What are the reasons for not being pregnant after 4 years of marriage?

Patient's question:

I started getting my period when I was 12 years old. Around 15, my periods have never been very regular. At one point, I didn't have a period for about six months, and I didn't really pay much attention to it then.

Doctor's answer:

Couples of childbearing age living together for 1 year, having normal sexual life, and never using any contraceptive measures but failing to conceive are diagnosed with infertility. Infertility is divided into two types: primary infertility and secondary infertility. I don’t know what caused your infertility? Infertility is not a simple disease but a comprehensive condition caused by over 150 different reasons.
Factors related to the female: issues with the ovaries, fallopian tube diseases, uterine cavity, cervix, vagina, and immunological antibodies (over 20 types) etc.
Factors related to the male: abnormal semen (e.g., non-liquefaction, inflammation, acidic or alkaline imbalance), blockages in the spermatic ducts, genital malformations, and systemic diseases. Additionally, there are common factors for both partners: lack of sexual knowledge, immunological factors (antibodies present in both partners), and psychological reasons (e.g., excessive stress).
It is recommended that both you and your partner choose a specialized hospital for further examination to identify the root cause and receive targeted treatment.

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