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    Why am I not getting pregnant? Common reasons to consider

    Updated 26 September 2023 |
    Published 12 August 2019
    Fact Checked
    Reviewed by Dr. Tiffanny Jones, Fertility specialist, Conceive Fertility Center, Texas, US
    Written by Olivia Cassano
    Flo Fact-Checking Standards

    Every piece of content at Flo Health adheres to the highest editorial standards for language, style, and medical accuracy. To learn what we do to deliver the best health and lifestyle insights to you, check out our content review principles.

    There are many different reasons but also many different solutions, so try not to lose hope.

    It might seem like getting pregnant should be one of the easiest things in the world, but sometimes it just isn’t. And you’re certainly not alone if you’ve been trying for a while and wondering why you’re not pregnant yet. So, what could be going on? In this article, we’ll explore some of the reasons you might not be pregnant yet and what you can do about it.

    Key takeaways

    There are many reasons a woman might struggle to get pregnant, from problems with ovulation and blocked uterine tubes to underlying medical conditions like endometriosis or problems with the partner’s sperm. It can also be a simple matter of not trying for long enough yet.

    Trying to conceive can take time. If a couple has unsuccessfully been trying to conceive for over 12 months, and they’re under 35 years old, they should contact their health care provider to test for fertility issues.

    Infertility can affect men and women, but there are treatment options available, depending on the cause.

    Some lifestyle changes — such as maintaining a healthy weight, quitting smoking, and limiting alcohol — can increase your chances of having a baby.

    Common reasons why you might not be getting pregnant

    Sex education classes may have led us to believe that unprotected sex would always result in a guaranteed pregnancy. However, it often isn’t that simple — or that quick. Let’s take a look at some of the possible reasons you might not have had a positive pregnancy test result just yet.

    You haven’t been trying for long enough

    It’s completely understandable to feel frustrated if you haven’t gotten pregnant yet. Checking when you’re ovulating, having sex on a regular schedule, and waiting to see if your period will arrive (or not!) can be all-consuming. However, it’s important to remember that getting pregnant isn’t always a speedy process, and most couples don’t conceive right away. In fact, recent research has suggested the following timelines for conception for young couples:

    • 45% of couples will conceive after three cycles of unprotected sex.
    • 65% of all couples will conceive after six cycles of unprotected sex.
    • 85% of all couples will conceive within their first year of having regular unprotected sex.

    So if you’re wondering why you’re not getting pregnant, just remember that it’s totally normal for it to take some time. After this point, it might be worth reaching out to your doctor or talking to a specialist for some extra advice. If you’re over 35 and trying to conceive, experts recommend reaching out to your doctor after six months of trying.

    READ MORE: What are the chances of pregnancy after birth control?

    Ovulation disorder 

    Conception relies on ovulation — the process of releasing an egg from the ovaries. It’s a delicate process that requires a rise of hormones just before the egg is released, and sometimes, even the slightest change can throw everything off. 

    Ovulation disorders are relatively common and are the root cause behind about 25% of infertility cases. They can include: 

    If you think you may have one of these disorders or you have any concerns, reach out to your health care provider for advice.

    Blocked uterine tubes 

    Assuming ovulation is happening as it should, the next step in a successful pregnancy is fertilization, which occurs when the egg meets a sperm. This usually happens in the uterine tubes, also known as the fallopian tubes. After this, the fertilized egg will then travel down the tube to burrow into the uterus. However, if the tubes are blocked or damaged, these processes might not be possible. The sperm might not be able to travel up the tube to reach the egg, or the damage could also result in the fertilized egg implanting in the tube itself. This is known as a tubal pregnancy, which is a type of ectopic pregnancy.

    Endometriosis 

    Endometriosis could be another reason you’re not getting pregnant. This is a common condition that occurs when tissue similar to the lining of the uterus (endometrium) grows outside of the uterus, such as on the ovaries, uterine tubes, or bowels. Along with causing endometriosis symptoms such as severe cramps and heavy bleeding, the condition can also make it harder for some people to conceive. It’s estimated that around half of all people with endometriosis have difficulty getting pregnant, but there are treatment options available. Speak to your doctor to see which approach would work best for you.

    Partner’s infertility

    We often talk about infertility as if it were just a female issue, but that’s not always the case. In fact, infertility due to female factors accounts for only one-third of infertile couples. Male factors account for another third, while a combination of male and female factors, or an unknown problem, accounts for the final third. 

    So what are some of the factors that could lead to male infertility? There are several causes, including:

    • Low sperm count
    • Low sperm motility
    • A blockage in the vas deferens tube (the duct that transports sperm)
    • Erectile dysfunction

    Another thing to be aware of is varicocele, a swelling in the veins that leads to an accumulation of blood. This condition can sometimes affect male fertility. The good news is that it can be treated, improving the chances of conception.

    Undiscovered medical problems

    While getting pregnant may seem like it should be easy, it’s a very complex process that requires more than just a sperm meeting an egg. Underlying or undiagnosed health issues, such as an untreated sexually transmitted infection or thyroid issues, could be causing issues.

    Whenever you are having difficulty conceiving, getting a complete physical and any necessary tests from your doctor is always a good idea to rule out an underlying issue.

    Age-related infertility

    Female fertility starts to decline around the age of 30. This is because as you age, so do your ovaries and their eggs. In fact, mothers aged 35 or older are considered to be of “advanced maternal age by current obstetrical standards. However, there are many reasons people choose to have children later, and the birth rate for women over 35 has been steadily increasing for decades. So it’s certainly not impossible to have a child after this age! 

