When you’ve been trying to have a baby and it hasn’t happened, what feels hardest isn’t always the “unknown”—it’s the sense that you’re moving forward without a map. Sometimes there are clear symptoms; sometimes there aren’t. In many cases, what’s missing isn’t “trying more,” but understanding what might be getting in the way and putting a name to it so you can make decisions with more calm and direction.
At Ingenes, we often see that before reaching a diagnosis, many women go through a stage full of questions: “Is it my age?”, “Is it my hormones?”, “Is it my tubes?”, “What if nothing is wrong?”. The good news is that, in most cases, there are identifiable causes—and once they’re detected, there are also medical paths that can help you move closer to your baby.
In this article, we’ll walk you through the most common conditions linked to infertility (in women and also on the male side), explained in a clear, approachable way—so you understand what they are, how they often show up, and why they can affect the path to getting pregnant.
First, what does “infertility” mean?
In general terms, the word “infertility” is used when pregnancy doesn’t happen after a period of consistently trying. What matters most isn’t the label—it’s what comes next: getting evaluated in an organized, intentional way.
It’s not always just one reason
Sometimes there’s one main cause (for example, a tubal factor). Other times, two or three factors overlap (hormonal + endometriosis + male factor). That’s why when we talk about “most common conditions,” we’re also talking about something essential: each case is best understood when it’s evaluated as a whole.
“Mild” symptoms can still be signs
Many people assume that if a woman’s cycle is regular, “everything is fine.” But there are conditions that can be present even with regular cycles. And on the flip side, irregular cycles can often be addressed with the right support and lead to good outcomes. That’s why it helps to understand these conditions—and, most importantly, to evaluate them with a specialized team.
Endometriosis
Endometriosis is one of the most common conditions linked to difficulty getting pregnant. It happens when tissue similar to the uterine lining grows outside the uterus, which can lead to inflammation, pain, and changes in the pelvic environment.
Common signs
- Severe menstrual pain (especially if it has gotten worse over time).
- Pelvic pain outside of your period.
- Pain during sex.
- Cyclical bowel or urinary discomfort.
- And in some cases: little or no symptoms, but persistent difficulty getting pregnant.
Why can it affect the path to having a baby?
It’s not just “about pain.” Endometriosis can affect fertility in several ways: inflammation, adhesions that involve the tubes/ovaries, changes in egg quality, or changes in how receptive the uterus is. That’s why when it’s suspected or confirmed, the plan is adjusted—it’s not about “hoping it works,” but choosing the right path.
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is very common and is often linked to irregular cycles and infrequent ovulation.
Common signs
- Long or irregular cycles (infrequent ovulation).
- Persistent acne or increased hair growth in specific areas.
- Difficulty managing weight (for some people).
- Insulin resistance (not always, but it’s common).
- An ultrasound showing polycystic-looking ovaries (this alone doesn’t confirm the diagnosis, but it can be part of the overall picture).
Why can it make it harder to get pregnant?
Because if ovulation doesn’t happen regularly, there are fewer opportunities to conceive. The difference is that with a clear diagnosis, there are ways to support the cycle, trigger ovulation when appropriate, and build a plan that increases your chances.
Low ovarian reserve and premature ovarian insufficiency
Ovarian reserve refers to the number of eggs available in the ovaries and, indirectly, how the ovaries tend to respond to stimulation.
What does it feel like (and what doesn’t it)?
Many women are surprised to learn that ovarian reserve can be reduced even when they:
- Have regular cycles.
- Don’t feel anything “off.”
- Don’t have obvious symptoms.
When premature ovarian insufficiency is present, changes like more irregular cycles or symptoms related to lower ovarian function may show up—but they don’t always appear clearly at first.
Why is it important to detect it early?
Because timing and strategy matter. When low ovarian reserve is identified, the approach typically becomes more targeted: defining priorities, timing, and options with a personalized plan to move closer to your baby.
Tubal factor
The fallopian tubes are the natural “bridge” where fertilization typically happens. If there’s a blockage, damage, or altered function, it can be very difficult to get pregnant naturally.
Common causes
- Prior pelvic infections (sometimes undiagnosed at the time).
- Abdominal or pelvic surgeries.
- Endometriosis.
- A previous ectopic pregnancy.
