Why Am I Not Getting Pregnant?' 22 Possible Reasons

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Couples struggling to conceive will know how frustrating it gets after several unsuccessful attempts. Women often start pondering, “Why am I not getting pregnant?” There can be different reasons for not getting pregnant. And if you know them, you may be able to achieve a successful conception by fixing the issue.

So, in this post, we talk about all the possible factors behind your inability to conceive and suggest some effective solutions and treatment options. Read on.

How Long Does It Take For A Woman To Get Pregnant?

If you are healthy and your reproductive parts are functioning at their best, you have a 25% probability of becoming pregnant during every menstrual cycle (1). According to the American Pregnancy Association, “ with frequent unprotected sex, most healthy couples conceive within one year.”

Of all couples trying to get pregnant (2):

  • 30 percent get pregnant within the first month (first cycle).
  • 60 percent get pregnant within three months (three cycles).
  • 80 percent get pregnant within six months (six cycles).
  • 85 percent get pregnant in about a year (12 cycles).
  • 92 percent get pregnant in about 4 years (48 years).

What Are The Most Common Reasons For Not Getting Pregnant?

While your periods may be regular, a number of everyday activities can impact your chances of conception. Let us know about them:

1. Too much or too little sex

Sex is probably the most basic human need for pleasure and reproduction. And, people can be in the extremes when it comes to this (3).

Having too much sex: Some people believe that having more sex could lead to conception. But this may not always be true. Though frequent sex will not decrease the vigor of a man’s sperm, it can cause potential health problems such as fatigue, dizziness, weak knees, and frequent urination. If you indulge in a lot of sex only to have babies, it could lead to BURNOUT (a state of fatigue, depleting your energy for sex). In this case, when the actual fertile window is open, either partner may not be interested in sex. And, as a couple you lose an opportunity to conceive.

Having too little sex: You may be cutting down on intercourse to save the sperm or you only have sex during ovulation. But staying without sex for many days may affect your conception. You could miss your fertile phase when sex is limited as you may not always be correct about your ovulation.

What next?

Try to have sex frequently and keep a close watch on your ovulation dates. If you have irregular periods or problems tracking your fertile window, use an ovulation kit. If the result shows that ovulation is due in one or two days, have sex during that time. Keep in mind not to have sex just for having a baby, because then you can’t enjoy the process.

Did you know?
It is not mandatory to have sex on the day of ovulation for conceiving. The sperms are likely to remain active for about 5 days (7).

2. Over-stress

Depression and anxiety can lower your fertility levels

Image: Shutterstock

Stress will take a toll on your health both physically and mentally and affect your ability to get pregnant. Other emotional disturbances such as depression and anxiety can lower your fertility levels. You should be calm and in a balanced state when trying to conceive. Stress hampers the hypothalamus functions, which control the pituitary gland. This gland regulates adrenal, thyroid, and ovaries and affects the periods, even leading to irregular periods.

What next?

You should give yourself some time to come out of the stress phase to improve your chances of conceiving. To beat stress, you could join a support group, see a psychologist, join yoga for fertility, meditate and exercise (4).

3. The man-problem

One of the primary causes of infertility is low sperm count and poor sperm motility (due to structural abnormalities). This factor accounts for 30 to 40% of infertility problems in couples (5).

What next?

The foremost step is to see a doctor or a fertility specialist for workup and treatment. For low sperm count or motility, testosterone supplementation or Clomid could help sometimes. After exhausting all the reasonable non-invasive options, in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) could be a solution. IVF involves mating the egg and sperms outside the human body, and transferring the fertilized egg to the vagina. In ICSI, a single sperm is picked and directly injected into the egg (6).

4. Running to the bathroom after sex

Many women rush to the bathroom after making love to clean up. It is essential to stay in bed for some time after sex to ensure that the sperm gets a chance to reach the egg and fertilize it. If you get up and rush, as soon as you are done with the act, you are letting gravity drag the sperm down and the rest of it is washed away when you clean up. And, this could be one of the natural reasons for not getting pregnant.

