What is Infertility? Know Causes, Symptoms, Diagnosis, Treatment, Cost & Next Steps

Updated on 21st August, 2026

Infertility is the inability to achieve pregnancy after 12 months of regular, unprotected sex. If you are 35 or older, fertility tests are recommended after 6 months, while people over 40 or those with known fertility problems may need tests sooner.

It can affect women, men, or both partners. Common causes include ovulation problems, PCOS, blocked fallopian tubes, endometriosis, age-related fertility changes, low or poor-quality sperm, and hormonal or reproductive problems. 

The good news is that infertility can often be treated. Depending on the cause, your doctor may recommend lifestyle changes, medicines, surgery, IUI, IVF, or ICSI. Let’s understand everything about infertility in men and women. 

Table of Content

Table of Contents

What is Infertility?

Infertility means having difficulty achieving a pregnancy despite having regular, unprotected sex. Doctors generally consider it infertility when pregnancy has not occurred after 12 months of trying. 

• If you are 35 or older, you should usually seek a fertility evaluation after 6 months of trying, 
• If you are over 40 or have a known fertility concern, you may benefit from an earlier evaluation.

According to the World Health Organisation (WHO), infertility is a disease of the male or female reproductive system that is defined by the failure to achieve a pregnancy after 12 months or more of regular, unprotected sexual intercourse.

What are the Types of Infertility?

Doctors generally classify infertility based on whether you have never achieved a pregnancy (primary) or are having difficulty conceiving after a previous pregnancy (secondary), or it is unexplained. Understanding the type can help your doctor plan the right evaluation and treatment.

1. Primary Infertility

Primary infertility means you have never achieved a pregnancy and are unable to conceive despite regular, unprotected sex for 12 months or more.

It can result from factors affecting either partner, such as ovulation or hormonal problems, low ovarian reserve or age-related fertility changes, blocked fallopian tubes, low sperm count or poor sperm movement, etc. 

2. Secondary Infertility

Secondary infertility means you have achieved a pregnancy before but are now having difficulty conceiving again after 12 months of regular, unprotected sex.

Having conceived before does not guarantee that fertility will remain the same. Factors such as increasing age, changes in sperm quality, ovulation problems, endometriosis, tubal problems or other health conditions can affect fertility over time.

3. Unexplained Infertility

Sometimes, fertility tests do not identify a clear reason for difficulty conceiving. Doctors may call this unexplained infertility.

This does not mean that pregnancy is impossible or that nothing can be done. Your treatment may depend on your age, how long you have been trying, previous pregnancies, fertility test results and other factors.

How Common is Infertility in India?

A 2026 systematic review done on infertility in India estimated that around 8% of women aged 15 – 49 experience infertility, with pooled estimates of 5% for primary infertility and 2% for secondary infertility.

This means infertility is not a rare problem, and it can affect couples across different age groups and backgrounds. Importantly, the cause may come from the female partner, male partner, both partners, or sometimes remain unexplained. 

If you have been trying to conceive without success, a fertility test like a semen analysis test for males and a hormone blood test can help identify the possible cause instead of assuming that the problem lies with one partner.

What are the Causes of Infertility?

The most common causes of infertility problems are with ovulation, sperm, fallopian tubes, the uterus, hormones, age-related fertility changes, or conditions that affect the reproductive system.

Infertility can happen for many reasons, and the cause does not always come from the woman. It may be related to the female partner, male partner, both partners, or remain unexplained even after testing. It includes:

• Female Infertility Causes: Ovulation problems, PCOD, age-related infertility, blocked fallopian tubes, hormonal disorder, etc. 
• Male Infertility Causes: Low sperm count, poor sperm motility, azoospermia, etc.
• Infertility Can Affect Both Partners: You may have an ovulation problem while your partner has reduced sperm motility.
• Unexplained Infertility: In some couples, fertility tests do not identify a clear reason for difficulty conceiving. 
• Lifestyle Factors: excessive drinking, smoking, pelvic infections, endometriosis, etc. 

What are the Signs and Symptoms of Infertility?

