The basics
How pregnancy happens, fertile days, age and what infertility means · 17 articles
How a pregnancy beginsEvery month an ovary releases an egg. If sperm meets the egg in the fallopian tube, they join to make an embryo. The embryo travels to the womb (uterus) and attaches to its lining. Many small steps must go right, so it can take several months even for healthy couples.What is infertility?Infertility means not becoming pregnant after 12 months of regular unprotected intercourse (6 months if the woman is 35 or older). It is a medical condition, not anyone's fault. Problems can be in the woman, the man, both, or no cause is found.The fertile window, simply explainedYou can get pregnant only on about 6 days each cycle: the 5 days before ovulation and the day of ovulation. Having intercourse every 2–3 days through the month covers this window without stress.Age and fertilityA woman's fertility slowly falls from her early 30s and more quickly after 35. After 40, chances are much lower. Men's fertility also declines with age, but more slowly.Unexplained infertilityWhen all standard tests are normal but pregnancy has not happened, it is called unexplained infertility. It affects about 1 in 4 couples who are tested. Many still conceive naturally or with simple treatment.Difficulty after a first childSecondary infertility is trouble conceiving after an earlier pregnancy. It is common and real, but often goes unnoticed because people assume it cannot happen.Repeated miscarriagesRecurrent pregnancy loss means two or more pregnancy losses. It is heartbreaking but often treatable, and many women go on to have a successful pregnancy. Both partners should be checked.The Sperm's Journey to the EggSperm take about 72 days to make, and then each one must swim a long way through the woman's body to reach the egg. Millions start the trip, but only a few hundred reach the egg, and just one fertilises it. Knowing this journey helps couples understand that fertility is a team effort.Chances of Pregnancy Each MonthEven when a couple is healthy, the chance of pregnancy in one month is only about 20-25% when the woman is under 30. About 85 out of 100 couples conceive within a year of trying. It often takes time, and that is normal.What is ovulation?Ovulation is when a woman's ovary releases a ripe egg, usually once a month. Hormones called FSH and LH guide this process, and the egg can only be fertilised for about a day after release. Knowing the signs of ovulation helps couples understand their fertile days.Infertility is shared: male and female causesInfertility is never one person's fault. Roughly one-third of the time the cause is found in the woman, one-third in the man, and one-third in both partners or no clear cause is found. That is why both partners should be tested together from the start.When to See a Fertility DoctorMost couples need to try for some time before a pregnancy happens, so waiting a little is normal. See a fertility specialist after 1 year of trying if you are under 35, after 6 months if you are 35 or older, and straight away if there are known problems, irregular periods, male factor concerns or age 40+. Go together, as a team.Early miscarriage: what happened and what nextEarly miscarriage is common, affecting about 1 in 5 known pregnancies, and it is most often caused by a chromosome change in the embryo that nobody could have prevented. Work, stress, exercise or something you ate did not cause it. Testing is usually suggested after two or three losses, and grief is real for both partners.Twins and multiples after treatmentFertility treatment can raise the chance of twins or triplets, mostly because more than one egg or embryo may grow or be placed. Twin pregnancies carry higher risks for both mother and babies, such as early birth. Single embryo transfer and careful monitoring help many couples have one healthy baby at a time.Chemical pregnancy explainedA chemical pregnancy is a very early pregnancy loss. The test turns positive, but the pregnancy stops growing before it can be seen on an ultrasound. It is common, it is usually nobody's fault, and most people go on to have a healthy pregnancy. A fertility specialist can guide you on the next step.The hormones of fertility made simpleHormones are tiny chemical messengers that tell the ovaries and testes when to make eggs and sperm. FSH, LH, oestrogen, progesterone, AMH, prolactin, thyroid hormones and testosterone each have a special job in both women and men. Simple blood tests can check them, and most hormone problems can be treated.Infertility in India: Facts and FiguresAbout 1 in 6 people worldwide face infertility at some point in life, and India is estimated to have 27-30 million affected couples. It is a common medical condition, not anyone's fault. Awareness is growing, but many people still find it hard to reach good care.