If you’re reading this article, you’re probably struggling with your fertility.
Wanting to get pregnant and not being able to is one of the hardest things you can go through. Though this experience is shared among millions around the world, when you’re going through it yourself it can feel very isolating.
So why aren’t you getting pregnant?
There are many possible answers to this question. Medical conditions, lifestyle factors, and problems with your partner's sperm can all play a role.
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Based on your answers, these are the things that could be preventing you from getting pregnant.
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Ovulation is the name used to describe the event when an egg is released from the ovary ready to be fertilized by a sperm. This takes place in the middle of your cycle, roughly 2 weeks after the start of your period. However, ovulation can take place anywhere between days 11 and 21, depending on the length of your cycle.
When we consider that after ovulation, an egg is only viable for 24-48 hours, it’s important to make sure you know exactly when you have ovulated so you can time intercourse accordingly.
Some symptoms typically associated with ovulation include increases to body temperature, tender breasts, mild lower stomach pains, changes to your cervical mucus consistency, and changes in your sex drive. If you have any of these symptoms, you may well have ovulated.
To maximize your chances of getting pregnant, make sure you’re having regular intercourse between days 7 and 21 of your cycle. To pinpoint the exact moment of ovulation, you can use an ovulation testing kit. These tests track the level of a hormone called LH in your urine. At the time of ovulation, concentrations of the hormone become sky-high, indicating that an egg has been released.
By timing sex with your ovulation you can give yourself the best shot of getting pregnant.
Your ovaries play an essential role in pregnancy. They support the eggs as they develop and mature, with one specially selected egg being released each month when you ovulate. If your ovaries are not functioning properly, it can be almost impossible to get pregnant.
PCOS, or polycystic ovary syndrome, is a common condition that can stop your ovaries working normally by interfering with ovulation and stopping you getting pregnant. Caused by an imbalance of hormones within your body, PCOS is characterized by three main symptoms. These are:
- Irregular periods. This can make it difficult to know when you have ovulated.
- Excessive facial or body hair. This is caused by an increased concentration of the ‘male’ hormone testosterone.
- Polycystic ovaries. Your ovaries may become large and filled with small fluid-filled follicles.
To be diagnosed with PCOS, you must exhibit two or more of the above symptoms. The causes of PCOS are still not completely understood, however, it often runs in families. You are also more likely to have PCOS if you are overweight due to the effect this can have on hormones, like insulin, within your body.
Unfortunately, there is currently no cure for PCOS. However, there are some treatments that can be used to ease your symptoms.
To help you ovulate regularly, your doctor may recommend that you take a medication like Clomifene. If medicine doesn’t prove effective, a surgery called laparoscopic ovarian drilling may help.
If you’re overweight, losing weight and ensuring you’re eating a healthy diet could reduce the severity of your symptoms. With help, many women with PCOS are able to get pregnant.
Blocked Fallopian Tubes
Fallopian tubes are an important part of the female reproductive system. They connect the ovaries to the uterus and are the site where fertilization happens. If these tubes become blocked, the route the sperm take to fertilize an egg will be closed off, making it difficult for them to meet.
If only one of the fallopian tubes is closed, the blockage shouldn’t stop you from getting pregnant as an egg can still move through the open tube and be successfully fertilized. When both tubes are fully blocked, the sperm will be unable to fertilize the egg and pregnancy won’t be possible without medical help.
If a tube is only partially blocked, an egg could be successfully fertilized, however, there is a risk that it could get stuck and implant in the fallopian tube instead of the uterus. This is called an ectopic pregnancy and requires immediate medical treatment.
Blockages can happen because of infections like chlamydia or conditions like endometriosis that cause scar tissue and adhesions that stick the two sides of the fallopian tube together.
To test whether you have closed tubes, your doctor may want to perform something called a hysterosalpingogram. This is a procedure that involves injecting a special dye into your womb. An x-ray is then used to see whether the dye gets stuck in your tubes at any point. If the dye gets stuck, you have a blockage in your tube.
If the blockages in the fallopian tubes are not too severe, they may be able to be re-opened with a surgery called a salpingostomy. This is not always successful, however, and the tubes may reseal after the surgery. This surgery is also not typically performed on women who have a lot of scar tissue in their tubes. If surgery is not an option, or if surgery is unsuccessful, you will need to seek fertility treatment to help you get pregnant.
A healthy, working uterus is essential for maintaining a successful pregnancy. It is where a fertilized egg will implant and grow into a baby. Problems in your uterus can negatively impact your chances of getting pregnant.
The uterus is lined by a specialist tissue that is not usually found anywhere else in the body. This tissue changes throughout your menstrual cycle in response to shifting hormones. Around the time of ovulation, the womb lining is thick and spongy, ready to receive a fertilized egg. If this doesn’t happen, the womb lining will break down, resulting in a period. This cycle of lining thickening and breaking down will reoccur each month unless a pregnancy occurs.
In women with endometriosis, this specialist uterine tissue starts to grow in other areas of the reproductive tract too. This tissue will still thicken and break down just like it would if it were in the uterus, however, the resulting period is unable to leave the body. Because of this, inflammation happens, leading to scar tissue and adhesions.
