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A Guide to Fertility

What are the signs and symptoms of infertility?

The most obvious sign of infertility is when the woman does not get pregnant, despite having regular unprotected sex for 12 months or more (or after six cycles of insemination for same-sex couples).

Once a woman has a regular (monthly) menstrual cycle, any change in
her menstrual cycle could indicate a problem. If her menstrual cycle becomes less regular, infrequent or absent then there could be a problem with ovulation. Heavier or more painful periods could be a sign of fibroids  in the womb or a condition called endometriosis. Pelvic pain could be a sign of infection or endometriosis.

There are few signs for male infertility. A man usually has to have medical tests to find out if he has a fertility problem. A man’s ability to have sex and ejaculate can be normal even if he has fertility problems. Men who have had mumps during puberty and men who have
an undescended testis (testicle) could be at risk of fertility problems. An undescended testis means that the testis is not located in the scrotum.

Some signs that could suggest a fertility problem

Bunting, L. & Boivin, J. (2010). Development and preliminary validation of the Fertility Status Awareness Tool: FertiSTAT. Human Reproduction, 25, 7, 1722–1733.

If you have noticed any of the signs or symptoms mentioned in graphic 5 or are concerned about your fertility, then talk to your doctor. The NHS ‘Fertility Self Assessment tool’ could also help you to decide if and when to seek help from your doctor. Fertility declines with age. Women aged 35 or older should seek help after 6 months of trying to get pregnant because if they need treatment then it is best not to delay.

More Information


This guide gives you information about fertility and infertility. To help understand this information we’ve included an explanation of the main medical terms used.

  • eggs and sperm

    Cells that are produced by the ovary (eggs, oocytes, ova) and testicles (sperm) and that combine after sex to produce a pregnancy. Women produce eggs and men produce sperm. A healthy sperm is motile, which means it has the ability to move. This movement is what makes it possible for sperm to reach the egg.

  • ejaculation

    Semen is the fluid produced by the male sexual organs to protect and carry sperm. The process of discharging this fluid from the penis is called ejaculation.

  • insemination

    Treatment that involves directly inserting sperm into a woman’s womb.

  • menopause

    The menopause is the time when menstrual periods stop permanently, and women are no longer able to have children. For most women this happens at about 51 years. The age a woman will reach menopause generally be similar to the age at which her mother reached menopause.

  • menstrual cycle

    The monthly changes that occur in the female reproductive system (specifically the uterus and ovaries) which make pregnancy possible. The length of the menstrual cycle is calculated as the time from the first day of a woman’s period (bleeding) to the day before her next period or bleeding. The average time between two periods for women is about 28 days but in teenagers it could be longer (up to 45 days) and sometimes 2 to 3 months, becoming shorter as the teenager gets older. There are events that occur during the menstrual cycle which are repeated each month. These are: development of the egg (phase 1), release of the egg from one of the ovaries (phase 2), preparation of the uterus for a pregnancy (phase 3), and menstruation or bleeding (phase 4). The next period then happens if there is no pregnancy. Young women should have regular periods within 3 years of the rst period occurring. Women could have some spotting in early pregnancy.

  • ovaries

    The two oval-shaped organs located in the lower abdomen (right and left side) that produce the female eggs.

  • ovulation

    Is the release of the oocyte (mature egg, sometimes called ovum) from the ovaries, ready for fertilization. Ovulation occurs about two weeks before the next period is due, for example around day 14 of a 28-day cycle or day 21 of a 35-day cycle. The actual day of release could differ between cycles and between women, and is a affected by many factors (e.g. lifestyle).

  • testicles also called testes or balls

    Oval-shaped organs that sit in a sac that hangs behind the penis. A main job of the testicles is to make and store sperm.

‘A Guide to Fertility’ was developed and evaluated by Prof J Boivin, Cardiff University.