Why am I not getting pregnant? Signs, causes and fertility tests

For many couples, the impossibility of fulfilling the dream of having children can be a real problem that leads many women to ask themselves “why don’t I get pregnant?”. If this is your case, in this article we will try to advise you by providing you with data and possible options.

Sometimes couples assume that they will get pregnant quickly. However, it may take several attempts. It is considered normal for a healthy couple to be looking for pregnancy for up to a year, even in a woman under 35 years of age and in good health. In fact, only slightly more than one-third of healthy couples experience conception within the first month of trying. On the other hand, one in six couples have conception problems that encompass a wide variety of causes affecting male and female fertility. Some of these are solvable with a simple lifestyle change, others need medical intervention to increase fertility.

Often, the most important thing is to find the reasons that may be affecting conception. So, below, we will review some of the most common causes or signs of female and male infertility and how to address them from a professional point of view.

How long does it take to get pregnant naturally?

When a couple begins trying to have a baby, they hope and expect that pregnancy will come as soon as possible. More than half of women expect to get pregnant within the first six months, and younger women expect it to happen even sooner. However, in 2013 a study of over 1400 women who were planning their pregnancy, 44% found that it took them longer than expected.

A frequent and easily correctable factor is choosing the right time for sex. So much so, that up to half of couples may be trying to conceive at the wrong time because they do not know when the 3 most fertile days are.

Symptoms, Signs and Possible Causes of Infertility
When talking about possible causes of infertility or its symptoms, it is necessary to remember that the probability of pregnancy depends on age. Specialists point out that the most fertile stage of a woman’s life is between 20 and 30 years of age, being from then on when her reproductive capacity begins to progressively reduce.

So, if in your case you wonder why you do not get pregnant if you do not have any problem, the reason may range from the lower probability of getting pregnant due to age to attempts to conceive at the wrong time, since conception is only possible in the days before and during ovulation and it is important that sexual intercourse is performed at that time. In any case, you should not worry about age, as more and more women are deciding to become mothers from the age of 35 onwards, and there are numerous assisted reproduction treatments designed to help increase the chances of being able to get pregnant.

Diet

The consumption of low quality and highly processed foods contributes to deficiencies of nutrients, vitamins and micro and macro elements, such as magnesium, iodine, fluoride, zinc and selenium. The last two play a major role in the proper functioning of the reproductive system, not only in women, but also in men.

In fact, in men, one of the main causes of male infertility is due to damage to spermatozoa and their genetic material due to oxidative stress. This is caused by too high a level of reactive oxygen species produced by leukocytes and abnormally constructed male reproductive cells. Excess hydrogen peroxide causes DNA damage, cell membrane leakage and sperm cell death. In other words, oxidative stress alters sperm motility, reduces their number, worsens morphological parameters and decreases their activity.

Weight problems

Closely related to the previous cause is the issue of weight. An overweight woman may have difficulty conceiving due to hormonal imbalances. An overweight man may also have a low sperm count, difficulties with erection, hormonal problems, and sometimes other health problems resulting from obesity that can make conception difficult.

In these cases, it is recommended to be as close as possible to the ideal body mass index, as this can increase the chances of getting pregnant. That is why the opposite extreme of overweight can also be problematic. In the case of women, a very low weight can lead them to not ovulate properly, affecting their fertility and the chances of pregnancy.

In short, and as we have already seen in our article dedicated to the ideal weight for in vitro fertilization, weight can be a key element in your fertility.

Stress

Stress is a condition that can affect those who suffer from it both mentally and physically. In the case of women, when they are stressed, cortisol levels (the stress hormone) are very high and can affect their ovulation, preventing it or altering their cycles. In the case of men, stress can lower sperm count.

Stress management, especially when it is impossible to get away from the reason for the stress, requires regular exercise, good sleep habits, diet and often psychological counseling. In any case, while high stress is never healthy, if it does not affect your cycles or sex life, it should not prevent you from getting pregnant.

Problems with ovulation or tubal problems

Ovulation is the release of the egg into the fallopian tube, which is where conception occurs. If a woman does not ovulate, she cannot get pregnant naturally. Ovulation can be affected by many different circumstances: polycystic ovary syndrome, low weight, hormonal imbalances (e.g. thyroid problems), low ovarian reserve… Signs that this may be happening are irregular cycles with irregular bleeding.

Although it is not essential to schedule intercourse around ovulation, it can be helpful to have intercourse every other day during the ovulation period (there is nothing to tell us the quality of the eggs).

But if you’re wondering why you don’t get pregnant if you ovulate correctly, it may also be due to another reason. Specifically, obstruction of the fallopian tubes, which prevents the sperm from reaching the egg. Sperm must pass from the vagina through the uterus to the fallopian tube to meet the egg, but if that entrance is closed, the encounter does not occur. This obstruction may be due to pelvic inflammatory disease, endometriosis, previous surgeries, a previous Chlamydia infection… In this case, the solution requires medical help.

Low sperm quality

Although we have already mentioned some habits that can decrease sperm count or lead to poorer sperm quality, there are other practices that can affect sperm quality and lead to asthenozoospermia, erection problems or even ejaculation problems. As the most common measures, it is advisable not to smoke, not to take drugs and to limit alcohol consumption, as well as to avoid taking testosterone supplements to build muscle. Exaggerated heat in the testicular area (e.g. in cooks or professional drivers) can also lead to a drop in sperm production. Excessive exercise (e.g. cycling) can also be detrimental.

In some cases, however, it may be a matter of birth or due to previous testicular damage. If so, medical assistance would be necessary, as male infertility rarely gives symptoms and is usually diagnosed with a semen analysis, where the professional will check the quality of the semen and sperm.

Other medical problems

Apart from the above-mentioned causes, there are other medical problems related to difficulty in getting pregnant. For example, anxiety and depression (antidepressants can reduce the chances of pregnancy), undiagnosed diabetes or gluten intolerance. That is why, at this point, the most recommended by experts is to go to a fertility specialist to see your case personally.

But if I have already had a child… why don’t I get pregnant now?

Age affects both egg quality and quantity. In the case of a woman, she is born with a number of eggs that she releases throughout her fertile life. This means that the older she gets, the fewer eggs she has, and the lower their quality. The same happens if the man is older than 40 years of age with respect to sperm quality.

Both circumstances could explain why you are not getting pregnant, even if you already have a child and rule out infertility. Therefore, if you are over 35 years old, have a child and have been trying to get pregnant for more than six months or a year without positive results, it may be secondary infertility. In these cases, a good alternative to become a mother is to resort to in vitro fertilization.

Female fertility tests to find out why I am not getting pregnant

If the problems in getting pregnant persist, the best way to find out the cause of these difficulties is to consult a gynecologist or a specialist in assisted reproduction. There are several tests to determine the causes of female infertility, ranging from transvaginal ultrasound (to rule out problems in the uterus or tubes) to hysteroscopy (which allows you to see inside and take samples). These are some of the most common tests:

• Transvaginal ultrasound
• Antimüllerian Hormone (AMH)
• Hysterosalpingography
• Hysteroscopy
• Endometrial biopsy
• Karyotype

In some cases, 10% of couples do not find the cause that explains why conception does not occur, which does not mean that there are no other ways to achieve conception, as we have already seen. So, if you have been trying for more than a year (or six months if you are over 35), there are several options for assisted reproductive treatment that can help you.