Scar tissue and adhesions are bad news for fertility. They can cause fallopian tube blockages and prevent proper blood flow to the ovaries, reducing egg quality. When on the ovaries, endometriosis may cause blood-filled cysts called endometriosis to develop. These cysts can reduce the number of eggs available and cause hormone imbalances that negatively impact egg development.
There is not currently a cure for endometriosis. Some women find success through surgery to remove the out of place uterine tissue, but unfortunately, some find that endometriosis reoccurs post-surgery.
Fibroid and Polyps
Fibroids are non-cancerous growths made of thick muscle and fibrous tissues. These can vary in size from small to very large and are found in or around the uterus. Polyps are small growths made from endometrial tissue that attach to the wall of the uterus. They may or may not be cancerous.
If either a fibroid or polyp grows too large, or you have multiple growths within the uterus, they can stop a fertilized egg from being able to implant into the uterus wall and therefore prevent you from getting pregnant. If your doctor finds large growths within your uterus, they may opt to remove these through surgery to maximize your chances of getting pregnant.
If you had ever had a gynecological procedure, the chances are it was in the hopes of improving your fertility. This could involve having polyps or fibroids removed, or a surgery to help alleviate symptoms of endometriosis. Unfortunately, some gynecological procedures carry risks of reducing your chances of pregnancy.
If you have been diagnosed with a HPV infection, your doctor may recommend having the abnormal cells removed to limit your risk of developing cervical cancer. Clearly this procedure is beneficial for the long-term health of a woman, but having these cells removed can have implications for your fertility. It can change your ability to produce cervical mucus and can cause the opening of the cervix to narrow. Both side-effects make it more difficult for the sperm to reach the egg.
Whenever you have a procedure undertaken on your genital tract, there is always a risk that it will impact your fertility. If your doctor has recommended a procedure for you, make sure you discuss all possible implications on your chances of getting pregnant.
Hormones are essential for both female and male fertility. Signals are sent from the brain to the ovaries and testicles to encourage them to produce healthy eggs and sperm. In women, hormones are heavily involved in the regulation of the menstrual cycle and making sure the uterus is a healthy environment to receive a fertilized egg.
Progesterone is a hormone that is key for promoting successful egg implantation and ensuring a healthy pregnancy. The amount of this hormone rises soon after ovulation and thickens the uterus lining ready to receive a fertilized egg. If your progesterone levels are too low, it can stop the egg from implanting as the womb lining will be too thin. Some women with low progesterone will get pregnant but find they suffer an early miscarriage. If you have low progesterone you can take progesterone supplements to help support your reproductive system.
Low LH and FSH
LH and FSH are hormones released by your brain that interact with your ovaries to stimulate follicle growth and egg development. If your brain is not producing adequate levels of these hormones, the ovaries will not get the signal they need, your eggs will not develop, and you will not ovulate. Low levels of LH and FSH may suggest a disorder in the region of your brain called the pituitary gland and may require further investigation to make sure nothing is going on. Hormonal treatment should help you reach normal levels of these chemicals.
Pre-Existing Medical Conditions
Although we may not always think about the different parts of our body being linked to one another, they most definitely are. If one area of your body is out of whack, it’s likely to have implications for other regions too. Many pre-existing medical conditions, such as diabetes and thyroid disorders, can reduce your chances of getting pregnant by changing hormone levels and altering egg quality. If you have a pre-existing medical condition, please speak with your doctor to see whether it may be having an impact on your fertility.
Unfortunately, some of the medication that we rely on can have a negative effect on our chances of getting pregnant by causing irregular periods and altering hormone levels. If you have been taking a medication for an extended period, please speak with your doctor to see whether it may be affecting your fertility.
Unhealthy Uterus Microbiome
In recent years, there has been increased interest in looking at the microbiome of the uterus as a potential reason why someone cannot get pregnant. It is believed that if the microbiome is unbalanced, the inflammatory response may be triggered, which can stop implantation from happening. Tests such as EMMA have started to be offered in fertility clinics to assess the health of women’s uterine microbiome. If the microbiome is thought to be unbalanced, she can be prescribed certain probiotics such as Lactobacillus to try and improve the environment of her uterus.
If you’re having trouble getting pregnant it could be due to the quality of your eggs.
When we talk about ‘quality’, what do we mean? Typically, when we’re talking about egg quality, we’re referring to their genetic make-up.
A healthy, normal egg will have half the genetic information, called chromosomes, that a normal body cell would contain. If an egg does not develop properly, it may have an incorrect number of chromosomes within it and it will be called ‘aneuploid’.
If an aneuploid egg is fertilized it will develop into an aneuploid embryo. Aneuploid embryos do not usually result in a successful pregnancy and will either not implant or will result in an early miscarriage. A notable exception to this is people with Downs syndrome, who have one extra chromosome but can live normal, happy lives.