What next?

Focus on relaxing and lying in bed for a while after sex so that you can improve your chances of conception and pregnancy (7) .

5. Undergarments too tight

Women wear tight undergarments for proper shape, and also to accentuate their body and figure. But, you may be hampering the functions of your reproductive organs. In men, sperm production goes down, and in women, the air circulation reduces and leads to discomfort or vaginal infections.

What next?

Wear well-fitted, but cotton undergarments to avoid infections. This will reduce sweat and moisture-related problems, and allow your privates to breathe and relax (8).

Did you know?
Using hot tubs for extended periods may cause overheating of the testicles and impair sperm production in men (33).

6. Sleeping less

Sleep deprivation can strain and exhaust the body and affect the functions of the immune system. This increases your chances of getting infections, and in turn, affects the reproductive cycle. The same applies to men. Infections could develop into a fever, and excess body heat can damage the sperm. Women may feel anxious due to a lack of sleep which could affect their menstrual cycle (9).

What next?

Get enough sleep to stay healthy. In case you suffer from insomnia, consult your doctor.

7. Under or overweight

Being too thin or too fat will also affect your chances of conceiving. If you are undernourished, you will not ovulate well. If you’re on the heavier side, then it will hamper your fertility. Therefore, an ideal body weight is what helps, and if you are much over your ideal BMI, there are fewer chances of conception even if your ovulation is regular (10).

What next?

Maintain a healthy diet and lifestyle. Indulge in a moderate fitness routine. You may check with your healthcare provider for nutrition and supplementation guidance.

8. Over-use of lubricants

Studies state that vaginal lubricants negatively affect the motility of the sperm and interfere with fertilization. This is true for both over-the-counter and homemade lubricants.

The reason – the pH of cervical mucus produced before ovulation is ideal for the survival of sperm and its motility. But lubricants have an acidic pH, which is enough to kill sperms. Also, the sperm’s motility is affected by the thickness of the lubricants and their water content (11).

What next?

Foreplay is the best lubricant for conception. Take your time to get into the mood. If that doesn’t work, use warm water or coconut oil for lubrication as it is non-toxic and will not interfere with the sperm’s motility. If you still require lubricant while trying to get pregnant, you can choose “fertility-friendly” lubricants such as Conceive Plus or Pre-Seed (12).

9. Poor lifestyle choices

Common lifestyle factors such as smoking, drinking, drug abuse, and caffeine affect your fertility. In men, these factors decrease the sperm count and motility and in females, they cause irregular ovulation.

What next?

Quit these habits, especially a few months before you plan to conceive. Switch to healthier life choices. Also, avoid the use of artificial sweeteners and exposure to chemicals (13).

10. Environmental pollution

Environmental toxins are known to harm both men and women. Exposure to pollutants such as chemicals, pesticides, cigarette smoke, polychlorinated biphenyls, plastics, food packaging, and personal care products (soaps, shampoos, and cosmetics), could affect your health, especially fertility. Studies say that they lower the couples’ ability to conceive by 29% (14).

What next?

Though it is inevitable to avoid exposure to environmental toxins and chemicals, you should try to avoid them as much as possible.

  • Stop using pesticides for your plants and lawn. Choose organic foods.
  • Use organic and natural personal care products.
  • Wear protective gear when you are working in chemical-prone areas, and always remain in highly ventilated places.

All of the above reasons are lifestyle choices or environmental factors that affect the ability to conceive. Now, let’s look at some medical causes of not getting pregnant.

Medical Causes For Not Getting Pregnant

In some cases, the egg may get aborted naturally, while in others, the couple could suffer from impotence. You must, however, give yourself a year to conceive. If things don’t work out by then, then you may reach out to a doctor for diagnosis and treatment. The causes of infertility are different in men and women.

