Subfertile

Subfertile is a term used to describe reduced fertility, where conception takes longer than expected but is still possible. It is a descriptive rather than a strict medical diagnosis and can refer to either one partner or both. In many settings, infertility is defined as the inability to conceive after about 12 months of regular, unprotected intercourse; subfertility emphasizes delayed conception and may be used when pregnancy has not occurred within a shorter or longer specified period depending on age and clinical context.

Causes are diverse and may involve female factors, male factors, or a combination. Female contributors include ovulatory disorders (such as polycystic ovary syndrome or thyroid problems), age-related declines in fertility, tubal or uterine abnormalities, endometriosis, and cervical factors. Male factors commonly involve abnormal sperm production or function. Lifestyle and health conditions—such as obesity, smoking, excessive alcohol use, drug exposure, stress, and certain medications—can also impair fertility.

Evaluation typically begins with confirming that pregnancy is not already established, followed by medical history, physical examination, and targeted testing. Core assessments often include semen analysis, evaluation of ovulation, and imaging such as transvaginal ultrasound. Depending on findings, tests for tubal patency and hormonal or age-related factors may be added. A fertility specialist helps identify the most likely causes and appropriate next steps.

Management is individualized and depends on the underlying causes, age, duration of subfertility, and patient preferences. Options range from lifestyle modification and timed intercourse to pharmacological ovulation induction, intrauterine insemination, and advanced assisted reproductive technologies such as in vitro fertilization. Early specialist referral is commonly advised for persistent subfertility.