Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, including some that medical intervention can treat. Infertility has increased by 4 percent since the 1980s, mostly from problems with fecundity due to an increase in age. About 40 percent of the issues involved with infertility are due to the man, another 40 percent due to the woman, and 20 percent result from complications with both partners.

Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile during the rest of the menstrual cycle. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature. Symptoms and signs of primary infertility in TCM include:

(1) Syndrome of kidney qi asthenia
Main symptoms: No pregnancy long after marriage, late occurrence of menarche,  delayed menstruation, scanty menorrhea with light or grayish color, even amenorrhea, blackish complexion, aching in the loins and flaccidity of legs, sexual frigidity, leukorrhagia with thin texture, clear and profuse urine, loose stool, scanty pubes,small uterus, light-colored tongue with whitish fur, deep and thin pulse or deep and slow pulse.

(2) Syndrome of liver and kidney deficiency
Main symptoms: No pregnancy long after marriage, delayed menstruation, scanty, light-colored or grayish menorrhea, even amenorrhea, emaciation, feverish sensation over palms, soles and chest, dizziness, tinnitus, palpitation, insomnia, aching in the loins and flaccidity of legs, red tongue with scanty fur, taut pulse or thin and taut pulse.

(3) Syndrome of qi and blood asthenia
Main symptoms: No pregnancy long after marriage,scanty menorrhea with light color, or amenorrhea, sallow complexion, lusterless skin, physical weakness, spiritual lassitude, dizziness, shortness of breath and palpitation, accompanied by maldevelopment of the uterus, light-colored tongue with white fur, thin and weak pulse.

(4) Syndrome of liver and heart qi stagnation
Main symptoms: No pregnancy long after marriage,mental upsets, depression, irritability, irregular menstruation, scanty menorrhea with blackish color, or unsmooth menorrhea, or abdominal pain during menstruaton, distending pain in the breasts before menstruation,discomfort in the chest and hypochondria, insomnia and dreaminess, deep-red tongue with thin and white fur, taut pulse or thin pulse.