How to Know if You Might Be Infertile

Definition, Diagnosis, and What's Next

Couple in bed worried they are infertile
If you have been trying to get pregnant for over a year, you may be facing infertility.. B2M Productions/Photographer's Choice RF/Getty Images

“Am I infertile?”

Many couples ask themselves this question after trying to conceive unsuccessfully. Some couples start worrying when they don’t conceive after just a few months. Others don’t worry until a year or more has passed.

Here’s the good news: if you’ve been trying for less than a year, as long as you don’t have any symptoms or risk factors, you can rest assured that it’s normal to take several months to conceive.

However, if you’ve been trying to get pregnant for a year (or for six months, if you’re 35 years or older), then you should see your doctor. You may be infertile.

Here’s why.

What Is Infertility?

Infertility is defined as the inability to get pregnant after repeated unprotected sexual intercourse over one year’s time.

So, by definition, if you have been trying to conceive for 13 months, for example, you’re facing infertility.

Also, while not technically “infertility,” if you miscarry two or more times in a row, this can also be a sign of a fertility problem.

You should see your doctor if...

  • you have been trying to conceive for 12 or more months unsuccessfully
  • you have had two or more miscarriages in a row
  • you are 35 years or older and have been trying to conceive for 6 months or longer
  • you have symptoms or risk factors for infertility (more on that below)

Why the shorter time period for women 35 and older?

Fertility naturally declines more rapidly starting at age 35. If there is something wrong, it’s important the issue is detected, diagnosed, and treated as soon as possible.

No matter how old you are, getting help sooner will increase your odds of pregnancy success.

How Is a Diagnosis of Infertility Made?

By definition, a doctor can diagnose you as infertile after one year of trying to get pregnant unsuccessfully.

You don’t need to have particular symptoms or test results to receive this diagnosis.

It’s made solely based on how long you have been trying to conceive.

That said, if you have certain symptoms or risk factors, your doctor may say you are at risk for infertility.

For example, perhaps your doctor has already diagnosed you with PCOS. Maybe this diagnosis was made before you even thought of starting a family.

Women with PCOS are at risk for infertility.

But are they guaranteed to have difficulty getting pregnant? Not at all.

There are women with PCOS who will conceive within a year without any medical help. There are others who will not get pregnant on their own. Some may go on to conceive with low-tech treatments; others may require IVF. A few may never conceive.

Whether you are at risk for infertility, have symptoms, or have been trying for a year and have no symptoms, please see your doctor.

What Does It Mean to Be Infertile?

Infertility is not sterility. It’s important to understand that.

If a person is sterile, he or she can’t conceive on his or her own.

It’s impossible for conception to happen naturally. (They may be able to have a baby with the help of assisted reproductive technologies, like IVF or surrogacy.)

If a person is infertile, they may have difficulty conceiving... but it is still theoretically possible to get pregnant the regular way.

Depending on the cause of infertility, the statistical odds of conceiving naturally may be very low. But they aren’t zero.

There have been couples that relied on their infertility as birth control. To their surprise, they have conceived!  

It’s not common, and you shouldn’t forgo fertility treatments in hopes of winning that rare pregnancy-but-infertile lottery ticket. But it’s possible.

Prognosis: What Are the Odds I’ll Get Pregnant if I’m Infertile?

The majority of infertile couples will conceive with the help of fertility treatments. Most of these couples will also conceive with low-tech treatments. Only a small percentage of couples with infertility require IVF.

The bad news is that there is no quick simple statistics on your personal odds of conception with or without treatment.

There are so many variables to consider.

Your odds of beating infertility, whether with fertility treatments or lifestyle changes, depends on...

  • your and your partner’s age
  • the cause of infertility
  • how long you’ve been trying
  • your financial resources (in cases where expensive treatments are what’s required)

An experienced reproductive endocrinologist is the best person to talk about your personal prognosis. But even a great fertility doctor can’t guarantee that a particular treatment will work.

Also, if a fertility clinic gives you a poor prognosis or refuses to treat you, always get a second opinion.

Sometimes a clinic may try to avoid “difficult” cases. They don’t want to pull down their IVF success rates. But you may actually still have a good chance of success.

I Think We’re Infertile. What Do We Do Now?

The first step is to see your gynecologist for some basic fertility testing. Your partner should see a urologist. You want to be sure that you’re both tested early on.

From there, your doctor may either offer treatment or refer you to a fertility clinic.

Sources:

Zarinara A1, Zeraati H2, Kamali K1, Mohammad K2, Shahnazari P1, Akhondi MM1. “Models Predicting Success of Infertility Treatment: A Systematic Review.” J Reprod Infertil. 2016 Apr-Jun;17(2):68-81.

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