Why Are You Not Getting Pregnant? 10 Possible Reasons

For a lot of couples, not getting pregnant despite repeated attempts may be frustrating. But before you conclude that either or both of you have a fertility problem, you should know that for a healthy couple with zero fertility complications, there is only a 25 percent chance of getting pregnant each month, which means that it can take 4 months or longer to conceive. Meanwhile, take a look at the 10 possible reasons you aren’t pregnant yet, beginning with the most benign and easily reversible one.

1. Mismatch Between Ovulation And Intercourse

If you have thought about family planning, it’s unlikely that you haven’t considered this aspect. Having sex on the day of ovulation may not be beneficial. The best day to have sex is the day before your ovulation. This gives the sperm to reach the fallopian tube and wait for the egg. While the sperm can live for 5 days inside your body, your egg is viable for 24 hours only. To increase the chances of conception, counting the first day of your last period as day 1, have sex from day 7 to day 20.

2. Use Of Commercial Lubricants

[pullquote]Commercial lubricants can slow down your partner’s sperms by 60 percent. Use natural lubricants like canola oil or depend on foreplay.[/pullquote]

Once you have decided to have a baby, you may find that personal lubricants become almost a necessity because of the more than frequent lovemaking. But make sure they don’t come in the way of your efforts. According to a study, commercial lubricants were found to inhibit sperms from reaching the uterus and slowing them down by 60 percent.[ref]Kutteh, William H., Chun-Huai Chao, John O. Ritter, and William Byrd. “Vaginal lubricants for the infertile couple: effect on sperm activity.”International journal of fertility and menopausal studies 41, no. 4 (1995): 400-404.[/ref]

This was seconded by another study, which added damage to sperm DNA as an effect of commercial vaginal lubricants.[ref]Mowat, Alex, Cora Newton, Clare Boothroyd, Kristy Demmers, and Steven Fleming. “The effects of vaginal lubricants on sperm function: an in vitro analysis.” Journal of assisted reproduction and genetics 31, no. 3 (2014): 333-339.[/ref] Both studies recommend using a natural lubricant like canola oil if you needed to use any.

3. Smoking And Drinking

[pullquote]Smoking can reduce a woman’s fertility by half and delay conception by at least 6 months.[/pullquote]

That some of your habits or addictions are called vices should give you a heads-up on their potential effect on your body. Many studies have proven repeatedly that smoking and drinking too much coffee or tea and alcohol can delay conception in women.

A study conducted on 4,000 couples aged between 24 and 44 advises women who have difficulty conceiving to reduce if not stop smoking altogether to increase their chances of becoming a mother.[ref]Bolumar, F., J. Olsen, and J. Boldsen. “Smoking reduces fecundity: a European multicenter study on infertility and subfecundity.” American Journal of Epidemiology 143, no. 6 (1996): 578-587.[/ref] Women who smoked were found to have about half the fertility of non-smokers, and it delayed their times to conceive by 6 months to a year.[ref]Alderete, Ethel, Brenda Eskenazi, and Robert Sholtz. “Effect of cigarette smoking and coffee drinking on time to conception.” Epidemiology 6, no. 4 (1995): 403-408.[/ref]

In another study of over 10,000 participants, it was found that women who smoked also consumed more coffee or tea, both of which were delaying their conception times greatly. Similar results were found for moderate to heavy alcohol consumption.[ref]Olsen, Jørn. “Cigarette smoking, tea and coffee drinking, and subfecundity.”American Journal of Epidemiology 133, no. 7 (1991): 734-739.[/ref [ref]Grodstein, Francine, Marlene B. Goldman, and Daniel W. Cramer. “Infertility in women and moderate alcohol use.” American Journal of Public Health 84, no. 9 (1994): 1429-1432.[/ref] Even in men, cigarette smoking and alcohol consumption have been found to have negative effects on sperm density and semen quality.[ref]Adashi, Eli Y., Marilyn F. Vine, Barry H. Margolin, Howard I. Morrison, and Barbara S. Hulka. “Cigarette smoking and sperm density: a meta-analysis.”Fertility and sterility 61, no. 1 (1994): 35-43.[/ref] [ref]Martini, Ana Carolina, Rosa Inés Molina, Daniel Estofán, Daniel Senestrari, Marta Fiol de Cuneo, and Rubén Daniel Ruiz. “Effects of alcohol and cigarette consumption on human seminal quality.” Fertility and sterility 82, no. 2 (2004): 374-377.[/ref]