The medical causes of infertility in women are:

11. Irregular periods

Women who do not menstruate regularly have more difficulty in getting pregnant. Irregular periods indicate inconsistent ovulation, and conceiving without an egg is impossible. Therefore, the less you ovulate, the less are your chances of getting pregnant (15).

How can I get pregnant with irregular periods?

A doctor can help you find the underlying cause for irregular periods and offer the treatment accordingly. You should also focus on a healthy diet, attain ideal weight, perform moderate exercises, and take fertility-enhancing supplements as suggested by the doctor.

12. Endometriosis

Endometriosis can create an unhealthy environment around the egg

Image: Shutterstock

This is a chronic disorder of the reproductive system in which the endometrial cells grow outside the uterus. It can block the fallopian tubes preventing fertilization or the fertilized egg from traveling towards the fallopian tubes or could make the environment unhealthy around the egg.

This condition can cause irregular and/ or painful periods, severe pain while penetration during sex, painful bowel movements, frequent urination along with a feeling of the bladder being full during the menstrual cycle, or chronic pelvic pain (16).

What could be the possible treatment?

There are many treatment options for endometriosis that may or may not include surgery to diagnose and stage the endometriosis. Usually, laparoscopy is recommended to diagnose and treat endometriosis at the same time. Suppression of endometriosis can lead to fertility in most but not all cases.

13. Ovulation problems

Almost 20 to 40% of infertility problems in women are caused due to irregular ovulation, which prevents the release of mature eggs from the ovaries. Where some women can never ovulate, others ovulate once in a few months. Hormonal fluctuations, excess weight gain or loss, excessive exercise, or severe stress could be the key reasons for ovulatory disorders (17).

What could be the possible treatment?

Your doctor will likely ask you to move to a low-carb diet, exercise to improve insulin sensitivity, and recommend some supplements or prescription medications. Later on, they might prescribe ovulation stimulators such as gonadotrophins, Clomifene, prolactin suppressants, or IVF cycles.

14. Polycystic ovary syndrome (PCOS)

It is a complex condition caused by a hormonal imbalance, which interrupts ovulation. Small cysts are formed in the ovaries that disrupt the ripening of ovarian follicles and maturation. The other possible symptoms include irregular menstruation, weight gain, excess hair growth, and acne.

What could be the possible treatment?

Laparoscopic surgery could help open and repair the tubes or could be treated by IVF (15).

15. Tubal diseases

Damaged or blocked fallopian tubes prevent eggs from reaching the uterus and sperm from reaching the egg, thus preventing conception. These conditions could arise due to sexually transmitted diseases, pelvic inflammatory diseases, or sterilization surgeries or endometriosis.

What could be the possible treatment?

Laparoscopic surgery could help open and repair the tubes or could be treated by IVF (13).

16. Egg factor

The egg quality and quantity decline around late 30s and early 40s. Women are born with approximately one to two million eggs at birth and the eggs gradually lessen to 300, 000 by puberty. Then about 300 mature and release through ovulation. And by menopause, you have minimal eggs left.

What could be the possible treatment?

As the loss of eggs is an irreversible process, you should try to plan pregnancy in your fertile age. Also, try losing weight if you are overweight, quit smoking, manage thyroid issues (if you have any), and take supplements including fish oils, prenatal vitamins, probiotics, vitamin D, and Coenzyme Q10. These can improve egg quality.

The possible solutions if the above do not work are egg or embryo donation, adoption, or surrogacy (19).

Quick fact
About two to four percent of women of reproductive age have hypothyroidism (low thyroid hormones) which if left untreated may cause problems with conceiving (34).

17. Low progesterone levels

After ovulation, the corpus luteum (the remnant egg follicle) produces progesterone to support embryo implantation during early pregnancy. The deficiency of progesterone in this phase is called a Luteal Phase Defect (LPD), and may be one of the reasons for infertility. Even if you conceive, the placenta and fetus would not grow further, causing non-viable fetus or early fetal loss. Other medical conditions such as prolactin or thyroid abnormalities could lead to abnormal luteal functioning (20).

