"Everything came back normal. So why isn't it working?"

A basic fertility evaluation checks four things: whether you ovulate, whether your fallopian tubes are open, whether the uterus is normal, and your partner's semen analysis. "Unexplained infertility" means those standard tests didn't find a cause — not that nothing is going on. It's one of the most common diagnoses fertility specialists give.

Many couples with unexplained infertility still conceive, some without treatment. Treatment also works well for many: options typically step up from ovulation-stimulating medication with insemination (IUI) to IVF, depending on your age and how long you've been trying.

• Has my partner had a full semen analysis?
• Have my tubes been checked, and how?
• Given my age, how long should we try each step before moving on?

Polycystic ovary syndrome often means you ovulate irregularly or not at all — so there are fewer chances to conceive each year. It's a hormonal condition, often with an inherited component.

PCOS is one of the most treatable causes of infertility. Many women with PCOS conceive, often with help from oral medication to trigger ovulation.

Ask whether ovulation induction (letrozole is commonly used first for PCOS) is right for you, and whether to check blood sugar before pregnancy, since PCOS raises the risk of gestational diabetes.

Endometriosis is tissue similar to the uterine lining growing outside the uterus. It can cause inflammation, scarring and blocked tubes that make conception harder.

Many women with endometriosis conceive without treatment. The impact depends on the severity and where the tissue is.

Ask how your stage of endometriosis affects your options, and whether surgery, IUI or IVF makes the most sense given your age and symptoms.

AMH (anti-Müllerian hormone) reflects how many eggs remain in the ovaries. It falls naturally with age.

A low AMH does not mean your eggs are low quality, and it's a poor predictor of natural fertility if your cycles are regular. It's most useful for predicting how the ovaries will respond to IVF medications.

Ask how your AMH changes your timeline — not whether it rules pregnancy out.

A male factor contributes in up to about half of couples having trouble conceiving. It usually has no symptoms, which is why a semen analysis belongs at the start of every evaluation, not the end.

Many male-factor problems are treatable, and IUI or IVF with ICSI can work even with low sperm counts. Smoking, heavy alcohol, cannabis, heat exposure, some medications and testosterone supplements can all lower sperm counts.

If the semen analysis is abnormal, ask about a referral to a reproductive urologist.

Miscarriage is common — about 10 to 20% of known pregnancies — and most early losses are caused by chromosome differences in the pregnancy that began at conception. Exercise, sex, work, lifting and ordinary stress do not cause miscarriage. You did not cause this.

After one miscarriage, the chance of a healthy next pregnancy is high. After two or more losses, an evaluation for causes of recurrent pregnancy loss is recommended — and it can find treatable causes.

After an early loss, there's usually no medical need to wait before trying again once you feel ready; ask your clinician about your situation, especially after a later loss. Pregnancy after loss often comes with intense anxiety. Ask in advance about earlier reassurance visits, and see mental health after loss.