Everything you need to know about subfertility: causes, diagnosis, treatment

Everything you need to know about subfertility
Everything you need to know about subfertility

Everything you need to know about subfertility: causes, diagnosis, treatment

Subfertility and infertility, two different terms, although they both contain the major word “fertility”. These terms are often confused to mean the same thing, but actually, they are very different.

While infertility is the inability to conceive or stay pregnant after at least one year of trial, subfertility is a delay in getting pregnant. In regards to subfertility, the couples could still conceive naturally, chances are it takes a while then normal. But in infertility, some medical processes and methods are needed for conception. Without these methods, the chances of getting pregnant are low.

As couples intending to start a family and trying to conceive, the whole concept of subfertility, infertility as well as their differences must be understood.

Subfertility is an extended time span of pregnancy trial. Yes, with proper and regular intercourse, a woman’s ability to conceive can be delayed even though intercourse occurs when she is most fertile- that is subfertility. While infertility is diagnosed after a year, subfertility could take a year or longer.

Couples described as subfertile have high hopes of conceiving, the only problem is it just takes a longer time than average to get pregnant. Subfertile couples need enough time and when it’s about time, they’ll conceive on their own.

Causes of subfertility

Both subfertility and infertility have similar causes. If you are well versed in the causes of infertility, then automatically, you also know the causes of subfertility.

Usually, most persons like to think of women as the only gender affected by fertility issues. As a matter of fact, conception issues or problems could be as a result of either male or female problems or a combination of both. And in some cases, the cause isn’t known.

Causes of subfertility in women include:

  1. Ovulation is a problem

For pregnancy to occur, some biological processes are involved. One of the biological processes involved in pregnancy is ovulation. A problem with ovulation is a common cause of subfertility in women.

During ovulation, an egg is released for fertilization, this fertilization is responsible for the formation of a zygote which further develops into an embryo(baby).

Different health conditions could negatively affect ovulation. They include:

  • Hormonal imbalance

The hypothalamus and pituitary gland can interfere with the vital hormones required for the overall and normal functioning of the ovary. Hormonal imbalances are one of the leading causes of subfertility in the world today.

  • Premature Ovarian Insufficiency (POI) or premature menopause

Ovaries could actually fail and stop working before the normal age (40 years). In women with POI, sub-fertility could occur during their teenage years or later, before they even get to 40 years of age. Failed ovaries could arise due to a treatment such as chemotherapy, or a medical condition.

  • Diminished Ovarian Reserve

Reserves do run out of supply sometimes and become incapable at some point. The ovarian reserve holds the remaining supply of eggs that can produce babies. This reserve provides egg cells necessary for fertilization and successful pregnancy.

The function of this reserve can diminish with age, previous ovarian surgery, or even medical conditions which could further lead to subfertility.

  • Polycystic Ovary Syndrome (PCOS) usually affects hormonal levels and causes subfertility. This constant fluctuation in hormonal levels could cause irregular menstrual periods and ovulation, prevent menstruation and ovulation making it hard for pregnancy to occur
  1. Abnormal Uterine Conditions

The uterus also known as the womb, houses your baby. What happens when there is growth, defect, or abnormality in the uterus? Pregnancy cannot occur.

Most uterine conditions are formed at birth while others develop later on. Some uterine conditions that cause subfertility include the septate uterus, double uterus, fibroids, and bicornuate uterus.

Causes of subfertility in men include:

  1. Sperm production

Generally, for any successful pregnancy to occur, sperm needs to fertilize an egg. Abnormal production or function of sperm can cause subfertility. This abnormality is influenced by different medical conditions such as gonorrhea, chlamydia, cancer, varicocele, genetic defects, HIV, diabetes, and also medical treatments such as cancer treatment.

  1. Sperm delivery

Sperm motility or movement is necessary for fertilization and pregnancy. If there is an issue with the delivery of sperm, conceiving will be difficult. The problem of sperm delivery can be caused by testicle damage or injury, structural defects on the reproductive organs, premature ejaculation, or genetic defects.


What are the risk factors for subfertility?