So it’s best to cut down on all your and your partner’s vices, at least while you are attempting to get pregnant.

4. Lack Of Vitamin D In Winter

[pullquote]Lack of vitamin D could delay pregnancy.[/pullquote]

Yes, your chances of conception during winter may be going down because you are not getting enough of the sunshine vitamin, vitamin D.[ref]Lerchbaum, Elisabeth, and Barbara Obermayer-Pietsch. “Mechanisms in endocrinology: Vitamin D and fertility: a systematic review.” European Journal of Endocrinology 166, no. 5 (2012): 765-778.[/ref] Almost 41.6 percent of Americans don’t get enough of this vitamin, which plays a crucial role in stimulating and balancing sex hormones.[ref]Forrest, Kimberly YZ, and Wendy L. Stuhldreher. “Prevalence and correlates of vitamin D deficiency in US adults.” Nutrition research 31, no. 1 (2011): 48-54.[/ref] [ref]Kinuta, Keiko, Hiroyuki Tanaka, Tadashi Moriwake, Kunihiko Aya, Shigeaki Kato, and Yoshiki Seino. “Vitamin D Is an Important Factor in Estrogen Biosynthesis of Both Female and Male Gonads 1.” Endocrinology 141, no. 4 (2000): 1317-1324.[/ref] Your vitamin D deficiency may mean that you take longer to conceive or it could even expose you to a higher risk of miscarriage.

5. Unhealthy Body Weight

[pullquote]Not just obesity, being underweight can also hinder pregnancy.[/pullquote]

Studies say that being underweight or overweight can reduce your chances of conceiving or delay pregnancy.[ref]Green, Beverly B., Noel S. Weiss, and Janet R. Daling. “Risk of ovulatory infertility in relation to body weight.” Fertility and sterility 50, no. 5 (1988): 721-726.[/ref] In underweight women, there’s damage or irregularities in the hypothalamus. This leads to problems in the functioning of organs that are controlled by the pituitary gland – most important here being the ovary – which might manifest as amenorrhoea or lack of menstruation.

In obese women, this delay is often associated with the inability of estradiol, an estrogen, to bind to a protein called sex-hormone binding globulin. Only in this combined form can it be transported to the part of the brain that controls the reproductive organs and to other sex hormone receptor cells throughout the body.[ref]Grodstein, Francine, Marlene B. Goldman, and Daniel W. Cramer. “Body mass index and ovulatory infertility.” Epidemiology (1994): 247-250.[/ref] It’s been found that weight loss could bring about an 80 percent improvement in the menstrual function in obese women.[ref]Hollmann, Michaela, Benno Runnebaum, and Ingrid Gerhard. “Infertility: Effects of weight loss on the hormonal profile in obese, infertile women.”Human reproduction 11, no. 9 (1996): 1884-1891.[/ref]

6. Stress

[pullquote]Excessive amount of cortisol interferes with ovulation.[/pullquote]

When it comes to fertility issues, stress can be both a cause and/or an effect of infertility. The pressure to have a baby at a certain age and the pressure that accompanies the possibility of infertility come crashing down upon the woman, and this sets off a vicious cycle.

