Infertility: Practical steps to understand causes, tests and treatment

About 1 in 6 couples face trouble getting pregnant. That can feel shocking, but knowing the facts and next steps helps you act instead of worry. This guide gives clear, practical advice on what causes infertility, what tests to expect, and common treatments so you can plan the right move with your partner.

Common causes and simple tests

Infertility can come from the woman, the man, both, or unexplained reasons. For women, age is the top factor — egg quality drops after about 35. Other common issues are blocked tubes, irregular ovulation, endometriosis, and uterine problems. For men, low sperm count, poor motility (movement), or abnormal shape are the usual culprits.

Basic tests are straightforward and usually the first step. Men get a semen analysis to check count, shape and movement. Women may have blood tests for hormones like AMH (ovarian reserve), FSH and TSH, and pelvic ultrasound to look at ovaries and uterus. Timing matters: ovulation tracking (using kits or basal body temperature) shows if and when eggs are released. If tubes are a concern, doctors may order a hysterosalpingogram (HSG) — an X-ray test that checks if fallopian tubes are open.

Most clinics start with these tests because they are simple, affordable, and give a quick picture of what’s happening.

Treatment options and next steps

Start with the least invasive fixes. Lifestyle changes can help: stop smoking, cut heavy alcohol use, reach a healthy weight, and reduce stress where possible. Timing sex during the fertile window makes a big difference too.

If basic changes and time don’t work, fertility treatments move from medicine to procedures. Ovulation drugs (like clomiphene) help women who don’t ovulate. IUI (intrauterine insemination) places prepared sperm into the uterus around ovulation and can be useful for mild male factor or unexplained infertility. IVF (in vitro fertilization) is the next step when other treatments fail or when there are severe issues like blocked tubes or low sperm quality. IVF success depends mainly on age and diagnosis — younger women have better odds.

Surgery can fix some problems, such as removing fibroids or unblocking tubes. Donor eggs, donor sperm, or a gestational carrier are options when needed. Your clinic will explain risks, success rates, and costs for each path — don’t sign up until you understand both outcomes and finances.

Infertility takes an emotional toll. Look for support groups, counselling, or online communities. Talk openly with your partner and your doctor about expectations and stress management.

When to see a specialist? If you’ve tried for one year without success, or six months if the woman is over 35, book an appointment. If you have known issues like irregular cycles, previous pelvic infections, or very low sperm count, see a specialist sooner. Bring test results, a list of medications, and be ready to track cycles — that helps the doctor start fast.

Small steps now — tracking cycles, basic tests, lifestyle changes — often lead to clear next moves. Ask questions, get a plan, and stay connected to support. You don’t have to figure it out alone.