What Causes Infertility, And What Are The Alternatives?

Infertility is the inability of a person to conceive or get pregnant, despite having unprotected sex for a year. But what causes infertility?

“You need to relax. This stress might be the reason for your infertility!” It’s not true! Well, then what causes infertility?

“Jija ji banjh hai?” is one of the most hilarious dialogues of the prominent web series ‘Tripling’ (season 1); which to some extent can prompt a few questions about what exactly the different causes of infertility for women, men, and non-binary and certain stigmas associated with it.

Infertility is defined as the inability of a person to conceive or get pregnant, despite having unprotected sex for a year.

Infertility is a phenomenon that is not confined only to women or is solely caused because of the age of a person. But it also affects the people who exist outside the binary.

One in every fifteen couples in India struggles with infertility, which can be socially, mentally, and emotionally taxing for the couple. Many factors cause infertility among cis men and women and trans people; but some of the most common causes include drug addiction, smoking, alcoholism, unhealthy lifestyle, repeated miscarriages, and obesity.

What causes infertility?

Multiple factors contribute to infertility. And there are also several cases, where fertility tests are unable to detect the reason or cause of a person’s infertility, and this is also known as ‘unexplained infertility’.

Major causes of infertility in cis-women

Problems in ovulation

Ovulation is a process, where a mature egg is released from your ovary to the fallopian tube and stays there for fertilization for 12–24 hours, which results in pregnancy.

However, having irregular cycles and difficulty in ovulating is mainly because of Polycystic ovary syndrome, premature ovary failure, and thyroid problems.

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And how can you know if you are ovulating or not?

There are several ways through which you can detect if you are ovulating or not without a doctor, and one way is to note if your menstrual cycle is regular or not. Generally, if a person is getting a period regularly about every 28–30 days, there is a high chance that the person is ovulating.

Another way to know if you are ovulating or not without a Doctor is to use a special thermometer that measures changes in the body temperature. However, it cannot be completely reliable to predict ovulation as there can be many external stimuli and factors that can contribute to changes in the body temperature.

One method to confirm if you are ovulating is a Progesterone blood test, for which a Doctor is required. The blood test looks at the level of progesterone, which indicates whether the ovulation occurred.


Endometriosis is a condition that results in severe pelvic and abdominal pain in women of reproductive age. It is a condition in which a tissue, which is normally found inside the uterus, develops on its lining.

Endometriosis can cause infertility as it leads to the swelling of the abdominal cavity which makes it difficult for the egg to travel to the fallopian tube during ovulation.

Uterine Fibroids

In simple terms, Fibroids are non-cancerous tumours that arise from the walls of the uterus. Whether Fibroids require treatment, depends on their location, size, and number. There are three main types of fibroids, which are classified according to their location. They can be found in the muscular wall of the uterus, the outer wall of the uterus, and protruding into the uterine cavity.

There are many ways through which fibroids can affect the fertility of a person. For instance, if a fibroid presses a fallopian tube, it’s not able to function normally and the egg and sperm cannot get together.

Or a change in the shape of the cervix can affect the number of sperms that enters the uterus, or a change in the shape of the uterus can hinder the movement of sperm.

Causes of infertility in cis-men?

 Low sperm count

As mentioned earlier, one of the major causes of infertility amongst heterosexual men is a low sperm count and low-quality of sperm.

Infertility specialist, Dr Jyoti Bali informed, “We have observed that male infertility factor is the primary reason for the inability to conceive, especially between the age group of 29 to 35. They either have a combination of low sperm concentration or poor sperm motility, or abnormal morphology. However, due to social stigma, male fertility problems are considered secondary and most often go undiagnosed and untreated.”

 Environmental factors affecting the quality of sperm

One major factor that affects the quality of sperm is the environmental factor. Pollution, pesticides, and stress, all contribute to the inability of the body to produce healthy sperm and might also hamper the number of sperm that are produced. Alcohol, smoking, and drugs can contribute to the development of problems in ejaculation.

Genetic disorders are also one of the major causes of male infertility, where one or more genes within our genetic code have a faulty mutation.

Infertility in trans people

Trans people who undergo gender-affirming surgery, which includes hysterectomy and oophorectomy in trans men and orchiectomy in trans women, become permanently sterile.

People generally erroneously assume that trans people do not have the desire to have biological children. However, studies have shown that many trans people want biological children.

What are some alternative options for infertile couples?

With the advancement of medical technology, there are now many techniques and options available that help an infertile couple to have children. The options can be medical as well as nonmedical.

Adoption and surrogacy

The most common options are adoption and surrogacy. Adoption is not a remedy for infertility, but is a separate method of family-building. In surrogacy, an embryo is donated by the intended parents which is then implanted in the surrogate’s uterus, which then delivers the child.

In vitro fertilization

However, there also exist several treatment options to help an infertile couple to conceive. One of the most highly adopted options by an infertile couple is in vitro fertilization (IVF), which is a process of fertilization in which the egg is combined with the sperm in a test tube (vitro).

Apart from medical and nonmedical solutions, it’s also significant for the couple to affirm that they can choose any option according to their situation, and to know that pregnancy is not the only normal way to embrace parenthood.

Infertility, social stigma, and its psychological impact

Many social stigmas around infertility are pervasive in society which further deteriorates and negatively impacts a couple’s psychological well-being.

“Aurat ke ek nahi teen janam hote hai … pehla jab woh kisi ki beti bankar is duniya mein aati hai … doosra jab woh kisi ki patni banti hai … aur teesra jab woh maa banti hai” (A woman is born not once but thrice … first when she comes in this world as a daughter … second when she becomes a wife to someone … and third when she becomes a mother).

This dialogue from the infamous Bollywood movie ‘Chori choru chupke chupke’(2001), highlights the thought process of the society, where being fertile and motherhood is considered the prime virtue of a woman’s life.

In a heterosexual relationship, either the male or female or both are responsible for not being able to conceive; however, every situation in a patriarchal society has a different impact on men and women. And in the case of infertility, it’s mostly the women who are blamed by their partner or family members for not being able to conceive, which further aggravates their mental health.

This blame game within the family leads her to question herself, to feel guilty, depressed and apologetic for something which is completely out of anyone’s control.

“Agar tu ek baccha paida kar paati, toh hume itne Doctors ke paas jaana he nahi padhta na” (if you had the capability to conceive, we wouldn’t have such frequent Doctor visits).

This statement has a very common usage around the country, especially in rural areas, where even if it’s the man who is sterile, he will blame his wife, otherwise, society might raise questions about his ‘masculinity’ or ‘mardangini’

To cope with these feelings, most Doctors and Psychologists, encourage couples to not hesitate in seeking help. The frustration and anxiety a couple goes through might be normal, but if the feelings become overwhelming, it becomes significant for the couple to reach out for help.

Image source: Ketut Subiaynto, via pexels, free and edited on CanvaPro

Check with your doctor first

At Women's Web we try to bring you information on Fitness & Wellness topics of interest to you. This is not, however diagnostic or prescriptive information, so please do consult your doctor or therapist before using any of it.

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About the Author

Ishita Varma

Hello! My name is Ishita Varma and I am in the final year of Political Science honors. I am always up for any feminist discussion and do not believe in only talking about gender equality read more...

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