A 2006 study reported finding an excessive amount of cortisol, the stress hormone, in the brain fluids of women who did not ovulate.[ref]Brundu, Benedetta, Tammy L. Loucks, Lauri J. Adler, Judy L. Cameron, and Sarah L. Berga. “Increased cortisol in the cerebrospinal fluid of women with functional hypothalamic amenorrhea.” The Journal of Clinical Endocrinology & Metabolism 91, no. 4 (2006): 1561-1565.[/ref] Of the 16 women who were studied, 8 were given basic cognitive behavioral therapy and the rest no treatment at all. In 20 weeks, 80 percent of those who underwent therapy started ovulating again and 2 months later, 2 of them became pregnant.

A study that dates back to the 90s has already explained this connection. The stress hormones and our central stress response system, i.e. the hypothalamic-pituitary-adrenal axis, interfere with the hormones that are responsible for normal ovulatory cycles, putting a stop to the normal ovulation process.[ref]Schenker, Joseph G., Dror Meirow, and Eran Schenker. “Stress and human reproduction.” European Journal of Obstetrics & Gynecology and Reproductive Biology 45, no. 1 (1992): 1-8.[/ref]

Take a break, talk to a professional or someone you trust and start concentrating on other things for a while.

7. Thyroid Problems

[pullquote]Hypothyroidism leads to delayed and improper egg follicle maturation, and hyperthyroidism disrupts your periods.[/pullquote]

Women with hypo- or hyperthyroidism can find a disruption in their reproductive hormone balance, say studies. Thyroid disorders can wreak havoc in your menstrual cycle through problems like irregular periods, scanty bleeding, or flooding.

Patients with severe hyperthyroidism showed a higher prevalence of secondary amenorrhea or hypomenorrhea, which is a disruption or a total absence of menstruation for 3 or more months.[ref]Kakuno, Yoko, Nobuyuki Amino, Maki Kanoh, Miho Kawai, Miyuki Fujiwara, Misao Kimura, Ayako Kamitani et al. “Menstrual disturbances in various thyroid diseases.” Endocrine journal 57, no. 12 (2010): 1017-1022.[/ref]

Low levels of thyroid function is associated with lower degree of estrogen and progesterone secretion and, hence, delayed or improper egg follicle maturation.[ref]Acharya, Neema, Sourya Acharya, Samarth Shukla, S. A. Inamdar, M. Khatri, and S. N. Mahajan. “Gonadotropin levels in hypothyroid women of reproductive age group.” The Journal of Obstetrics and Gynecology of India 61, no. 5 (2011): 550-553.[/ref] It has also been linked with ovarian cysts, which can be another reason you aren’t able to conceive.

Fret not, you aren’t the only one. An estimated 20 million American women suffer from some kind of thyroid disorder, and 1 in 8 women has hypothyroidism. So the only way to go about is the straightforward one of taking routine treatment for hypothyroidism.

A 2012 study found that of 394 hypothyroidism patients interviewed, almost 76 percent conceived in 6 months to a year after undergoing treatment.[ref]Verma, Indu, Renuka Sood, Sunil Juneja, and Satinder Kaur. “Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.” International Journal of Applied and Basic Medical Research 2, no. 1 (2012): 17.[/ref]

8. PCOS

[pullquote]Across the world, about 10 percent women of childbearing age and 20–30 percent Caucasian women are rendered infertile by PCOS.[/pullquote]

Do you have irregular period cycles, heavy flow, excess body or facial hair but hair loss from the scalp, and excess body weight? These are symptoms of polycystic ovarian syndrome or PCOS. It can be confirmed by an ultrasound of your ovary. PCOS can be the reason for your failure to conceive despite multiple attempts. In women with PCOS, the higher than normal level of male hormones, specifically testosterone, and low levels of progesterone negatively affect the development of egg follicles and the release of the egg during ovulation. One of its obvious results is infertility.

A study claims that worldwide, about 10 percent of women in the reproductive age group suffer from this disorder, with the percentage rising to 20 to 30 in Caucasian women.[ref]Patki, Ameet. “Polycystic ovarian syndrome in infertility.” Sri Lanka Journal of Obstetrics and Gynaecology 34, no. 3 (2012).[/ref] Of the 10 percent, approximately two-thirds do not ovulate on a regular basis and require treatment for ovulation induction.[ref]Hart, R. “PCOS and infertility.” Panminerva medica 50, no. 4 (2008): 305-314.[/ref] There’s no reason to lose all hope, though. PCOS can be managed, and a good OB-GYN can help you plan your pregnancy despite the condition.