The main factor that leads to decreased egg quality is increased age, although other factors such as having had chemotherapy can also have an effect. If you choose to have IVF and are worried you may be at risk of reduced egg quality, you can opt to have something called preimplantation genetic screening (PGT). PGT tests eggs and embryos for genetic quality so only the healthy ones are used for pregnancy.
Maybe It's Not You, It's Him
Across the globe we are experiencing a male fertility crisis. In the past 40 years, sperm counts have more than halved and experts are concerned we will continue along this downwards trajectory.
Poor quality sperm can prevent pregnancy and even cause miscarriages. It happens more than most people think. Although society used to assume infertility was mostly the woman's fault, men and women are equally likely to cause infertility.
Some cases of male infertility can be attributed to things that cannot be controlled, such as genetics and hormones.
However, specialists believe that a large proportion of men experiencing decreased sperm quality seen over the past few years are due to changes in lifestyle. Smoking, being overweight, pollution, chemical exposure, and stress can all have a detrimental effect on sperm quality and quantity.
In recent years, scientists have been looking into a particular group of chemicals and their impact on both male and female fertility. Endocrine-disrupting chemicals, or EDCs for short, are substances that interfere with our endocrine systems. The endocrine system is extremely important, controlling many parts of our body. One primary role of the endocrine system is to help maintain healthy reproductive systems in both men and women.
When we come into contact with Endocrine Disrupting Chemicals, they play havoc with our bodies and throw our endocrine systems out of whack. The result of this in men is reduced sperm quality, sperm number, and increased damage to their sperm’s DNA. In women, EDCs can influence menstrual cycle length and speed up the menopause. Exposure to EDCs in the womb can have lifelong implications for boys, altering their sexual development by decreasing the level of testosterone they come into contact with.
Unfortunately, Endocrine Disrupting Chemicals are everywhere. From the cosmetic products we put on our faces, to the plastic containers we microwave our dinners in, it’s almost impossible to avoid EDCs completely. There are however small changes you can make to your everyday life to minimize your exposure to EDCs, along with general improvements to your lifestyle which can maximize your chances of getting pregnant.
14 Ways to Boost Your Fertility
Although some of the things that influence your fertility cannot be fixed without a trip to your doctor, there are many ways all of us can improve our lifestyles to help boost our fertility. An easy rule of thumb is that what’s good for your heart, mind, and immune system is also good for your reproductive health.
Take a look at some of our suggestions below:
- Minimize your stress - the stress hormone, cortisol, can play havoc with your reproductive system. Try reducing the amount of stressful activities you do in a day by delegating responsibilities and saying no to non-essential requests. Try yoga or meditation as amazing stress-busting activities.
- Eat more healthy fats - A diet high in monounsaturated and omega-3 fatty acids has been shown to boost fertility in both men and women. Nuts, seeds, fish and olive oil are all great sources of these healthy fats. Watch out if you choose to eat a lot of oily fish, as they can be contaminated with PCBs which can be detrimental to your fertility. Opt for wild-caught salmon, mussels, rainbow trout and Atlantic mackerel to minimize your changes of exposure.
- Eat lots of fruits and vegetables - fruits and veggies are full of antioxidants which are key for promoting healthy sperm and fertility.
- Wash your fruits and veggies - Most fruits and vegetables will be treated with pesticides to stop bugs from eating them while they’re growing. Pesticides are damaging to sperm so make sure you wash all products before eating them.
- Steer clear of cigarette and marijuana smoking - both of these are really harmful to your eggs and sperm.
- Maintain a healthy weight - In both men and women, being overweight can interfere with your key fertility hormones. Keep your weight within healthy levels to promote good fertility.
- Get moving - whether you enjoy running, tennis or dance, keeping fit and active has been shown to boost your chances of getting pregnant.
- Keep it cool - your partner's testicles are on the outside of their body for a reason! Sperm like to be 2 degrees celsius colder than the rest of the body. Ask your partner to avoid activities like saunas, hot baths and long bike rides to keep their testicles feeling cool.
- Don't microwave plastic! - this is the biggest way you can get exposed to endocrine disrupting chemicals. Don't microwave plastic containers, even the ones that are 'microwave safe'. This becomes even more important when you (hopefully) get pregnant!
- Ditch the ready made meals - fertility-harming Endocrine Disrupting Chemicals (EDCs) can be found in a wide variety of ready made food products such as microwave dinners and canned goods. Generally, if food has a commercial, it's probably not very good for you.
- Scrap single use plastics – Limit your exposure to EDCs from plastics by opting for reusable cups, straws, plates, and cutlery.
- Look up EDC-Free cosmetic products - Some EDCs are used in personal care products as they help retain color and fragrance. A quick internet search will tell you which products are free from these harmful chemicals so you can limit your contact.
- Take vitamin supplements - Although a balanced diet should get you all the vitamins you need, it can be easy to miss out on a few key ones. By taking a multivitamin tablet once a day you can ensure you’re getting your recommended dose of fertility-boosting vitamins like vitamin D.
- Try ‘bioactive’ yogurts - yogurts high in a bacteria called Lactobacillus can help to promote a healthy uterus microbiome.