Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Infertility and Women’s Health

Advancing Reproductive Health Through Knowledge of
Fertility and Treatments for Infertility
What is infertility?
Infertility is clinically defined as an inability to achieve pregnancy after one year of regularly
having unprotected intercourse or after six months if the woman is older than age 35 years.
In 2023, the American Society for Reproductive Medicine expanded this definition to include
anyone who needs medical intervention to achieve a successful pregnancy as an individual or
with a partner. The word is also used to describe an inability to carry a pregnancy to term.

There are several causes of infertility, including health conditions, age, genetics, and other
factors. In many cases, the exact cause remains unexplained. Infertility is equally likely to affect
women and men. In some couples, both partners have factors that reduce their fertility.

How does NICHD support infertility research?

Addressing factors related to infertility is an important part of NICHD’s mission. NICHD
conducts and supports research to identify the causes of infertility in females and males and
to develop treatments that may allow more people to achieve pregnancy and deliver a healthy
baby. Other areas of interest include demographics of infertility and its treatments, efficacy
of treatments, and understanding conditions and disorders that cause, contribute to, or are
associated with infertility. Fertility serves as an important indicator of overall health, and
infertility can be a sign of current or future health issues.

Success Snapshots
Mapping Gene Expression in the Ovaries Enhancing Fertility in Hyperprolactinemia
Ovulation, when an egg leaves the ovary and People with hyperprolactinemia have
travels into the fallopian tube, is essential for high levels of the hormone prolactin in
a healthy pregnancy. Many women experience their blood because of overgrowth or
infertility because their ovaries do not overstimulation of the pituitary gland,
routinely produce or release healthy, mature which produces the hormone. Females
eggs. To better understand factors that drive with hyperprolactinemia may experience
ovulation and egg quality, researchers mapped infertility because the prolactin suppresses
gene expression changes in different ovarian the hormone cascade that regulates
cell types during the ovulatory cycle in a mouse ovulation. NICHD-funded researchers
model. The resulting, detailed data resource found that administering another hormone,
enhances knowledge of ovarian function and called kisspeptin, restarts the cascade and
holds promise for treatments to improve allows ovulation to occur, thereby improving
ovulation and fertility in humans. the chances of conception.
Selected NICHD-Funded Infertility Projects
Knowledge Advances
Elucidating the Role of Lifestyle on Fertility
Environment, lifestyle, and other factors can
affect a couple’s fertility. A large NICHD study
found that working in a physically demanding job
or taking two or more medications was linked to
lower sperm counts. Other research is examining
how a female partner’s diet, exercise, and other
lifestyle factors affect pregnancy outcomes
among couples undergoing fertility treatments.
Mapping the Genetics of Pregnancy Loss
An estimated 5% of U.S. couples experience
recurrent pregnancy loss. In about one-half of
cases, the cause remains unexplained. NICHD- Factors & Treatments (Continued)
funded research seeks to better understand risk
Tailoring Treatments for Infertility
factors by delving into the underlying genetics.
Personalized infertility treatments may improve
Investigators created a searchable database of
success and reduce unnecessary treatments.
genetic variants that may be linked to recurrent
Sperm extraction surgery is the primary option
pregnancy loss, helping further knowledge about
for helping men with no detectable sperm in their
the condition and inform strategies to prevent it.
semen to conceive, but it is often unsuccessful.
Identifying the Genetics of Sperm Production NICHD-funded research is exploring noninvasive
Expanding knowledge about sperm production ways to identify those most likely to benefit from
and quality may help improve fertility treatments. the surgery. Other NICHD-funded work seeks to
An NICHD-funded analysis of more than 2,000 measure a sperm’s ability to fuse with an egg,
men with very low sperm counts revealed the information that could improve diagnoses and
involvement of multiple X-chromosome genes in treatment success.
sperm production, including 21 genetic variants
Preserving Future Fertility
strongly linked to very low sperm levels.
Researchers are exploring ways to preserve
fertility among children and adolescents likely
Factors & Treatments
to experience infertility because of cancer
Viewing Fertility as a Sign of Overall Health treatments, genetic disorders, or other factors.
Fertility can be an indicator of overall health, Current options involve freezing ovarian tissue,
even for those not trying to conceive. One study in girls too young for egg-freezing procedures,
found that women with infertility were at greater and freezing testicular tissue in boys who may
risk for coronary heart disease than those not later be unable to make sperm. Researchers
affected by infertility. Other research showed also are developing methods to produce sperm
that men with very low sperm counts were at outside of the body using pre-pubertal testicular
higher risk for certain cancers. Awareness of tissue samples.
these risks may enable more timely care.
Treating Ectopic Pregnancy Learn More About NICHD
Non-surgical treatments for ectopic pregnancy,
a life-threatening condition in which a pregnancy
Infertility Projects
implants outside the uterus, are not always
effective. In mice, a nanoparticle delivery system NICHD Infertility Website:
brought medication directly to the ectopic https://go.nih.gov/x0U0fsl
pregnancy site, stopping pregnancy development
and allowing the animals to later conceive and
give birth to healthy offspring. Similar technology
could help treat ectopic pregnancy in humans.