    Body weight

    Your weight can affect your ability to get pregnant, too. One review found that the risk of infertility can increase for overweight women, while on the other hand, a low BMI could also affect your menstrual cycle and make it harder for you to ovulate, which is essential for getting pregnant. 

    It’s worth noting that your weight isn’t a perfect measurement to assess your health or fertility, which are both impacted by several factors. If you have any concerns, it’s a good idea to speak to your doctor.

    Uterine abnormalities 

    Uterine abnormalities could also impact fertility. For example, some women may have an unusually shaped uterus that formed before birth. This could affect their ability to get pregnant or carry a baby to term

    However, it is possible for women with a uterine abnormality to have a successful pregnancy. So if you’ve been diagnosed with a uterine abnormality and want to get pregnant, speak to your doctor for their advice. 

    Medication 

    Not all medications have been studied for their impact on fertility, but most medicines are generally safe and won’t affect your fertility. There could be some exceptions though. 

    Your doctor is always the best person to determine the benefits and risks of taking medication when you’re trying to conceive. Even if you’re already taking prescription drugs, don’t stop without first talking to your doctor. Stopping abruptly can be dangerous, and continuing your medication might be the best option for you and your potential future little one. 

    Cancer treatment 

    Some forms of cancer treatment can impact your chances of having a baby. Your doctor will discuss the potential risks of any treatment options based on factors like your fertility status, age, and type of treatment. The good news is that there are options available to help preserve fertility before undergoing cancer treatment, such as egg or embryo freezing. 

    What is infertility?

    Infertility is defined as not getting pregnant after a year of trying (having regular unprotected sex) for those under the age of 35, or six months for those over the age of 35. While this can be a difficult diagnosis to receive, keep in mind that there are treatment options and lifestyle tweaks you can make to still have a high chance of conceiving in the future. There are many treatment options to consider, which we’ll look at later on in this article.

    Types of infertility

    There are two types of infertility:

    Stress, anxiety, and infertility: Is there a connection? 

    This is currently unclear. Researchers aren’t entirely sure whether stress can cause infertility, but it might make it harder to get pregnant. Similarly, having anxiety might mean it takes you longer to get pregnant. Always reach out to your health care provider if you want advice or support on stress and anxiety or if you think they’re impacting your ability to get pregnant.

    When to see a doctor 

    As we’ve seen, there are many instances when it’s a good idea to speak to your doctor if you’re struggling to conceive. As a reminder, if you’re under 35 and have been trying to conceive for a year without success, then it’s time to reach out to your doctor. If you’re over 35, reach out to your doctor after six months of trying.

    If you’re one of the 48 million couples globally that are struggling with infertility, it’s perfectly normal to feel confused or like your body is failing you. However, keep in mind that there are many treatment options available. If you’re wondering why you can’t get pregnant, then talking to your doctor can be the first step toward getting answers.

    Fertility treatment options

    Trying to conceive can be a challenging and emotional journey, especially when dealing with infertility. Luckily, there are many different treatment options out there. 

    The type of treatment you receive will depend on a number of things, including the underlying reason for your infertility. Your health care provider may recommend

    • Lifestyle tweaks (more on these below)
    • Medications that could stimulate ovulation 
    • Surgical procedures to address any reproductive system irregularities, such as blocked uterine tubes or endometriosis
    • Assisted reproductive technology, such as in vitro fertilization

    Tips for a healthy lifestyle that promotes fertility

    While some causes of infertility can’t be controlled, there are some things you can do to help improve your chances of conceiving.

    • Cut out alcohol. Experts recommend that there is no safe amount of alcohol to drink during conception or when pregnant. 
    • Stop smoking. Smoking can be a major factor in fertility issues for men and women, leading to issues with hormone production, damage to the reproductive system, and damage to sperm DNA. It can also increase ectopic pregnancy rates by slowing egg transport through the uterine tubes.
    • Avoid drugs. Recreational drugs like cocaine and marijuana can decrease sperm count and motility.
    • Look after your weight. Both being underweight and overweight have been linked to problems conceiving. 
    • Get regular STI checkups. When left untreated, some sexually transmitted infections (STIs) can lead to complications that cause infertility, specifically uterine tube damage.

    FAQs

    What is the most common reason for not getting pregnant?

    As we’ve seen, there are many different reasons for not getting pregnant, from issues with ovulation to conditions such as endometriosis and male factor infertility. Always reach out to your health care provider for advice if you’re struggling to conceive.

    How do you test if a woman is infertile?

    If a woman is having difficulty getting pregnant, doctors may run some tests to help figure out what’s going on. This is likely to begin with general physical and gynecological exams. Following this, there are a variety of tests that doctors might use, such as a blood test to check ovulation or hormone tests to check your hormone levels. The tests offered to you will depend on your specific situation.

    How common is infertility in your 20s?

    Biologically speaking, your 20s are one of the best times to conceive. However, infertility can affect anyone, and other factors such as tubal issues or low sperm count in the male partner can still impact fertility.

    How long is normal to be trying for a baby?

    Making a baby takes time! As we’ve seen, it’s normal for it to take up to a year. Try not to get discouraged if getting pregnant takes you longer than expected, and always remember that you can speak to your doctor for advice and support if needed.

    Does folic acid improve egg quality?

    There’s not enough evidence to suggest that folic acid helps you get pregnant. Nevertheless, experts recommend taking folic acid while you’re trying to get pregnant and in the first 12 weeks of pregnancy to help with your baby’s development.

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    History of updates

    Current version (26 September 2023)

    Reviewed by Dr. Tiffanny Jones, Fertility specialist, Conceive Fertility Center, Texas, US
    Written by Olivia Cassano

    Published (12 August 2019)

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