What is infertility and when should you consult a doctor?Infertility is “the inability to conceive after 12 months of regular unprotected intercourse.” This means that a couple is not able to become pregnant after a year of regular trying. However, for women aged 35 and older, inability to conceive after 6 months is generally considered infertility.The chance of getting pregnant in a month of trying is about 25-30%. 85% of couples should get pregnant in one year of trying. So if you are less than 35 years and it been a year since you are trying, you should consult a doctor. If you are over 35 years, you must consult sooner, after 6 months of trying.A couple might also seek a fertility consultation sooner if there is a risk for infertility such as irregular menstrual cycles or potential risk for fallopian tube damage. For men who have any prior health problems that can increase the chance of infertility, such as childhood problems with the testicles or prior cancer treatment, the couple can seek evaluation sooner.How common is infertility?You are not alone. Infertility affects one in 10 couples (10%-15% of couples). Infertility is more common than you think; over 30 million Indian couples are affected with infertility.This makes it one of the most common diseases for people between the ages of 20 and 45.What causes infertility?Irregular periods :Menstrual cycles < 21 days or > 35 years may indicate that you are not ovulating. If a woman doesn’t ovulate (release an egg) about once a month, she may have trouble getting pregnant. Problems like polycystic ovary syndrome (PCOS), thyroid disease, and other hormonal disorders can affect ovulation and lead to infertility. Women who are overweight or underweight are more likely to have problems with ovulation than women of normal body weight. In this case, you may consult with your fertility doctor in the first year of trying itself.Painful MenstruationMost women experience pain along with their period, but debilitating pain may be a symptom of something else entirely. Seek an appointment with a gynaecologist on Cloudnine to rule out the possibility of endometriosis.Painful intercourse may also be an indicator of endometriosis.Damaged or Blocked Fallopian Tubes:Fallopian tubes are the tubes attached to the uterus. They open towards the ovaries and pick up the released egg during ovulation. This is where the sperm and egg usually meet (fertilisation). Blocked or damaged tubes can cause infertility or ectopic pregnancy (pregnancy outside the uterus). This is usually asymptomatic and is diagnosed mostly during infertility workup. The chances of having blocked tubes are higher in women who have or have had endometriosis, surgery in the pelvis, or sexually transmitted infections (like gonorrhea or chlamydia).Male factorA third of all cases of infertility are because of a problem in the male partner. In the male partner, infertility can be caused by not being able to make or ejaculate (release) sperm. Sperm quality is also important and is measured by the amount, the movement, and the shape of sperm. Sometimes other medical problems can affect a man’s ability to make normal amounts or normal quality sperm. Men with diabetes, for instance, might have trouble ejaculating. Overweight men, those who smoke, or men who use recreational drugs such as marijuana are more likely to have problems with their sperm. A semen analysis is one of the first tests advised for couples with infertility.Other causes : Problems in the uterus such as growths in the uterus (polyps, fibroids), abnormal shape of the uterus can sometimes cause infertility. Pelvic disturbances such as adhesions (because of pelvic surgery in the past, pelvic infections, endometriosis) can cause infertility too. In one third of the cases, all reports are normal. This category is referred to as unexplained infertility.Is infertility mainly due to the woman?No. In One third of cases, the cause is in the woman; one third is because of problems in the male partner and in the other one third, problems can be in both.What is the impact of age on fertility?A woman’s age can have a big effect on her ability to have a baby, especially as she enters her 30s and 40s. For a healthy woman in her 20s or early 30s, the chances of conceiving each month is 25%-30%. But by the time a woman is 40 years old, the chances are 10% or less. So the older the woman, the lesser the chances of conceiving naturally or with treatment.Coming to terms with infertility can be draining, emotionally, physically and financially. But the sooner you embrace reality, the sooner you can seek an infertility treatment plan that paves way for a bright and beautiful future for you and your partner. If you do recognise any of the signs mentioned above, there’s no reason to fret. On Cloudnine, there’s always a way out.