Infertility often does not cause any clear symptoms. However, for many couples, the first sign is simply that pregnancy has not occurred after trying for a certain period. The symptoms you notice may come from an underlying condition that affects fertility.

Signs and Symptoms of Infertility in Women

Some symptoms that may suggest an underlying fertility problem include:

• Irregular or absent periods
• Very painful periods
• Pelvic pain
• Unusual vaginal bleeding
• Pain during sex
• Changes such as excess facial hair or severe acne
• Previous pelvic infection or surgery

Expert Tip: These symptoms do not automatically mean you are infertile. They simply indicate that fertility or gynaecological tests may be useful.

Signs and Symptoms of Infertility in Men

Male infertility also may not cause noticeable symptoms. When symptoms occur, they may include:

• Problems with ejaculation or erection
• Pain, swelling or a lump around the testicles
• Reduced sexual desire
• Changes in testicular size

Can You Have Infertility Without Any Symptoms?

Yes, you can have infertility without any symptoms. You can have infertility even if your periods are regular, your sexual health seems normal and neither partner has any obvious symptoms.

For example, blocked fallopian tubes may not cause noticeable symptoms, and some sperm problems only become apparent through semen testing. This is why doctors look at your fertility history and, when needed, recommend tests for both partners rather than relying only on symptoms.

Hence, if you have been trying to conceive without success, you don’t need to wait for symptoms before seeking advice. Connect with 20+ years of experienced doctors at Crysta IVF.

When Should You See an Infertility Specialist?

You do not have to wait until you have symptoms to see an infertility specialist. If you have been trying to conceive without success, the right time for an evaluation mainly depends on your age, how long you have been trying, and whether you have any known fertility concerns.

As a general guide, you should consider a fertility evaluation if:

Your situation	When to seek help
You are under 35	After 12 months of regular, unprotected sex without pregnancy
You are 35–39	After 6 months of trying without pregnancy
You are 40 or older	Consider seeing an infertility specialist sooner
You have irregular or absent periods	Consider an earlier evaluation
You have known endometriosis, PCOS, tubal problems or another fertility concern	Do not necessarily wait 6 – 12 months
Your partner has a known or suspected sperm problem	Consider evaluation sooner
You have had previous fertility treatment	Discuss your next steps with a specialist

Note: These are just hypothetical situations. Please connect with a fertility expert to know about your problem.

Should Both Partners Get Tested for Infertility?

Yes, fertility tests should involve both partners when needed. Infertility can result from female factors, male factors, factors affecting both partners, or sometimes no clearly identified cause.

For females, the evaluation may include your menstrual and medical history, ovulation assessment, ultrasound or other tests. For males, a semen analysis is often an important first step when male-factor infertility is possible.

Expert Advice on Why Both Partners Should Be Evaluated for Infertility

As per experts, infertility should be evaluated as a couple and not as a problem that automatically belongs to the woman. 

Dr. Nidhi Sehrawet suggests, “semen analysis is often a simple first step for the male partner, while the female partner may need tests to assess ovulation, ovarian function, the uterus and fallopian tubes. Testing both partners early can help us identify the complete picture and avoid spending months treating only one possible cause.”

The goal is not to try every possible test. The choice of treatment is completely based on your age, medical history, duration of infertility and previous pregnancy or treatment history.

~ Dr. Nidhi Sehrawet

Senior IVF Specialist

Crysta IVF – Best IVF Centre in Delhi

Can Infertility Be Cured Permanently?

Infertility can often be treated, but there is no single cure for every type of infertility. Infertility is a broad condition with many possible causes, so your treatment depends on what is affecting your ability to conceive.

For some couples, treating the underlying problem may restore natural fertility. For others, treatment may help achieve pregnancy through options such as IUI, IVF or ICSI. Sometimes, doctors cannot find a clear cause even after fertility testing.

How is Infertility Diagnosed?

Infertility is not diagnosed through a single test. Your doctor looks at how long you have been trying to conceive, your age, medical and reproductive history, and the health of both partners. 