What could be the possible treatment?

Your doctor may refer you to a reproductive endocrinologist. The treatments include progesterone supplements, progesterone injections, or suppositories to thicken the uterine lining for embryo attachment.

18. Cervical mucus problems

Cervical mucus usually changes its consistency to clear and elastic forms so that the sperms can easily move through the mucus into female reproductive organs. In the case of cervical mucus abnormalities, the mucus prevents the sperm from passing through. The mucus may contract an infection, or contain antibodies that kill sperms. These problems are encountered in women with chronic cervicitis or a narrowed cervix from prior surgery and lead to pregnancy failure.

What could be the possible treatment?

Identifying and treating infections and using assisted reproductive methods such as IUI and in-vitro fertilization, help solve the problem.

The medical causes of infertility in men are:

19. Sperm problems

Poor sperm mobility, low or no sperm count, and abnormally shaped sperms can decrease a man’s fertility.

What could be the possible treatment?

Fertility drugs and testosterone supplements could be the first line of treatment to boost sperm production. The next options are IUI and ICSI (21).

20. Tube blockages

Blockages in the epididymis (a long coiled tube that lies behind testicles and stores mature sperms) and vas deferens (the muscular tube that carries sperm from the epididymis to the ejaculatory duct) could adversely affect the transport of fertile sperms. The obstruction in the tubes could be due to infections including gonorrhea or chlamydia, birth defects, or injuries. Also, varicoceles (enlarged veins in the scrotum) will affect sperm mobility.

What could be the possible treatment?

Health practitioners usually prefer surgical correction of tube blockages, which corrects fertility (21).

Besides lifestyle choices and medical reasons, there are a few other factors that can affect fertility.

Are There Any Other Factors That Affect Fertility?

Yes! Unexplained and combination reasons account for almost 25% and 40% respectively of all infertility cases (22).

21. Unexplained infertility

Of all infertility cases, 25% are diagnosed as unexplained infertility, due to failure in finding the actual cause even after a range of tests and assessments. Both partners undergo a variety of tests without any definitive results. Though you may not actually have any problem, it results in confusion (23).

What next?

Doctors usually advise the next best step, which is to conceive by having regular intercourse (without focusing on having babies). If it doesn’t work even after a couple of years, you may be given an IVF treatment.

22. Combination infertility

Here, both the partners are diagnosed with fertility problems, or when one of them has a couple of fertility issues.

What next?

Appropriate treatments are offered according to the cause of infertility.

In women, sometimes the menstrual cycle may change in intensity and duration. This could also directly affect fertility.

Are Heavy Periods A Sign Of Fertility?

Heavy periods are not a sign of fertility, and sometimes could indicate a different problem. You may feel fatigued and worn out. In the process of losing more blood, you will lose the essential body resources built over time. If you get sudden, heavy periods, you should immediately discuss with your doctor (24).

Can You Get Pregnant At Any Time Of The Month?

It is not possible to get pregnant at anytime of the month. You must be ovulating in order to conceive. This means that you should have sex in the days leading to and around ovulation. The two to three days before ovulation and the day you ovulate are most fertile days (25).

You must, however, understand that fertile days do not necessarily mean that everything is functioning well.

Are You Fertile If You Have Regular Period?

If you have been failing to conceive for a long time, then you must see a doctor

Images: iStock

If you have regular periods, your chances of fertility are high. However, fertility is tricky as there may be reasons that could prevent conception despite having a good number of eggs.

If you have been trying to conceive for months or years and failing, then you must see a fertility specialist or gynecologist to rule out the possible causes. Also, remember that you do not always need medical assistance for conception. Certain lifestyle changes could naturally help you conceive.

How Can You Get Pregnant Faster?