Various factors could increase your chances of being subfertile. It is best to check which risk factor applies to you and take suitable measures to avoid them. Do note that these risk factors are not gender-based, they are both applicable to men and wo

Everything you need to know about subfertility
Everything you need to know about subfertility


  1. Excessive consumption of alcohol
  2. Obesity or weight loss
  3. Regular smoking of either marijuana or tobacco. In women, smoking could cause diminished ovarian reserve and block the uterus.
  4. Exposure to radiation
  5. Age (For females who are 35 and above, and males who are 40 and above, age is a risk factor)
  6. Stress, whether physical or emotional
  7. Certain medications
  8. Exposure to environmental elements such as toxins, pesticides
  9. Certain medical conditions such as thyroid or adrenal gland disorders, rheumatoid arthritis, etc.

How is subfertility diagnosed?

Usually, issues related to fertility are diagnosed by a fertility specialist and as such, one will help diagnose the reason for the occurrence of subfertility.

The first step the doctor takes is to ask the patients questions regarding their medical or sexual history. This step is very important as some medical conditions or sexually transmitted diseases are root causes of subfertility.

Secondly, a physical examination would be performed on the woman using a pelvic examination, and on the men by examining the genitals for any structural abnormality.

A fertility examination is necessary and involves numerous tests. This form of examination varies among men and women.

For women, the tests may include:

  • Ovarian reserve testing to inspect the quality and quantity of eggs contained within it.
  • Blood tests
  • Transvaginal ultrasound. This test is carried out to check the female’s reproductive organ.

For men, the tests include

  • Genetic testing to check for the presence of a genetic defect
  • Testicular biopsy to check for abnormalities on the testicle
  • Imaging testing
  • Semen analysis to check the health and viability of the sperm. In this analysis, sperm count, sperm shape, and sperm motility are observed.

Can subfertility be treated?

Being subfertile doesn’t mean you are incapable of conceiving naturally. As a matter of fact, you are not infertile. The only problem is conceiving might just take a longer time than average.

So yes, subfertility can be treated and the treatment includes different options. Lifestyle changes and taking positive steps can increase your chances of getting pregnant. These changes and steps should be learned till it becomes a habit.

Also, medical treatments and other options are available as an addition to boost fertility.

How I increase the odds for conception?

Following the tips listed below can increase your chances for conception, naturally. These tips are easy and could become habitual if you are consistent.

  • Maintain healthy and normal body weight. Being overweight or underweight can have a huge effect on fertility.
  • Avoid smoking: this applies to both men and women
  • Use an ovulation predictor kit to help keep track of when you are ovulating and are most fertile. Ovulation is the perfect time during your cycle where you can have sexual intercourse and get pregnant. But most women are not even aware that they are ovulating and it is time to make babies.
  • Limit caffeine intake
  • Avoid alcohol as much as you can
  • Keep track of your basal body temperature as it will help you know when you are most fertile.
  • Some medications are risk factors for subfertility. We advise you to consult your doctor if you are on medication or intend to begin one.

Medical treatments are also effective in treating subfertility. Treatment is dependent on the cause of subfertility and varies among men or women.

For women, medical treatments may include surgery to fix uterine issues, intrauterine insemination (IUI), and fertility drugs are usually taken to promote fertility. These treatments may work alone or have to be combined before conception can occur.

While in men, treatment may include medications to boost sperm count, production, motility, and function. Also, surgery can be carried out to repair testicular damage, blockage, or a varicocele. To collect sperm in males with ejaculation issues, sperm retrieval techniques are required.

Final thoughts

Subfertility is usually confused with infertility. But subfertility means the process of conception is taking so long than normal. This is really depressing and stressful, some lifestyle factors can help boost your chances of conception.

What you have self-diagnosed as infertility might actually be subfertility. Ensure that you visit your doctor to fully grasp the differences between both terms.

Infertility can be treated just like subfertility, however, there is a higher chance of natural conception in subfertility.

Despite the kind of fertility issue, you are faced with, there are different treatment options available. Treatment like in vitro and in vivo fertilization in cases of infertility and medications in subfertility.