Here is how infertility is diagnosed in males and females for different causes of the problem:

Infertility Diagnosis in Women

• Ovulation Assessment: Checks whether you are releasing an egg regularly through your menstrual history, hormone tests, or ultrasound monitoring.
• Ovarian Reserve Tests: Tests such as the AMH test and AFC help estimate your remaining egg supply and support fertility treatment planning.
• Pelvic Ultrasound: Examines your ovaries, uterus, uterine lining, and follicles to identify conditions that may affect fertility.
• Fallopian Tube Tests: The HSG test checks whether your fallopian tubes are open so the egg and sperm can meet naturally.
• Uterine Evaluation: Tests such as sonohysterography or hysteroscopy check the inside of your uterus for polyps, fibroids, adhesions, or other abnormalities.

Infertility Diagnosis in Men

Male fertility evaluation often starts with a semen analysis because sperm-related factors are a common part of infertility.

A semen analysis can assess:

• Sperm Count: Measures the total number of sperm present in the semen sample.
• Sperm Concentration: Measures the number of sperm present in a specific volume of semen.
• Sperm Movement (Motility): Checks how well the sperm move, which helps them travel towards the egg.
• Sperm Shape (Morphology): Examines the size and shape of sperm to assess whether they have a normal structure.
• Semen Volume: Measures the total amount of semen produced in the sample.

If the results are abnormal, your doctor may repeat the test because sperm results can vary between samples.

What if All Infertility Tests are Normal?

Sometimes, fertility tests do not identify a clear reason for difficulty conceiving. Doctors may call this unexplained infertility.

This does not mean that there is no possibility of pregnancy. It means that the commonly evaluated factors have not revealed a specific cause.

Your doctor may consider your age, duration of infertility, previous pregnancies, test results and treatment history before suggesting the next step.

What are the Treatment Options for Infertility?

Infertility treatment can include lifestyle changes, medicines, surgery, IUI, IVF or ICSI. It depends on what is affecting your fertility, your age, how long you have been trying, your previous pregnancy or treatment history, and the results of your fertility tests. 

Here are the different treatment options for infertility:

1. Lifestyle Changes

Lifestyle changes may support fertility when they address a relevant health or reproductive factor. Your doctor may advise you to:

• Stop smoking or tobacco use
• Limit excessive alcohol
• Maintain a healthy weight
• Follow a balanced diet
• Stay physically active
• Manage conditions such as diabetes or thyroid problems
• Review medicines that may affect fertility with your doctor

Lifestyle changes can support reproductive health, but they cannot treat every cause of infertility. For example, blocked fallopian tube problems may need medical treatment.

2. Medicines for Infertility

Medicines may help when ovulation or hormones are affecting your chances of pregnancy. As per Mayo Clinic, medicines may include oral pills like Clomid and Letrozole, as well as injectable gonadotropins. Depending on your diagnosis, your infertility doctor may use medicines to:

• Help you ovulate regularly
• Correct certain hormonal problems
• Stimulate the development of eggs
• Support ovulation during fertility treatment

Your doctor will choose the medicine and dose based on your condition. You should not take fertility medicines without medical guidance because the wrong treatment can cause side effects or increase the risk of complications such as multiple pregnancies.

3. Surgery for Infertility

Some structural problems affecting fertility can be treated with surgery. Depending on your condition, your infertility doctor may recommend procedures such as:

• Laparoscopy for selected cases of endometriosis, pelvic adhesions or other pelvic conditions
• Hysteroscopy to diagnose or treat certain problems inside the uterus
• Treatment of selected fibroids or uterine abnormalities
• Treatment of some tubal problems
• Varicocele treatment in selected men when it may improve fertility

Surgery is not needed for everyone. Your doctor will consider whether treating the condition is likely to improve your chances of pregnancy.