9. Toxins Like BPA And PCB

[pullquote]Plastics containing BPA can reduce your egg count by 24 percent.[/pullquote]

Many things that you use on a daily basis may be exposing youto harmful toxins – think of plastic water bottles, food cans, and even cash receipts. Increased contact with such things leads to the increased absorption of an estrogen-mimicking plastic-softening chemical called bisphenol A or BPA.

In a study at the Massachusetts General Hospital Fertility Center, it was found that patients with high BPA levels produced 24 percent fewer eggs than average, of which 27 percent fewer could be fertilized.[ref]Mok‐Lin, E., S. Ehrlich, P. L. Williams, J. Petrozza, D. L. Wright, A. M. Calafat, X. Ye, and R. Hauser. “Urinary bisphenol A concentrations and ovarian response among women undergoing IVF.” International journal of andrology 33, no. 2 (2010): 385-393.[/ref]

Another toxin to look out for is PCB or polychlorinated biphenyl which, if present in either of the partners’ blood, decreases the odds of getting pregnant. Traces of PCB are nearly everywhere, but a major source is animal fat, especially meat and fish broth. Increased meat consumption (the study does not include beef, though) has also been linked to decreased semen quality in men.[ref]PCBs, other pollutants may play role in pregnancy delay. National Institute of Health.[/ref]

10. Radiation From Mobile Devices

[pullquote]Laptops connected to the Wi-Fi when kept on the lap can make sperms immobile and damage their DNA.[/pullquote]

This is more of a concern for men as studies have found that electromagnetic radiation from cellphones can cause sperm damage, especially if you are used to carrying the device in your pocket or close to your reproductive organs.[ref]EWG’s Guide to Safer Cell Phone Use: Cell Phone Radiation Damages Sperm, Studies Find. EWG.[/ref]

This can be attributed to the heat generated, causing a rise in temperature in the scrotum and the testes, which affects sperm production and development and fertility, even if the rise is by 1–2.9°C. A study found that even 15 minutes of working on a laptop while keeping it on the lap increases the temperature in the scrotum by 1°C. In the study itself, after two separate 60-minute sessions, the left scrotal temperature increased by a median 2.6°C and the right by a median 2.8°C.[ref]Sheynkin, Yefim, Michael Jung, Peter Yoo, David Schulsinger, and Eugene Komaroff. “Increase in scrotal temperature in laptop computer users.” Human Reproduction 20, no. 2 (2005): 452-455.[/ref]

Further to this, another study that tried to find the exact magnitude of damage caused found that a laptop connected to Wi-Fi causes further damage. When sperms isolated from test subjects were kept under a laptop connected to Wi-Fi, it turned out that 25 percent of the sperm had become immobile and 9 percent had DNA damage.[ref]Avendano, Conrado, Ariela Mata, César A. Sanchez Sarmiento, and Gustavo F. Doncel. “Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation.” Fertility and sterility 97, no. 1 (2012): 39-45.[/ref]

Trying to get pregnant can be stressful. But listen to your body, read the signs it gives you, and seek medical help if the following factors check out:

• You are under 35 and haven’t conceived after a year of regular unprotected sex without birth control.
• You are 35 or older and have not been able to conceive after 6 months of frequent sex without birth control.
• You believe that either or both of you may have fertility-related problems. One-third of all infertility cases rise out of the woman’s reproductive health issues, one-third because of the man’s, and one-third can be attributed collectively as a couple.[ref] Dr. Philip B. Imler and David Wilbanks, The essential guide to getting pregnant. American Pregnancy Association.[/ref]
• You or your partner has low sex drive.[ref]Pregnancy. U.S. Department of Health and Human Service.[/ref]