Signs of Infertility

There are few obvious physical signs of infertility, other than the fact that the couple has not fallen pregnant. However, it is important to bear in mind a few facts when looking for signs of infertility.

Firstly, even for couples without infertility, conception is not guaranteed: the chances of conception are about 25% each month in women under 35 years of age.

Secondly, it is important to understand that the term ‘infertility’ is used when ‘the ability to become pregnant is diminished or absent’. It does not mean that you are unable to have children, but rather that you may require treatment or assistance to achieve a pregnancy.


The term ‘infertility’ is generally used if a couple has not conceived after 12 months of regular unprotected intercourse, or after 6 months of regular unprotected intercourse if the female partner is aged over 35. It is a challenge shared by one in six couples around the world.

Thirdly, infertility affects men and women equally – about one-third of infertility cases are due to female fertility problems; one-third are due to male fertility problems; and the remaining one-third are due to a combination of male and female factor issues.

Lastly, there are also two types of infertility: primary infertility – when a couple has never achieved having a baby before; and secondary infertility – when a couple is unable to conceive after they have already had a child.

Some of the possible signs of infertility for both women and men are detailed below.

Signs of Infertility for Women

In general, the term “infertility” is used when a couple has had unprotected intercourse for 12 months or more without falling pregnant where the woman is younger than 35. It is also used when a couple has had unprotected intercourse for 6 months or more without falling pregnant where the female partner is over the age of 35.

As such, the first sign of infertility is if you have been trying to fall pregnant for 6 months to a year, depending on your age. Remember, however, infertility doesn’t mean you can’t have children, only that you may require treatment or assistance to achieve a pregnancy.

Other possible indicators of infertility could include irregular cycles, pain during menstruation and/or intercourse, and a BMI of more than 30.

A diagnosis of Polycystic ovary syndrome (PCOS) or endometriosis, as well as a history of pelvic infection disease (PID) or sexually transmitted diseases could also be warning signs.

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is an ovulation disorder affecting up to 10% of reproductive-aged women. Notable symptoms of PCOS include disordered or lack of ovulation, elevated male hormones (androgens), and/or polycystic appearing ovaries on ultrasound. In addition, women with PCOS may experience excess facial and body hair growth, hair loss, acne, skin discoloration, obesity, diabetes, hypertension, and/or elevated cholesterol.


This is a common and sometimes painful condition of the reproductive system which can affect up to one in ten women. It is a known cause of infertility and roughly 30% of women with infertility problems have endometriosis.

It is possible to become pregnant when you have endometriosis. Treatment can either be surgical or medical (by means of medication) or a combination. At Medfem Fertility Clinic endometriosis patients suffering from infertility are treated with specific stimulation protocols which have superior success rates. Every effort is made to avoid surgery to prevent deterioration of ovarian reserve and damage to healthy ovarian tissue.

Pelvic Inflammatory Disease (PID)

PID is usually the main cause of tubal infertility. An infection of the female reproductive organs, often without signs or symptoms, it usually occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries. It is also associated with an increased risk of subsequent ectopic pregnancy (when the fertilised egg implants in the fallopian tube instead of the uterus).

Patients who have had or are planning to have cancer treatment are also at risk of infertility. In such cases, as well as in cases where a woman is 35 and older and not yet ready to have a child, egg freezing should be considered to ensure they can achieve a pregnancy at a later time.

Signs of Infertility in Men

Usually there are no obvious signs or symptoms of an infertility problem in men other than the inability of the couple to fall pregnant.

Erections, intercourse and ejaculation will usually happen normally and the quantity and appearance of the ejaculated semen generally appears normal to the naked eye. However, a male fertility problem can be identified in nearly half of all couples who have difficulty achieving conception. Almost all causes of male infertility are usually related to sperm disorders – either too few in number or of inadequate quality.

Possible signs of infertility include chronic pain in the genital area or erectile dysfunction. Other indicators include previous sexually transmitted diseases, testicular surgery or trauma, and a history of mumps during teenage years, as well as lifestyle choices such as the use of anabolic steroids or gym supplements, a BMI of more than 30, and excessive smoking, alcohol use and illicit drug abuse.

When should you act on signs of infertility?

At Medfem Fertility Clinic, we believe that anyone concerned about their fertility should take immediate steps to have their situation assessed.

Immediate evaluation and treatment of infertility is warranted in cases of known problems such as anovulation, tubal occlusion (blocked fallopian tubes) and severe male factor infertility.


Anovulation is a cause of infertility in approximately 30% of fertility patients. Normal ovulation occurs monthly from alternating ovaries. Anovulation is the failure of the ovary to release an egg (oocyte) over a period of time generally exceeding 3 months. Usually, women with anovulation will have irregular periods or they may not get their cycles at all. If your cycles are shorter than 21 days, or longer than 36 days, it could be a sign of ovulatory dysfunction.

Tubal Occlusion

Tubal disease – a blockage of or damage to one or both of the fallopian tubes – can cause infertility as these tubes are the “roadway” for the sperm to find and fertilise the egg. Thin and delicate, these tubes can be damaged and blocked due to a variety of reasons.

We also believe that it is important to be proactive in evaluating and treating women who are 40 years of age and older because of their increased potential for significant loss of ovarian reserve in this age group.

If you have been trying to conceive for at least one year (or at least six months if you are older than 35), it’s also time to seek help from an expert. There is always a reason why you have not been able to conceive – in fact, in 25% of couples, there is more than one factor contributing to infertility.

It’s just a matter of finding out what treatment or assistance you require to fall pregnant.

At Medfem Fertility Clinic, that is our single goal: helping you get pregnant.

The first step in any infertility treatment – contacting a fertility clinic to set up your initial consultation – is never easy.

However, you could view this as a progressive and positive step in uncovering what your infertility problems might be, receiving professional treatment, and ultimately falling pregnant with your much desired baby.

A first consultation is necessary before any treatment begins. You will meet one of our four specialists, who will discuss your medical history, conduct a comprehensive infertility work up, advise you of your options, and start to plan your treatments.

Simply click here or contact us on +27 (11) 463 2244 to book your initial consultation and take your first step to parenthood.

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