A couple of friends (both under 35, non-smokers, and in reasonably good health) have failed to conceive after 2 years of trying. a fertility clinic found no physical infertility issues. what are potential reasons for their failure to conceive?

Great Q 4 Fert, Urol: Thanks for asking on behalf of your friends. They might consider creating accounts so that each can provide additional details from evaluations and medical history. In the meantime i will refer this to physicians in urology and fertility medicine for answers in their areas of expertise for couples ttc (trying to conceive).

Several: Basic tests evaluate the fallopian tubes, the uterus, the eggs and the sperm. Often an actual physical exam is not as helpful. Often subtle problems with the uterus are overlooked. If those basic tests are normal, then usually the problem is the actual fertilization of the egg and sperm. Sometimes the problem may be genetically abnormal eggs or embryos preventing implantation.

Lots: Timing of sex, lubricants, hormones, varicoceles, other physiological issues can matter greatly to fertility. In fact, "physical fertility" issues are quite unusual causes of female infertility. More sophisticated female testing with day 3 fsh levels, amh levels and antral follicle counts is indicated and possibly a semen analysis with dna fragmentation testing.