Article supervised by the medical team of the IVF-Life clinic

It’s not easy to stay optimistic when you want to become a mother and it just won’t work. The hope of eventually getting there, going to the doctor and trying to get pregnant is associated with intense and also frustrating feelings. In these moments, you may ask yourself: Why am I not getting pregnant? The answer to this question is that fertility can be affected by various reasons.

A pregnancy that does not occur naturally is something that affects two people. When a couple tries to get pregnant but the dream of becoming pregnant does not come true, it is often the woman who asks herself, “Why am I not getting pregnant?”. Usually, it is the woman who takes all the responsibility, even though this is not justified.

The question that many couples facing this situation should ask themselves is: at what point should we start worrying and what can we do? In this article, we will talk about the possible causes of infertility and what to do if the dream of having a child remains unfulfilled.

Recognising fertile days and knowing when pregnancy is likely to occur

If you want to get pregnant, it is very important to be able to identify your fertile days. Some women are not aware of their own cycle or do not know on which days they ovulate. However, it is important to know this.

Ovulation occurs about 13-15 days before your period starts. Like your menstruation, the timing of ovulation can vary from cycle to cycle. Sometimes there may be no ovulation at all.

Although ovulation takes two to three days, you may become pregnant if you have unprotected sex before this time. Sperm survive in a woman’s body for 48 to 72 hours, so if you have had intercourse two or three days before ovulation, the sperm may be waiting for the egg to fertilise.

When to consider fertility consultation?

Another question to ask yourself is when you should think about seeking help. Should you make an appointment for a consultation as early as possible or is it perhaps better to wait rather than rush?

At IVF-Life, we advise you to see a specialist in the following situations:

• Between the ages of 30-35: After one year of unprotected sexual intercourse during the fertile period without getting pregnant.
• At the age of 35+ years: After 6 months of unprotected sexual intercourse during the fertile period without becoming pregnant.

Female factor: age

Age is one of the most important factors affecting a woman’s fertility. This is because from the age of 35 onwards it becomes increasingly difficult for women to conceive naturally because both the ovarian reserve and the quality of the oocytes decrease, which can also result in an increased number of chromosomal abnormalities in the eggs.

An important reference point for ovarian reserve is a fertility test, which measures AMH (anti-mullerian hormone) levels. This hormone is produced in the follicles where the oocytes are stored.

Why am I not getting pregnant? – Other possible causes

As mentioned previously, age is an important factor for female fertility, but there are many other factors that can make it difficult to get pregnant. The most common reasons for infertility are the following:

• Quality of the endometrium

  The endometrium is a crucial factor in achieving pregnancy. Therefore, it is of great importance to perform a personalised diagnosis to determine the receptivity of the endometrium during the implantation window. At IVF-Life we perform the ER Map test to determine the best time for embryo transfer.

• Endometriosis

  Endometriosis is one of the leading causes of infertility. Endometrial tissue grows outside the uterus preventing a normal development of the pregnancy.

• Poor oocyte quality 

  Poor oocyte quality is a condition that is often age-related and usually occurs after the age of 35. However, it can also occur in young women due to a medical condition or medication that affects the oocytes. Patients with poor egg quality have a higher rate of structural chromosome abnormalities. With the help of pre-implantation genetic diagnosis (PGS) you can be sure that only the best embryo will be transferred. This increases the success rate of pregnancy.

• Ovulation disorders

  This occurs when the eggs do not mature or the ovaries do not release the mature eggs.

• Fallopian tube blockage

  A change in the fallopian tubes that affects their patency and freedom of movement. Causes of tubal occlusion include pelvic inflammatory disease or sexually transmitted infections. Hysterosalpingography (HSG) is one of the most important examinations for diagnosing this type of infertility.

• Polycystic ovary syndrome

  Polycystic ovarian syndrome is a condition in which a woman has very high levels of hormones (androgens) that make it difficult for the ovaries to release mature eggs. This condition can be diagnosed with a simple ultrasound scan at a routine annual check-up.

• Lifestyle

  There is a possibility that the results of the various tests are normal, preventing the specialist from identifying the medical cause of infertility and answering the question “Why am I not getting pregnant?” The cause could stem from various habits that affect fertility, such as obesity, excessive caffeine consumption, smoking or constant stress.

Male factor 

It is evident that men are also an important factor. The most common causes of infertility in men are:

• • Stress
  • Obesity
  • Smoking
  • Premature ejaculation
  • Diseases such as benign prostatic hyperplasia
  • Problems with the urethra or vas deferens
  • Problems with the production and quality of sperm. At IVF-Life we check this parameter through various tests, such as the spermiogram.

When should you consider assisted reproduction treatment?

As mentioned above, a young couple who has been trying to conceive and has not been able to get pregnant should see a specialist after around one year. This time period should be reduced if the woman is older or if the man is over 40.  After the appropriate examinations have been performed, In vitro fertilisation treatment (the egg is fertilised in the laboratory by the partner’s or a donor’s sperm) or artificial insemination (A previously in the laboratory prepared amount of sperm is inserted into the woman’s uterus) is recommended, depending on each case.

It is important that in the case of a heterosexual couple, a full examination of both parties is performed, as the causes of infertility are evenly distributed between 40% in men and 40% in women, while the remaining 20% are of unknown origin.

The right information is crucial 

At IVF-Life, we have adapted to the digital world we live in and we know that communication and reliable information are very important.

With an initial online consultation you can discuss all your doubts about your fertility with a specialist at our clinic. During this online consultation, we will prepare a digital medical history with you, including your entire medical history, and, if desired, we will arrange a face-to-face visit, where we can perform all the specific and necessary tests that we have described in today’s article, in order to find an answer to your question: Why am I not getting pregnant?