Infertility

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 13, 2026

Infertility is the failure to achieve a clinical pregnancy after 12 months of regular unprotected intercourse, or after 6 months for women aged 35 and older. The World Health Organization estimates infertility affects approximately 17.5% of adults globally, or roughly 1 in 6 people.¹ Primary infertility refers to couples who have never achieved pregnancy. Secondary infertility refers to those who have previously conceived but cannot again. See Secondary Infertility for the distinct clinical picture that condition presents.

In the RRM framework, infertility is not a diagnosis. It is a symptom. The 12-month threshold identifies couples who need a workup, not couples who have a condition called infertility. The condition causing the delay is what needs the name. Calling it unexplained infertility is not a diagnosis either. It is an admission that the workup has not yet found the answer. RRM treats that as an incomplete evaluation, not a settled one.

The causes are distributed across both partners. Male factor is solely responsible in approximately 20% of couples and contributes alongside female factors in another 30 to 40%. A couple-based workup evaluates both from the first appointment. See Male Factor Infertility and Semen Analysis.

On the female side, common identifiable contributors include endometriosis, PCOS, luteal phase deficiency, tubal factor, thyroid dysfunction, and hormonal abnormalities identified through cycle-timed diagnostics. RRM approaches each of these as a treatable root cause. The goal is diagnosis followed by correction, not bypass. A comprehensive evaluation in RRM maps the cause before any treatment begins.²

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.