Infertility can occur in both females and males, and is defined as the inability to conceive after 12-months of regular intercourse without contraception for women 35 years of age and younger and for women 35 years or older after six months of attempted conception. Infertility affects approximately 15% of couples and a common condition, however proper diagnosis and treatment is necessary in both male and female to increase the likeliness of conception.

Female Infertility Symptoms

Changes in the menstrual cycle and ovulation may be an indication directly related to infertility. They include:

  • Abnormal periods. Heavy bleeding or lighter than usual.
  • Irregular periods
  • No periods. Never had a period, or periods stop suddenly.
  • Painful periods. Back and pelvic pain and cramping may occur.
  • Endometriosis/Fibroids/Cysts
  • Hormone Imbalance
  • Complexion changes, acne
  • Pain during intercourse
  • Changes in sex drive and desire
  • Loss or thinning of hair
  • Weight gain
  • Premature menopause

Other symptoms include:

  • Milky white discharge from nipples
  • Any history of sexually transmitted diseases (STDs)
  • Any genetic disorder or chronic illness, in you or your family, such as diabetes, thyroid or adrenal disorders
  • Any history of radiation and chemotherapy treatment

Evaluation and Diagnosis

A series of tests are conducted to check if the woman is ovulating and to look for any abnormalities in her uterus or fallopian tubes. Hormone levels, including FSH, LH, prolactin, and progesterone, are also checked. A basic workup is usually done within 1-2 menstrual cycles.

Treatment is based on the findings from a diagnostic workup, which may include various blood tests and imaging to determine the identifiable cause(s) of infertility. Reversible causes will also be identified if possible. Counseling on lifestyle modifications, such as quitting smoking, reducing caffeine and alcohol consumption, and appropriate timing and frequency of intercourse are suggested.

Male Infertility Symptoms

Infertility symptoms in men may be vague and unnoticed until a man attempts to reproduce. Symptoms depend on the cause of infertility. They include:

  • Changes in hair growth
  • Changes in sexual desire
  • Pain, lump, or swelling in the testicles
  • Problems of erections and ejaculation
  • Small, firm testicles

Evaluation and Diagnosis

Men: Blood, urine, and imaging tests may be performed as well as a sperm count analysis to determine the overall health of the sperm. A reproductive endocrinologist specializes in infertility and can investigate these infertility symptoms along with a complete medical history.


There are multiple causes of infertility. About 35% of cases are due to problems with the male reproductive system, and 35% are due to anatomic abnormalities or damage involving the female reproductive organs, such as endometriosis. Abnormalities associated with ovulation account for approximately 15% of cases, and another 10-15% of infertility is unknown. Other possible causes are autoimmune disorders, genetic abnormalities, and  asymptomatic genital infections.

To learn more about infertility, or to find out if you are a candidate for treatment, contact a representative at Nezhat Medical Center in Atlanta and request an in-office consultation with Dr. Ceana Nezhat.