Infertility is more common than many may think. It affects one in eight heterosexual couples who are trying to get pregnant. Overall, 12 to 15% of people are infertile. Show
As a reproductive endocrinologist, my colleagues and I witness firsthand the impact that infertility has on people who desire to have a baby. It’s part of what drives our passion to help them find hope whenever possible. At the Center for Reproductive Medicine and Fertility, we start by identifying the causes of infertility in each person or couple, then exploring every possible option to help our patients build their families. How do I know if my partner or I may be infertile?Infertility is defined as the inability to conceive after one year of regular, unprotected intercourse. If you or your female partner are over the age of 35, you should see a fertility specialist after six months. After age 40, we recommend seeking help right away because we know fertility declines as age increases. What are other signs and symptoms of infertility in females?Aside from having trouble conceiving, symptoms can vary significantly from one person to another. Depending on the reason for infertility, sometimes women may experience pelvic pain, heavy periods, skipped periods or unpredictable vaginal bleeding. It’s important to discuss any unusual symptoms with your doctor. Some of these symptoms may represent underlying hormonal conditions that should be addressed even if you are not trying to conceive. What are the most common causes of infertility?Infertility can be a result of many different factors — even in one person or couple. The most common causes include problems with ovulation, structural issues in the uterus or fallopian tubes, or abnormalities in sperm. In females, medical conditions such as uterine fibroids, endometriosis, polycystic ovary syndrome (PCOS), uterine polyps or a history of pelvic infections are often associated with infertility. Can you still be infertile if you have a period?Yes. Having regular predictable periods is a good indicator that you ovulate regularly. In other words, it means an egg is being released from your ovaries on a regular basis. But, ovulation alone does not guarantee that you can get pregnant. Sometimes there can be an issue with egg quality, how the egg is fertilized, its ability to be transported to the uterus, or how it becomes implanted in the uterus. There may also be a problem with the sperm. If you’re having a period and regular intercourse but have not conceived, it is important to talk to your health care provider about whether a referral to a fertility specialist is warranted. How is infertility a unique health challenge for women of color?Outcomes indicate that black, Asian and Hispanic or Latina women may have less success with fertility treatments compared to white women. Overall, we don’t know exactly why this happens. However, we do know certain medical conditions that can impact fertility occur more frequently in some races than in others. For example, women of color have a higher likelihood of having uterine fibroids than white women. Additionally, studies show that women of color are more likely to be affected by socioeconomic factors that can make it more difficult to get treatment — or even to understand the need the need for treatment. At UChicago Medicine, we take a personalized approach to educating each patient about their reproductive health and family-building options. Our team is committed to providing excellent care for everyone. What should I do if I think I’m infertile?If you believe that you or your partner may be experiencing infertility, it’s important to seek an evaluation with a reproductive endocrinologist as soon as you can. Typically, the first steps will involve a visit to the doctor, blood tests, a pelvic ultrasound and a semen analysis. Can infertility be cured?Infertility isn’t cured but it can be treated. In many cases, factors that lead to infertility can be overcome with treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF). Your doctor can help you understand which family-building options may work best for you. 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. 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): While your periods may be regular, a number of everyday activities can impact your chances of conception. Let us know about them: 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. 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). 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 sexMany 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 tightWomen 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). 6. Sleeping lessSleep 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 overweightBeing 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 lubricantsStudies 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 choicesCommon 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 pollutionEnvironmental 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.
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 periodsWomen 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 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 problemsAlmost 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 diseasesDamaged 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 factorThe 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). 17. Low progesterone levelsAfter 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 problemsCervical 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 problemsPoor 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 blockagesBlockages 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 infertilityOf 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 infertilityHere, 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? 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? 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.
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 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:
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 ConceptionThe 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. 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 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... more 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... more Why ovulation occurs but not getting pregnant?You may have ovulation irregularities, structural problems in the reproductive system, low sperm count, or an underlying medical problem. Or you simply haven't tried long enough. While infertility can have symptoms like irregular periods or severe menstrual cramps, most causes of infertility are silent.
What is the most common reason for not getting pregnant?Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods. Ovulation problems are often caused by polycystic ovarian syndrome (PCOS).
What are the chances of not getting pregnant while ovulating?If she has sex on the day of ovulation, or the two days before, the chance of getting pregnant is around 30 percent. These are average figures and depend on a woman's age.
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Why am i not getting pregnant even though i am ovulating
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