Why am I not Pregnant?

There are some potential causes of infertility include, which include:

1. Timing
2. Ovulation Issues
3. Semen/ sperm issues
4. Age- related issues
5. Fallopian Tube issues
6. Uterine issues
7. Birth Control

Timing

In order to become pregnant, sperm needs to come in contact with the egg during ovulation. Not every day of the month is fair game for this.

If you haven’t narrowed in on an exact ovulation window yet, you could just be trying to get pregnant at the wrong time during the month. Tracking menstrual cycles helps to address this issue.

It’s important to remember that even if you’ve determined when you ovulate it’s not a guarantee that sex during that time will result in pregnancy. A healthy 30-year-old has about a 20% chance of pregnancy each month.

Ovulation issues

If you’re not ovulating it can be nearly impossible to become pregnant. In cases like this, you can speak with a fertility specialist about additional tests and procedures, they can offer to help regulate and identify why ovulation isn’t occurring.

Semen/sperm issues

While it’s true those who do so can produce sperm their entire lives there is also a question of sperm quality. The number, shape, and motility (movement) of sperm can affect fertility. If there is a concern, your provider can do a sperm analysis.

Age-related issues

Generally speaking, a person with a uterus in their early 20s and 30s has a one in four chances of getting pregnant each month. After age 30, the chance of becoming pregnant decreases though, and by the time they are 40, they have a one in ten chances of getting pregnant each month.

By the time a person with a uterus is 45; their chances of becoming pregnant are very low.

The fertility of a person who produces sperm will also decrease with age, but that’s not as predictable as the decline of a person with a uterus.

Fallopian tube issues

Ovulatory cause accounts for about 25% of female infertility cases.⁵ The rest can have problems with blocked fallopian tubes, uterine structural problems, or endometriosis.

In case you don’t know, the fallopian tubes are the pathway between your ovaries and the uterus. The fallopian tubes do not directly attach to the ovaries. Sperm must swim up from the cervix, through the uterus, and into the fallopian tubes.

When an egg is released from the ovaries, hair-like projections from the fallopian tube draw the egg inside. Conception takes place inside the fallopian tube, where the sperm and egg finally meet.

Uterine issues

In order to become pregnant, the fertilized egg must implant in the uterus. A misshaped uterus or buildups of tissue in the uterus are two examples of things that can prevent this process from happening as expected.

Birth control

Some types of birth control can delay future fertility even if they are reversed or otherwise stopped.

Methods of birth control like condoms or the pill shouldn’t impact future fertility, but some, like the contraceptive shot, can delay fertility for months.

Other methods like tubal ligation or a vasectomy can have a long term impact on your fertility that may never be fully reversible.

Other medical issues

There are many medical issues that can impact your fertility. Some common ones include Polycystic Ovary Syndrome {PCOS} and Endometriosis. If you have a medical condition known to impact fertility, it’s important to speak with your doctor sooner rather than later.

You should also see a fertility specialist if you have a history of multiple miscarriages or are aware of a genetic or other medical condition that would impact your fertility.

In some cases, there may be unexplained infertility, a somewhat controversial diagnosis of exclusion. This means that even after testing there may not be an obvious cause to explain why you’re not getting pregnant.

Can you increase your chances?

If you’re frustrated with not being pregnant, but also not ready to see a fertility specialist just yet, there are some things you can do.

Pinpoint ovulation timing

You have your greatest chance getting pregnant if you have sex in the days before and during ovulation. If you want a baby, you’ll want to know when ovulation is occurring, so you can plan accordingly. To determine when you’re ovulating you can track your menstrual cycle:

• Take your basal body temperature, before getting out of bed — every morning, at the same time, using a special thermometer that can read to a tenth of a degree. Ovulation is typically detected by a slight temperature decrease and then a temperature increase for 3 days in a row.
• Look for changes in cervical mucus. Before ovulation, estrogen levels will rise, which can cause cervical mucus to increase and be thinner and more slippery. This is a sign that it’s a good sign to have sex if you want to conceive. When ovulation has occurred, cervical mucus will typically become cloudy, thick, and sticky.
• Use ovulation strip. These work a lot like pregnancy tests and can be purchased at your local drugstore. Tracking your ovulation by using basal body temperature and cervical mucus changes can help pinpoint when to begin using the test strips.

Request medical tests

If you’re not able to identify ovulation using the above methods, you can speak with your doctor about seeing a specialist. A fertility clinic can handle more involved testing, like blood hormone tests and ultrasounds of your ovaries to determine whether ovulation is occurring.

You may be tested over the course of your cycle to track hormones. They can also look for fallopian tube blockages or other uterine issues that may impact conception.

Focus on your overall health

Make lifestyle changes to get as healthy as possible and put yourself in the best position to be pregnant. If you don’t have regular periods, diet, exercise, and a healthy lifestyle can help your body to get in a better alignment.

You can actually meet with your O&G consultant before attempting to get pregnant to talk about any existing health problems and get screened for any genetic problems. Some suggestions for ways you can change your lifestyle include:

• working toward or maintaining a healthy weight
• avoiding caffeine, tobacco, alcohol, and drugs
• finding ways to manage or decrease stress
• taking prenatal vitamins