Reasons for not getting pregnant

It has never been possible to say how long it takes to get pregnant, because every woman is different. But if you have been trying for a while now, you may be wondering about the reason for not getting pregnant when everything is normal.

There are many factors that can affect your chances of conceiving. These include age, your general health, the health of your reproductive system, and how often you have unprotected sex. Whilst it can be upsetting if it is taking time to become pregnant whilst others have done so quickly, it is actually normal for everyone to be different.

Most healthy couples will conceive within a year if they are actively trying. That means having unprotected sex every two to three days throughout the month. If that’s you, and you still haven’t conceived, you have probably asked yourself, “What are the reasons I’m not getting pregnant?”

The truth is that there are various potential reasons for not being able to get pregnant. Fertility issues affect one in seven couples in the UK, and can occur in either women or men. In around 40% of infertile couples, there is a problem with both the man and the woman.

What are the reasons for not getting pregnant?

Some of the common reasons for not getting pregnant include:

1. Ovulation issues

According to published research, ovulation failure is the most common reason for infertility. This can be caused by an array of factors, including hormonal imbalances; thyroid problems; polycystic ovary syndrome (PCOS); obesity; low body mass index (BMI); premature ovarian failure; perimenopause, or excessive stress.

Without ovulation (the release of an egg from the ovaries), it is impossible to get pregnant. Tests can be carried out to check for lack of ovulation, and there are investigations that will help identify why ovulation isn’t occurring.

2. Semen (Sperm) disorders

Issues with the male partner’s semen, the fluid containing sperm, can be one of the most common reasons for not getting pregnant.

Sperm quality is one factor. The number, shape and ability of sperm to swim towards the egg can all affect fertility. Ejaculation disorders, making it difficult to release semen during sex, can also cause issues with getting pregnant, as can damage to testicles caused by infection, injury, surgery, cancer or congenital (birth) defects.

A semen analysis will help to pinpoint whether a sperm disorder is a reason for not getting pregnant when everything is normal.

3. Age

Women become less fertile as they get older. One study found that among couples having regular unprotected sex, 92% of 19-26 year olds will conceive after one year, and 98% after two years. However, when the age increases to 35-39, only 82% will conceive after one year, and 90% after two years.  It is therefore essential that older women seek professional advice sooner.

The effect of age on fertility in men is not as clear.

4. Fallopian tube or uterine issues

If the fallopian tubes, the channels that connect the ovaries to the womb, are blocked or damaged, or carrying fluid, then eggs won’t be able to travel down them to be fertilised and implanted in the womb. Sometimes pelvic surgery can damage and scar the fallopian tubes.

Pelvic inflammatory disease (PID), an infection of the upper female genital tract often caused by a sexually transmitted infection (STI), can damage and scar the fallopian tubes, making it near impossible for an egg to move down them into the womb.

Problems with the uterus (womb) are also one of the reasons for not being able to get pregnant. A misshapen uterus, or a build-up of tissue in the womb, are examples of why a fertilised egg fails to implant.

Non-cancerous growths known as fibroids can affect fertility. These grow in or around the womb, sometimes preventing a fertilised egg implanting. They may also block fallopian tubes.

Endometriosis is another of the common reasons for not getting pregnant. This is a condition where parts of the lining of the womb start growing in other places, such as the ovaries. This can damage the ovaries or fallopian tubes, leading to fertility issues.

Ultrasound scans and/or a laparoscopy and hysteroscopy can determine whether there are issues with the fallopian tubes or uterus.

5. Drugs and medicines

Side effects of some types of drugs and medicines are sometimes considered reasons for not being able to get pregnant.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, used long term or in high doses, can make it more difficult to conceive. Antipsychotic medicines, can sometimes lead to infertility.

Spironolactone, used to treat fluid retention (oedema), can lead to infertility, although it should reverse around two months after the last dose. And chemotherapy medicines can sometimes lead to ovarian failure.

Ovulation can also be impacted by illegal drugs such as marijuana and cocaine.

6. Unexplained fertility

Unexplained fertility, when no cause can be identified in either partner, is the reason behind around one in four cases of infertility in the UK.

The National Institute for Health and Care Excellence (NICE) recommends that women with unexplained infertility who have not conceived after two years of having regular unprotected sex should be offered IVF treatment.

What to do next

The examples we’ve provided in this article are just some of the reasons behind infertility. Everyone is different, and for you, there may well be another reason for not getting pregnant when everything is normal.

If you have been trying to get pregnant for a year without success, you should seek advice from your GP in the first instance, so that they can refer you both for investigative tests. Women aged 36 and over, and anyone who’s already aware they may have fertility problems, are wise to see their GP sooner.

You may also seek private fertility advice, for which there is no need to arrange a GP referral. But it is worth bearing in mind that all patients, whether or not self-funded, are entitled to NHS funded fertility investigations.

Hull & East Riding Fertility has helped create thousands of babies since it was founded in 1986. Offering a range of services for those seeking fertility assistance, we are East Yorkshire’s only registered clinic providing specialist infertility investigations and personalised treatment, both self-funded and NHS. We also offer a range of investigatory and fertility treatment planning services at our two satellite fertility clinics in York.

We would be delighted to welcome you at any of our clinics to discuss your needs. Please get in touch to let us know how we can help you.