Why tubal factor matters
When the tubes aren’t open or functioning well, continuing to try without checking this piece can be exhausting. Detecting it helps adjust the strategy and choose a path that actually makes sense.
Fibroids, polyps, and uterine changes
The uterus is where the embryo implants and pregnancy develops. Some conditions can interfere—especially if they affect the uterine cavity.
Common conditions
- Fibroids: not all fibroids affect fertility; it depends on size, location, and whether they distort the cavity.
- Endometrial polyps: in some cases, they can make implantation harder.
- Adenomyosis: may be associated with painful periods and changes in the uterine lining.
Signs that may suggest evaluation
- Very heavy periods.
- Strong menstrual pain.
- Bleeding between periods.
- Previous pregnancy losses or ongoing difficulty getting pregnant.
The key is not to be alarmed by the name, but to understand whether that finding matters in your case.
Common hormonal imbalances
There are hormonal imbalances that can affect ovulation, implantation, or the body’s overall reproductive environment.
Thyroid
Both hypothyroidism and hyperthyroidism can affect cycle regularity and reproductive health. Sometimes changes are mild, but identifying and treating them can help stabilize the picture.
High prolactin
High prolactin can interfere with ovulation. It may be related to stress, medications, or specific underlying issues. The important thing is to measure it and interpret it correctly.
Insulin resistance and metabolism
In some patients—especially those with PCOS—insulin resistance is present. Addressing this can support ovulation and improve overall conditions for pregnancy.
Male factor
Yes—infertility is not “just a women’s issue.” Male factor is one of the most common contributors (either as the main cause or alongside other factors).
Semen changes
A semen analysis may show changes in:
- Count
- Motility
- Morphology
And with that information, the next step is chosen. The biggest difference is that when it’s checked early, it helps avoid putting the entire process on one person and speeds up clarity.
Varicocele and other factors
Varicocele (enlarged veins in the scrotum) may be linked to changes in semen quality for some men. Lifestyle factors—like heat exposure, smoking, alcohol, certain medications, and health conditions—can also play a role.
Reproductive age
Age is not a “condition,” but it is one of the most important factors, especially for women.
Why does it matter?
Over time, both egg quantity and quality can change. This doesn’t mean “it can’t happen”—it means the plan should be more strategic, with timely evaluation and decisions.
The value of getting evaluated early
Many patients feel relief when they stop guessing and start seeing clear data. Age doesn’t tell the whole story, but it does help define the path.
Infections, inflammation, and medical conditions
Some infections or inflammatory processes can affect the tubes, the uterine lining, or the body’s overall environment.
Previous infections
Some pelvic infections may have been silent or treated late. That’s why if there’s clinical suspicion, it’s investigated with specific tests.
Chronic conditions
Autoimmune, metabolic, or inflammatory conditions can also influence fertility. In these cases, the approach is often more comprehensive: caring for overall health while defining the reproductive plan.
How do you know which of these conditions may be affecting you?
The most honest answer is: you don’t guess—you evaluate. And you do it in a structured way.
Three keys to guiding an evaluation
- A complete medical history
- Well-interpreted baseline testing
- A personalized plan
Frequently asked questions
Is it possible to get pregnant even with a diagnosis?
Yes. Many diagnoses have management options and clear medical pathways. A diagnosis isn’t the end—it’s the beginning of a plan with direction.
What if I don’t have symptoms?
That’s also common. Some conditions aren’t “felt” and are only discovered during an evaluation. That’s why if you’ve been trying for a while without success, it’s worth being evaluated with a specialized team.
Can there be more than one cause at the same time?
Yes, and it happens often. That’s why a comprehensive approach is so important: it prevents you from treating “one piece” while leaving another unchecked.
Conclusion
If you’ve been trying to have a baby, understanding the most common causes of infertility can be the first step toward clarity and renewed hope. Endometriosis, PCOS, low ovarian reserve, tubal factor, uterine conditions, hormonal imbalances, and male factor are all common—and the most important thing is this: when they’re correctly identified, a real path can be built to move closer to your baby.
At Ingenes, the focus isn’t to give you generic answers—it’s to support you with a complete evaluation, a specialized team, and a plan designed for your case, with the goal that brought you here today: having your baby.