Causes include hormonal imbalances (such as polycystic ovary syndrome or thyroid disorders), structural problems (blocked fallopian tubes, uterine abnormalities, endometriosis), age-related decline in egg quality, male factor such as low sperm count or motility, genetic conditions, and lifestyle or environmental factors like smoking, obesity, alcohol use, radiation, or toxin exposure. Some cases are due to unknown factors. Coexisting health conditions and certain medications can also affect fertility.
Diagnostics typically begin with medical history and physical examination, followed by semen analysis, assessment of ovulation, hormonal testing, and imaging (ultrasound, hysterogram). In some cases genetic testing or diagnostic laparoscopy is indicated. Because infertility and related problems can involve both partners, evaluation often requires a joint approach and may involve referrals to fertility specialists.
Treatment depends on the underlying cause and may include lifestyle changes, medications to induce ovulation (such as clomiphene or letrozole), surgical repair for structural problems, and fertility treatments such as intrauterine insemination (IUI) or assisted reproductive technologies (ART) like in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Donor gametes and surrogacy are options in selected circumstances, and counseling is an important component of care.