Why Are We Not Getting Pregnant?

Trying to conceive can go from fun to heartbreaking as months go by without the longed-for positive test result. While making a baby can seem like a simple process, there are many factors that affect fertility. Here are some common reasons why you may be struggling to get pregnant, and what you can do to optimize your fertility.

You Don’t Ovulate When You Think You Do

Certain medical guidelines, including calculating the due date of a pregnancy, are based on a 28-day menstrual cycle, with ovulation on day 14. It’s completely normal, however, for your cycle to run anywhere from 21-35 days (although it should be fairly consistent in length). You’re only fertile for ovulation day and a few days before, so mistiming sex can sabotage conception plans.

If your periods are irregular, talk to your doctor about testing for an underlying condition that could affect your health and fertility. If your periods are normal, and you don’t have PCOS (which can affect ovulation test accuracy), you may benefit from using an ovulation predictor kit (OPK) at home. As with a pregnancy test, an OPK test strip analyzes hormones in your urine to determine your most fertile days of the month. This can also help you understand your cycle better. If your cycle is the same length, but ovulation day varies by more than a few days, that’s worth noting to a doctor.

You Have PCOS

Polycystic ovarian syndrome, or PCOS, is a common hormonal condition. It’s characterized by the formation of multiple small cysts on the ovaries, but you’re more likely to notice issues with irregular periods, weight gain, excess hair growth, or acne. PCOS is often treated with a combination of medical and lifestyle interventions. Your doctor can prescribe medication to help balance hormones. Elevated insulin levels (which kick in to combat a sugar high) can potentially signal your body to produce lower levels of ovarian hormones you need for ovulation, so managing your weight and diet can be beneficial to improving your fertility with a PCOS diagnosis. Your doctor may also suggest medical interventions like IVF earlier for you than other would-be parents.

Your Partner’s Sperm Has an Issue

Sperm-related factors account for 40-50% of infertility cases. Sperm need to meet the following criteria to have a good chance of leading to a pregnancy:

  • Count (how many sperm there are per ejaculation)
  • Motility (how well the swimmers move)
  • Morphology (how many sperm are normally versus abnormally formed)

Issues with any of these factors can impact fertility. If you’ve been having well-timed sex for 12 months, or 6 months if you’re 35 or older, it’s time to get both of you checked out. A reproductive endocrinologist may have suggestions to improve certain elements of your partner’s sperm. They can also recommend an intrauterine insemination, or IUI, which injects your partner’s sperm closer to your egg, improving the chances of pregnancy.

If you’re not ready to see a doctor about fertility yet, you can also buy at-home sperm testing kits to help determine if your partner’s sperm count is high enough.

You Need More Time

Up to 3 in 10 couples dealing with infertility receive a confusing diagnosis of “unexplained infertility.” In other words, there doesn’t seem to be anything wrong with either partner that would inhibit conception, but pregnancy isn’t happening, either. While this diagnosis can be frustrating because you want to hurry up and fix the problem already, unexplained infertility is kind of a best-case scenario.

If you’ve been diagnosed with unexplained infertility, your ovarian reserves are good, you’re ovulating normally, your fallopian tubes are healthy and open, and your uterus is clear of any adhesions or scarring that could interfere with implantation. Your partner’s sperm are plentiful enough for conception, move well, and have enough correctly formed sperm to fertilize an egg. You’ve got a lot going for you, although it definitely doesn’t always feel that way.

What You Can Do

Maintain a healthy lifestyle, eating a balanced diet, avoiding tobacco and drugs, and limiting alcohol for both partners. Talk with your partner about how long to try naturally before seeking treatment. You may have a good chance of conceiving without intervention, but the emotional toll of infertility is real and valid, and setting a month to bring in the “big guns,” as it were, can help you both feel like you’re taking charge of a process that can often leave you feeling helpless.

Jessica Sillers
Jessica Sillers is a parenting and finance writer whose work has been featured in Pregnancy & Newborn, Headspace, and more. As a new mom herself, she’s passionate about helping other parents find the community and support they need. When she’s not writing, she loves spending time with her family, reading, and hiking.

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