4. ART Procedure

When the initial infertility treatments like medications and lifestyle changes fail to work, the best fertility doctors recommend Assisted Reproductive Technology (ART) procedures such as:

• In vitro fertilisation (IVF): In this procedure, eggs and sperm are taken from both partners for incubation in a fertility laboratory to produce an embryo. Medical specialists put the prepared embryo into the woman’s uterus for implantation.
• Intrauterine Insemination (IUI): In this process, the fertility experts put a man’s sperm into a woman’s uterus with the help of a long, narrow tube. IUI is performed in conditions like low sperm count, erection problems, sperm with low motility, etc.
• Gamete intrafallopian transfer (GIFT): In this ART procedure, fertilisation occurs naturally when eggs and sperm are put inside the fallopian tube.
• Zygote intrafallopian transfer (ZIFT): ZIFT is another effective ART procedure, where fertilised eggs are transferred to the fallopian tube.
• Intracytoplasmic sperm injection (ICSI): In this ART procedure, the fertility experts inject a single sperm into a mature egg.

What Factors Help a Doctor Decide Your Infertility Treatment?

Your doctor chooses a treatment based on why you are having difficulty conceiving, your age, your fertility test results, and your previous pregnancy or treatment history.

• Your Age: Female age can affect egg quality, ovarian reserve and treatment response, so it may influence how quickly your doctor recommends treatment.
• The Cause of Infertility: Your treatment depends on the cause, such as ovulation problems, blocked tubes, endometriosis, uterine conditions or male-factor infertility.
• Sperm Quality: Sperm count, concentration, motility and morphology can help your doctor decide whether timed intercourse, IUI, IVF or ICSI may be suitable.
• Fallopian Tube Health: If your fallopian tubes are blocked or damaged, your doctor may consider surgery in selected cases or recommend IVF depending on your overall fertility profile.
• Uterine Health: Fibroids, polyps, adhesions or other uterine problems may need treatment before you try to conceive naturally or proceed with IUI or IVF.
• How Long You Have Been Trying: The duration of infertility, along with your age and test results, helps your doctor decide whether to continue trying naturally or consider fertility treatment.
• Other Health Conditions: Conditions such as PCOS, endometriosis, thyroid disorders or diabetes may affect fertility, so managing them can be an important part of your treatment plan.

How Long Does Infertility Treatment Take?

There is no fixed timeline for infertility treatment. It can take a few weeks, several months, or longer depending on the cause of infertility, your age, the treatment you need, and how your body responds.

Here is an approximate timeline for each type of infertility treatment:

Treatment	Approximate timeline
Fertility evaluation	A few weeks, depending on the tests needed
Ovulation medicines	Planned around your menstrual cycle
Timed intercourse	Usually planned around your fertile window
IUI	Usually completed within one menstrual cycle (28 – 30 days)
IVF	An active cycle commonly takes around 2 – 4 weeks, although the complete process may take longer
ICSI	It is performed during IVF, hence the timeline is around 2 – 4 weeks.
Fertility surgery	Depends on the procedure and recovery needed

Note: These are general timelines, not guarantees. Your doctor may recommend a different schedule based on your fertility results.

What is the Cost of Infertility Treatment in India?

The cost of infertility treatment varies from person to person because there is no single treatment for infertility. Your total expense depends on the cause of infertility, tests required, medicines, treatment type, number of cycles and whether you need any additional procedures.

The cost of infertility treatment in India can vary widely depending on the treatment you need. As a general estimate:

• Ovulation medicines and monitoring
• IUI treatment: ₹20,000 – ₹30,000 per cycle
• Laparoscopy/Hysteroscopy: ₹30,000 – ₹70,000+
• IVF treatment: ₹1,00,000 – ₹2,50,000+ per cycle
• IVF with ICSI: ₹1,20,000 – ₹3,00,000+ per cycle
• Frozen embryo transfer (FET): ₹50,000+ per cycle
• Embryo freezing and storage: starts at ₹20,000 initially, with storage charges varying by centre

Note: These are approximate ranges, not fixed prices. Your actual infertility treatment cost may be higher or lower depending on your diagnosis, medicines, tests, treatment protocol and number of cycles required.

This cost can also change depending on the city of treatment. For example, IVF cost in Delhi will be different from IVF cost in Patna, due to infrastructure, accessibility and doctor’s experience. 

How to Prepare for Your First Infertility Consultation?

Your first fertility consultation is mainly about understanding why you are having difficulty conceiving and what to do next. You can make the visit more useful by carrying your medical records and preparing a few details about your fertility history.

