Have you been trying to conceive for a while with no success? It's not fun to consider that perhaps infertility is playing a role in this, but facing up to reality may be what you have to do to reach your goal of conceiving a child.

There are two basic categories of infertility: male factor and female factor. Sometimes, it's a combination of the two. Let's start with male factor.

Men need to have a suitable number and motility of sperm to father a child. Generally, doctors want to see a motile count above 10 million. It's uncommon for a man to have no sperm, but some drugs (chemotherapy, for example) can result in lower counts. If a man has a low count, intrauterine insemination or in vitro fertilization with intracytoplasmic injection can work around it.

For female factor, it is more complicated. The fallopian tubes can be affected by sexually transmitted infections, resulting in fluid-filled infections or even scarring. Surgery on the cervix for cervical cancer or warts can create stenosis, making it difficult for sperm to travel into the uterus.

Endometriosis can also result in tubal problems and scarring as well as distortion of the tubes, impairing their ability to pick up an egg once released from the ovary. Tissue from endometriosis can be deposited and grow anywhere in the pelvis, including in the ovaries.

We have discussed in other articles about age-related infertility, so I won't belabor that in this article. That, of course, is an important factor for some women.

Uterine deformities from birth may play a role for some women. Some women have only one fallopian tube (unicornate uterus), some have a septum (a partial "split" in the uterus) or even a two-chambered uterus (bicornuate uterus). Septums have been implicated in early miscarriages or even problems with implantation. Surgery can remove a septum.

Fibroids may or may not affect fertility. A myomectomy to remove fibroids may be the answer for some women, whereas for others, it is unnecessary. It depends on the size and location of the fibroids.

This is not meant to name all the possible causes of infertility, but to introduce you to the most common causes. If you are worried, make an appointment with a reproductive endocrinologist. Maybe there is absolutely nothing wrong with you or your partner, and the relief of finding that out will help you relax and make a baby naturally!