Infertility: When the Stork Isn’t Delivering
For many people, the idea of fertility starts out as an exciting chapter. You imagine it as hopeful, intimate, maybe even fun. But when things don’t work out the way you hoped, that excitement can quickly turn into disappointment - or even despair.
What began as optimism can start to feel like a referendum on your body, your relationship, and your future. Add in well-meaning questions from family members, friends’ pregnancy announcements, and a medical system that often places most of the burden on one partner, and it can quickly become a deeply isolating experience.
If you’re here, we’re here for you. This is not something you’re overreacting to - it’s something that is genuinely hard emotionally, physically, and socially. Let’s talk about what infertility actually means, when it makes sense to start testing, and how the workup works, step by step.
The Emotional Weight of Infertility
Infertility isn’t just a medical diagnosis. It’s a sustained emotional stressor.
There’s pressure from timelines you didn’t choose, expectations you didn’t create, and a culture that still treats pregnancy as something that should “just happen.” Month after month, hope builds and crashes. Planning your life starts to feel impossible. Even joy for others can feel complicated - and that doesn’t make you a bad person.
And while infertility affects couples, the emotional and logistical labor often falls on one partner: tracking cycles, scheduling appointments, undergoing testing, absorbing information, and carrying the mental load of “what’s next.”
Naming that weight matters.
What Counts as Infertility?
Medically, infertility is defined as:
· Trying for 12 months with regular, unprotected intercourse if under 35
· Trying for 6 months if 35 or older
However — and this is important — you don’t always need to wait that long.
You may be advised to start testing sooner if you have:
· Age ≥35
· Irregular or absent periods
· Known ovulation disorders (like PCOS)
· Endometriosis or pelvic surgery history
· Known uterine or tubal conditions
· A history of cancer treatment
· Known male-factor concerns
If something already suggests conception may be harder, waiting a full year isn’t helpful — or necessary.
A Quick Word on Timed Intercourse
Timed intercourse matters — but only if ovulation is actually happening.
This often includes:
· Ovulation predictor kits
· Cycle tracking
· Intercourse during the fertile window
If you’re using OPKs and timing correctly without success, that’s useful information — not failure.
Check out our Ovulation Tracking article so you’re not guessing!
How Common Is Infertility, Really?
Infertility is far more common than people realize.
About 1 in 6 couples experience infertility at some point. Roughly speaking:
· ~30–40% of cases are primarily related to female-factor issues
· ~30–40% are primarily male-factor
· The rest are combined or unexplained
What’s unfair is that the female partner often carries a lot of the blame or expectation — even though the data clearly show this is not “usually the woman” or “usually the man.”
In other words: it’s usually complicated.
And regardless, this shouldn’t be a blame game. It should be a “figure out what’s going on so we can start helping” game.
What Has to Go Right for Pregnancy to Happen
Pregnancy isn’t one event. It’s a chain of events, and every link matters.
For conception to occur:
· An ovary must release a healthy egg
· The egg must enter an open fallopian tube
· Sperm must be present, mobile, and able to reach the egg
· Fertilization must occur
· The embryo must travel to the uterus
· The uterine lining must be receptive
· Implantation must happen and be sustained
Infertility testing is about figuring out where that chain might be breaking.
The Infertility Workup: What Gets Tested and Why
Ovulation & Ovarian Reserve
We assess:
· Whether ovulation is happening
· How the ovaries are functioning overall
Common tests include:
· Cycle history (regular vs irregular periods)
· Hormone bloodwork (often day 2–4 of the cycle)
· Progesterone in the second half of the cycle to confirm ovulation
· AMH (Anti-Müllerian Hormone) – estimates ovarian reserve
· Antral follicle count on ultrasound
This does not predict whether you’ll get pregnant naturally — it helps guide expectations and treatment planning.
The Uterus
The uterus needs to be structurally normal and able to support implantation.
Evaluation may include:
· Pelvic ultrasound (uterine shape, fibroids, lining thickness)
· Saline infusion sonogram (SIS) to look for polyps or cavity issues
· Hysteroscopy if something abnormal is suspected
· Endometrial biopsy in select situations
The Fallopian Tubes
Tubes must be open for sperm and egg to meet.
Testing options include:
· HSG (hysterosalpingogram)
· HyCoSy / HICoSy (contrast ultrasound)
· Chromopertubation (done during laparoscopy in specific cases)
Blocked tubes don’t always cause symptoms — this is why testing matters.
Sperm
For whatever reason — cough fragile masculinity cough — getting a man to do a semen analysis can sometimes be harder than it should be.
But here’s the reality: a semen analysis is one of the easiest, least invasive, and completely pain-free tests in the entire infertility workup. Meanwhile, many tests performed on the other partner are uncomfortable, invasive, or both.
Testing sperm early is not just practical — it’s fair. If there’s an issue, it’s far better to know sooner than later.
Why the Workup Feels So Unfair
Many people notice quickly: one partner undergoes far more testing.
This isn’t because medicine assumes infertility is “their fault.” It’s because reproduction in bodies with ovaries, tubes, and a uterus is biologically more complex — there are simply more steps where things can go wrong.
That said, male-factor testing should happen early, not as an afterthought.
What Comes After Testing
Treatment options depend entirely on what the workup shows.
They range from:
· Ovulation induction medications
· Timed intercourse with monitoring
· Intrauterine insemination (IUI)
· In vitro fertilization (IVF)
Fertility treatment is complex, layered, and highly individualized — and it deserves its own dedicated article. This is just the map.
A Final Word
Infertility is not a moral failure, a punishment, or something you caused by waiting too long or doing something wrong.
It’s a medical condition - often multifactorial - happening in bodies that are far more complicated than we’re taught.
You’re allowed to grieve the ease you expected. You’re allowed to feel angry, numb, hopeful, and exhausted - sometimes all at once. And you’re allowed to ask questions before you’re ready to decide what comes next.
We are here to help you understand what’s happening - and remind you that you’re not alone in it.
Tell us how you really feel
Share the knowledge with your friends!
The post contains affiliate links (because we gotta pay the light bill). As an Amazon Associate, we earn from qualifying purchases at no extra cost to you - but don’t worry: we only recommend products we truly believe in. 