Eat a healthy and nutritious diet to get pregnant faster

Image: Shutterstock

Once you decide to have a baby, you may want to get pregnant faster. There are ways to boost your likeliness of conceiving quickly.

  • Schedule a preconception check-up or counseling
  • Stay away from birth control pills a few months before you try to conceive
  • Figure out your ovulation time. You could use an ovulation predictor kit.
  • Have sex at the right time
  • Give sperm a boost by improving diet, exercising regularly, limiting chemical exposure, and consuming supplements
  • Eat a healthy and nutritious diet
  • Relax and have fun while making love

The sooner you implement these changes, the faster you can get pregnant (26).

While some couples have issues getting pregnant the first time, others have issues conceiving a second time. And we’ll tell you why.

Reasons For Not Getting Pregnant The Second Time

Substance abuse can be a reason for not getting pregnant

Images: iStock

Your fertility can reduce from your first pregnancy and women may find it difficult to become pregnant for the second time. This is known as secondary infertility. Here are some common reasons for not getting pregnant:

  • If you are a woman over 35 years, then the egg count will fall, leading to no or lesser eggs
  • Men over 50 have a decreased fertility and abnormal sperm
  • Changes in ovulation and menstrual cycles due to hormonal dysfunction, weight issues, stress, medications (steroids, antibiotics, and antihistamines), and substance abuse (drugs, tobacco and alcohol)
  • Damage to fallopian tubes due to abdominal surgery, endometriosis, sexually transmitted infections (27)

Frequently Asked Questions

1. How can I check if I am still fertile?

Certain blood tests might help evaluate your fertility. If you do not have regular periods, you may contact a doctor for the right treatment strategies suitable to your situation (28).

2. At what age is a man’s sperm most fertile?

In general, women below 35 and men below 40 have greater chances of conception (29). A group study (in couples with IUI) revealed that men aged below 35 had about 50% more fertility rates than men over 35, suggesting that the fertility rate might decrease significantly in men after 35 (30).

3. Can I be infertile and still have regular periods?

Yes, you may get a period regularly but fail to conceive for several reasons, including egg quality issues, improper implantation, or other problems. A doctor is the best person to determine the exact cause of infertility (31).

4. Is it difficult to get pregnant after a miscarriage?

According to the American pregnancy association, about 85% of women have a successful pregnancy following a pregnancy loss. Therefore, there is a fair chance of attaining a healthy pregnancy after miscarriage (32). It could be tough deciding to plan for subsequent pregnancies after a miscarriage. Also, it is ideal to speak to a doctor to make sure you are physically and mentally prepared for it.

If you are unable to conceive after several attempts, you may wonder, why am I not getting pregnant? Improper intercourse, low sperm count in men, health issues in women, stress, obesity, and lifestyle practices are some factors that could be contributing to this situation. You may track your ovulation cycle to have timely intercourse, maintain a balanced diet, reduce stress, and implement certain lifestyle changes to improve your chances of conception. However, if you have been trying to get pregnant, but are unsuccessful, contact a fertility specialist or gynecologist to identify the underlying issue and work towards an appropriate solution.

Infographic: Lubricants That May Interfere With Conception

The role of lubricants in hindering conception may be overlooked by couples trying for a baby. Therefore, the FDA has taken measures to help people identify sperm-friendly or fertility-friendly lubricants. In this infographic, we tell you about the things to consider when choosing lubricants.

more about sperm friendly lubricants [infographic]
Illustration: MomJunction Design Team

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
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Rebecca Malachi

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and...
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Dr. Anita Gondy

(MD, FACOG)
Dr. Anita Gondy is an Ob/Gyn at The Ob-Gyn Center in Las Vegas. In practice since 1998, Dr. Gondy began her medical training at Rangaraya Medical College in Kakinada, India and completed studies at the University of Nevada School of Medicine, where she also did an obstetrics and gynecology residency. She is also a Fellow member of The American College...
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