Not getting pregnant, despite having carefully timed, unprotected sex for one year. The cause of infertility may be difficult to determine but may include inadequate levels of certain hormones in both men and women, and trouble with ovulation in women.

The main symptom is an inability to get pregnant. In many cases, there are no additional symptoms. Many treatments significantly improve the chances of getting pregnant. They include hormone treatments, fertility drugs and surgery. In addition, assisted reproduction uses various medical techniques to fertilise an egg.

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, a woman with infertility may have irregular or absent menstrual periods. In some cases, a man with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function.

Most couples will eventually conceive, with or without treatment.

You probably don’t need to see a doctor about infertility unless you have been trying regularly to get pregnant for at least one year. Women should talk with a doctor earlier, however, if they:

• Are age 35 or older and have been trying to conceive for six months or longer
• Are over age 40
• Have irregular or absent periods
• Have very painful periods
• Have known fertility problems
• Have been diagnosed with endometriosis or pelvic inflammatory disease
• Have had multiple miscarriages
• Have undergone treatment for cancer

Men should talk to a doctor if they have:

• A low sperm count or other problems with sperm
• A history of testicular, prostate or sexual problems
• Undergone treatment for cancer
• Small testicles or swelling in the scrotum
• Others in your family with infertility problems