Keep the following information ready:

• Menstrual history: Note your cycle length, period dates, irregular cycles, pain or unusual bleeding.
• Trying-to-conceive history: Know how long you have been trying and whether you have been tracking ovulation.
• Previous pregnancy history: Share details of previous pregnancies, miscarriages or ectopic pregnancies.
• Medical history: Mention conditions such as PCOS, endometriosis, thyroid problems, diabetes or previous infections.
• Previous surgeries: Include pelvic, abdominal, ovarian or testicular surgeries.
• Previous fertility treatment: Carry reports from any previous IUI, IVF or other fertility treatments.
• Test reports: Bring previous AMH, ultrasound, HSG, semen analysis, hormone tests or other relevant reports.
• Medication and supplement list: Tell your doctor about regular medicines, supplements and fertility medicines you have taken.

Common Myths About Infertility You Should Stop Believing

Infertility is surrounded by myths that can create unnecessary fear, guilt, or delay in seeking the right care. Here are some common myths and facts around infertility you should know about.

Myth 1: Infertility Is Only a Woman’s Problem

Fact: Infertility can affect either partner or both. Male factors, female factors, a combination of both, and unexplained infertility can all contribute to difficulty conceiving. This is why doctors often recommend evaluating both partners.

Myth 2: If You Have Regular Periods, You Cannot Have Infertility

Fact: Regular periods often suggest that ovulation is occurring, but they do not guarantee normal fertility. Problems with sperm, fallopian tubes, ovarian reserve, the uterus or other factors can still make conception difficult.

Myth 3: Infertility Means You Can Never Have a Baby

Fact: Infertility does not mean pregnancy is impossible. Many causes can be treated or managed with medicines, surgery, IUI, IVF, ICSI or other fertility treatments, depending on the cause.

Myth 4: IVF Is the Only Treatment for Infertility

Fact: IVF is only one treatment option. Depending on your diagnosis, treatment may include lifestyle changes, medicines, timed intercourse, surgery or IUI before IVF is considered.

Myth 5: Infertility Happens Only After 35

Fact: Fertility can be affected at any age. However, female fertility generally declines with age, particularly after 35. Younger people can also experience infertility because of conditions such as PCOS, endometriosis, tubal problems or male-factor infertility.

Myth 6: Stress Alone Causes Infertility

Fact: Stress can affect your overall wellbeing and may influence some reproductive behaviours or cycles, but it is not correct to assume that stress alone causes infertility. Fertility problems can have many medical causes and need proper evaluation.

Myth 7: A Previous Pregnancy Means You Cannot Have Infertility Later

Fact: You can experience secondary infertility after having a previous pregnancy. Age, changes in reproductive health, sperm quality, endometriosis, tubal problems and other factors can affect fertility over time.

Myth 8: Fertility Problems Always Have Known Symptoms

Fact: Many fertility problems cause no noticeable symptoms. A person can have regular periods or normal sexual function and still have an underlying fertility issue. Testing may be needed to identify the cause.

Myth 9: Fertility Supplements Can Cure Infertility

Fact: No single supplement, food or home remedy can cure every cause of infertility. Some nutrients may be recommended for specific health or pregnancy needs, but supplements should not replace proper fertility evaluation and treatment.

Myth 10: You Should Try for Several Years Before Seeing a Fertility Specialist

Fact: Waiting too long can delay treatment, particularly when age or known fertility problems are involved. In general, evaluation is recommended after 12 months of trying if you are under 35 and after 6 months if you are 35 or older. 

Summing It Up

Infertility can feel confusing, especially when you don’t know why pregnancy has not happened or what you should do next. But an infertility diagnosis does not mean that you cannot have a baby. Many causes can be treated, managed or addressed with fertility treatments.

The first step is to understand what may be affecting your fertility. Evaluating both partners, identifying the possible cause and considering factors such as age, ovarian reserve, sperm health, fallopian tubes and previous pregnancy history can help your doctor choose the right approach.

If you have been trying to conceive without success, connect with Crysta IVF expert doctors directly who can help you provide a personalised treatment plan as per your situation.

Frequently Asked Questions About Infertility