you’re looking for.
We offer fertility assessments for male and female individuals and couples, for fast and accurate fertility insights. We’ll sensitively discuss the problems you’re experiencing and arrange for you to have some tests to identify any problems and help you plan your next steps.
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.
Not everyone struggling with fertility has to have treatment to get pregnant.
Some people go on to have a baby naturally - it just takes more time.
But it’s good to know that there are lots of options for you to explore, especially if you’re getting to an age where fertility is a worry.
If you have a specific condition that affects your fertility, then there are often treatments to ease symptoms or to help conceive.
Conditions that may need treatment include:
Polycystic ovarian syndrome (PCOS)
The treatment could be surgery or medicine.
Sometimes this is enough to restore fertility, but for other people, fertility treatment is also needed to get pregnant.
Fertility treatment is medicine or procedures that have the specific aim of pregnancy, rather than treating the condition itself.
At TFP Fertility, we offer a range of specialist fertility services for:
Female and male infertility
Individuals or couples
LGBTQ + fertility services
We offer full fertility assessments and treatment to help people conceive and have the families they long for, including intrauterine insemination (IUI) and in vitro fertilisation (IVF).
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
Other signs of male infertility can include:
Problems with ejaculation
Cloudy urine after sex
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)
Genetic conditions known to cause male infertility include:
Cystic fibrosis (rare)
Kleinfelter syndrome (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.