TL;DR: The causes of infertility are often complex, and they’re not anyone’s fault.
Trouble getting pregnant can be linked to ovulation problems, fallopian tube blockages, endometriosis, uterine conditions, poor sperm quality, diminished ovarian reserve, low sperm count, or a combination of concerns.
Sometimes, testing doesn’t find a clear cause, but treatment options may still help. If you’ve been trying to conceive for 12 months, or six months if you’re over 35, speak with your doctor about getting a referral to a fertility clinic like King Square Fertility in Markham.
You’ll receive thoughtful testing, clear explanations, and culturally sensitive care to help you understand what may be affecting your fertility and what steps may come next.
You’ve been trying for months, maybe longer. As each cycle passes without the result you hoped for, more questions and worries can start to build.
Is it me? Is it something we’re doing? Why can’t I get pregnant?
Often, infertility doesn’t come with clear signs. For many people, the first sign is that pregnancy hasn’t happened yet. As a result, it can be easy to start blaming your body, your choices, or your partner when you don’t have answers.
However, infertility is a medical concern, and you deserve thoughtful answers.
At King Square Fertility in Markham, we help patients understand the possible causes of infertility with care, clarity, and support. This article will help you prepare for a more informed conversation with your doctor and ask about getting a referral when you’re ready.
Before looking at the possible causes of infertility, it helps to understand how many steps are involved in getting pregnant. Conception is a series of events that must all occur at the right time.
An egg needs to mature and be released. Sperm needs to reach and fertilize that egg. Then, the fertilized egg must travel through the fallopian tube, reach the uterus, attach to the uterine lining, and begin developing. If any part of this process is affected, even in a small way, pregnancy may not happen as expected.
That’s why finding the causes of infertility often takes more than one test or one appointment. It’s also why blame isn’t helpful. Fertility involves both partners, and when pregnancy doesn’t happen, the reason may involve one partner, both partners, or no clear cause at all.
About one in six Canadian couples experience infertility. So if you’re going through this, what you’re facing is more common than many people realize. And with the right testing and support, you can start getting clearer answers.
Female factors are one possible part of infertility, but they’re not the whole picture. Male factors, both partners, or no clear cause may also be involved.
Here are some common female infertility causes that may affect how easily pregnancy happens:
Ovulation is when a mature egg is released from the ovary. If ovulation doesn’t happen regularly or doesn’t happen at all, it can be harder to get pregnant.
Polycystic ovary syndrome, or PCOS, is one of the most common causes of irregular ovulation. It can affect hormone levels and may lead to infrequent or missed periods.
Thyroid concerns, whether overactive or underactive, can also affect ovulation. In some cases, conditions involving the pituitary gland may play a role because this gland helps control reproductive hormones.
The fallopian tubes are where the egg and sperm usually meet. If one or both tubes are blocked or damaged, fertilization may be more difficult.
This can happen after pelvic inflammatory disease, which is often linked to sexually transmitted infections.
Previous abdominal or pelvic surgeries, including surgery for an ectopic pregnancy, can also cause scar tissue that affects the tubes.
Endometriosis happens when tissue similar to the uterine lining grows outside the uterus. It can affect the ovaries, fallopian tubes, and pelvic area.
For some women, endometriosis causes painful periods, pelvic pain, or discomfort during sex. For others, there may be few or no symptoms.
The inflammation and scarring associated with endometriosis can sometimes make it harder for fertilization or implantation to occur.
Sometimes, the uterus or cervix can affect fertility. Fibroids, which are noncancerous growths, or polyps, can affect the uterine lining and make implantation more difficult.
Some women are also born with a uterus that has a different shape, which may affect pregnancy in certain cases.
The cervix can also be a factor. For example, cervical stenosis, or narrowing of the cervix, may make it harder for sperm to pass through.
Ovarian reserve refers to the number and quality of eggs remaining in the ovaries. It naturally declines with age, but for some women it may do so earlier than expected.
Several male fertility factors can affect how sperm is produced, transported, or able to fertilize an egg. Here are a few common ones your care team may look for:
A low sperm count means there are fewer sperm available to reach and fertilize an egg.
Poor motility means the sperm may not move well enough, while changes in sperm shape may affect how easily sperm can fertilize an egg.
These concerns can be linked to hormonal changes, genetics, infections, medical conditions, or lifestyle factors.
A varicocele is an enlarged vein in the scrotum. It’s a common and sometimes treatable cause of male infertility.
A varicocele can raise the temperature around the testicles, potentially affecting sperm production and quality. If a varicocele is suspected, your doctor may recommend further evaluation.
Sometimes, sperm production may be normal, but sperm can’t move through the reproductive tract properly. This can happen if there’s a blockage in the tubes that carry sperm.
Blockages may be associated with infections, prior surgeries, injuries, or congenital conditions.
Hormones help control sperm production. If there’s an imbalance involving the pituitary gland, hypothalamus, or testicles, sperm production may be affected.
Genetic conditions can also play a role in male infertility. In some cases, further testing may help explain low sperm count or other semen analysis results.
If you’ve been trying to conceive for 12 months, or six months if you’re over 35, it may be time to speak with your family doctor about a referral to a fertility specialist.
Fertility testing usually starts with simple steps. Female fertility testing may include blood tests to check hormone levels, such as anti-mullerian hormone (AMH), along with imaging tests such as a sonohysterogram (SHG) to evaluate the uterus and fallopian tubes.
Male fertility testing often begins with a semen analysis to check sperm count, movement, and shape.
At King Square Fertility, testing is handled with care and clarity. Our team explains what each test measures, why it matters, and what your results may mean for your next steps.
Our genetic screening services are also designed to help individuals and couples better understand their reproductive health and potential risks, before and during fertility treatment.
Contact us to find out more about fertility testing and the next steps that may be right for you.
Regular periods are a good sign, but they don’t tell the whole story. You may still be ovulating irregularly, or other factors may be involved, such as fallopian tube blockages, uterine concerns, egg quality, or male fertility factors.
The only way to know is through testing. Fertility involves both partners, so evaluating both sides early can save time and help your care team understand the full picture.
Sometimes, yes. Healthy habits can support fertility for both men and women. However, lifestyle changes may not fix an underlying medical issue, which is why a fertility assessment can be helpful.
This is called unexplained infertility. It can feel frustrating, but it doesn’t mean there are no options. Many people with unexplained infertility still move forward with treatments like In Vitro Fertilization (IVF).
Living with fertility uncertainty can be exhausting, especially when every month brings more questions. Seeking support is a way to understand your body, your options, and what may come next.
At King Square Fertility in Markham, we provide culturally sensitive, patient-centred care for individuals and couples from all backgrounds. Our team is here to offer testing, guidance, and support that respects your experience.
Speak with your doctor about a referral, then contact King Square Fertility to learn more about your next steps.
