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The obvious symptom of infertility is that you can't get pregnant when you want to.

Your doctor will be looking for clues why. He or she may ask personal questions that you may find upsetting or embarrassing. Be as open and honest as you can. This will make it easier to find out why.

Below are some of the things that may help explain why you haven't been able to get pregnant.

If you don't have a period roughly every four weeks, it may mean that the hormones that control your menstrual cycle are not working properly. So you may not be ovulating regularly. You'll need hormone tests.

See What happens every month to find out more about hormones and your menstrual cycle.

This may mean there is:

• Something wrong with the lining (endometrium) of your womb
• A benign (non-cancerous) growth in your womb, such as a fibroid or cyst
• Tissue of the same type as the lining of the womb growing in other places. This is called endometriosis.

Sex can be painful for lots of different reasons. Some of them affect your fertility. For example, endometriosis can be painful for women during sex, bowel movements or when passing urine. Endometriosis is often found in women who have trouble getting pregnant.

Trying to get pregnant can be stressful for both of you especially if you're having sex when you don't feel like it. This can lead to you both losing interest in sex. If you're not having sex frequently, it may lower your chances of getting pregnant. Discuss it with your doctor.

You may have a climax during sex but nothing comes out. This is called retrograde ejaculation and it's rare if you haven't had surgery. It means semen is going into your bladder (the sac that holds your urine) instead of your penis. Normally, the neck of the bladder closes during sex to prevent semen from getting into it. But if there is damage to the nerves, the bladder may not close fully, allowing semen to get inside. Nerve damage can happen if you have diabetes, or after surgery.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.