Why am I not getting pregnant?
Many factors can contribute to difficulty getting pregnant, whether you've never conceived before – known as primary infertility – or you're trying for a baby having already had at least one child – secondary infertility.
Could a disease or medical condition be the reason I can't get pregnant?
There are several conditions that could be preventing you conceiving. Many of them can be treated, if not cured.
Polycystic ovary syndrome or PCOS, Hughes syndrome (also known as 'sticky blood' or antiphospholipid antibody syndrome), thyroid disorders, endometriosis (where womb tissue grows outside of the womb itself), fibroids (benign tumours growing on the womb), pelvic inflammatory disease, and chlamydia (which can cause blocked fallopian tubes) are some of the disorders that mean you may have problems getting pregnant.
Make sure your GP knows that you are trying to conceive if you have thyroid problems, even minimal ones, as it affects your treatment.
Do you know when you're ovulating?
Can irregular periods stop you getting pregnant?
Hormones regulate your menstrual cycles so any hormonal imbalances can make your periods irregular. This has nothing to do with the length of your cycle (some Mumsnet users have reported 50-day cycles), although if your cycle is long you need to be more aware of when you ovulate – usually 14 days before the start of your period.
Irregular periods, however, can mean ovulation isn't taking place every month. This is known medically as anovulation and it can make it much harder to know when you're fertile. All this doesn't mean you won't get pregnant, but conception is a numbers game and so your chances decrease if ovulation doesn't occur every month.
Can a long luteal phase cause problems with conception?
Your luteal phase is the days between ovulation and your period starting. For most women this is around 12-14 days but if it's short, it may mean that although fertilisation takes place, the egg doesn't have time to implant securely in the womb lining before being lost in the next period.
Is my age stopping me getting pregnant?
The older you get, the slimmer your chances of conceiving (about the only thing that gets slimmer as you get older). That said, many women over 35 have healthy pregnancies and babies – and more people than ever are getting pregnant over 40 – so it's certainly not an impossibility, but things are likely to take a little longer.
Can your lifestyle stop you conceiving?
There are lots of 'lifestyle factors' that have been shown to have an effect on fertility. These include:
- Being over- or underweight
- Heavy drinking
- Taking drugs
- Lack of sleep
It's a good idea to have a thorough spring clean of your lifestyle before trying to conceive to ensure you're in the tippest of toppest good health.
Should my partner have a sperm count or fertility test if we aren't conceiving?
There are many factors that have an impact on male fertility and the quality and quantity of your partner's sperm can affect your chances of getting pregnant. Sperm production can be affected by untreated sexually transmitted infections, excessive heat (such as hot baths), smoking, drinking and taking drugs, mumps and injuries to the testicles.
Age also affects a man's fertility, though not to the same extent that it affects women's.
But sometimes the reason why there aren't enough healthy sperm for conception can't be found and it's simply a case of doing all you can to improve your lifestyle and keeping at it.
How long should I try to get pregnant before seeing a doctor?
All sorts of factors can affect how long it takes to get pregnant. Around 85% of women will get pregnant within a year, but if you're having difficulties, there is lots of help available. If you've been having regular, unprotected sex for a year with no success, it's worth paying a visit to your GP. If you're over 35 or have a known condition, such as endometriosis, you're advised to go after six months.
What fertility tests can be done for women?
Your GP will probably examine your pelvis to check for tenderness, which can be a sign of endometriosis or PID. He or she will also probably recommend a blood test to check your hormone levels for ovulation. They may then refer you for further tests and procedures, such as:
- Pelvic ultrasound – this uses high-frequency sound waves to create an image of your womb and ovaries
- Progesterone blood test – to check you're ovulating
- Chlamydia test – if it's positive, chlamydia can be treated with antibiotics
- Thyroid function test – it's estimated up to 5% of women experiencing problems conceiving have an abnormal thyroid
- Hysterosalpingogram – a type of X-ray of your fallopian tubes, to check for blockages
- Laparoscopy – a thin microscope is inserted under your skin to look more closely at your womb, ovaries and fallopian tubes
- Dye test – dye is injected through the cervix and then the person doing the procedure uses a laparascope to see whether there are any blockages
- The tests you'll be offered will depend on your medical history, for example whether you know you've had something like chlamydia or endometriosis.
I would prompt anyone who's failing to conceive to get to the GP asap. If anything is actually wrong with either of you, all the sex in the world on the right days isn't going to make a blind bit of difference. Best to know this, really. If all the tests come back fine, then not to worry – and if they don't then at least you know where you are and can plan accordingly.
What male fertility tests are done?
A GP will test the quality and quantity of a man's sperm. About one in 10 men has an abnormal result, so the test is usually repeated. About two in 100 men will have a second abnormal test.
The medical language to do with fertility and infertility treatments is hard to pronounce and pretty difficult to understand. For example, if you hear 'oligozoospermia', the doctor's talking about low sperm count.
Other things that may need to be ruled out for men are hormone disorders and plumbing problems ie blockages in the testicles or problems ejaculating.
What if there's no reason I can't get pregnant?
This can be upsetting to hear because it feels like there's nothing you can do, but it's very common – 15-20% of infertility cases have no obvious cause and are classed as 'unexplained infertility'. Don't despair: even if this is your diagnosis it doesn't necessarily mean you'll never get pregnant, particularly if you've only been trying for a year or so. It may even mean you have just been unlucky so far and could hit the bullseye at any time.
The stress of trying to conceive long term can take its toll, though. So if you're having problems getting pregnant and are feeling anxious about it, think about taking a break or talk to someone about how you're feeling.
It's incredibly frustrating even when you are in the system, as things cannot go quickly enough. Every month is an ovulation (and an opportunity) that has been and gone.
Why increasingly fewer women are having babies
A report has found that fertility rates are falling dramatically across the world, with fewer and fewer babies being born every year.
Researchers say that the fall in fertility rate means more than half of all countries are facing a “baby bust” – this means that not enough children are being born to maintain the population size. They have described the findings as a “huge surprise”.
The study tracked trends in every country from 1950 to 2017.
In 1950, women were having an average of 4.7 children. The fertility rate almost halved to 2.4 children per woman by last year.
However, there is and has always been a lot of variation between nations.
For example, the fertility rate in Niger is 7.1, but in Cyprus women are having one child on average.
In the UK, the rate is 1.7, similar to most Western European countries.
Why are women having fewer babies?
Researchers are putting the fall in fertility rate down to three main factors:
- Fewer deaths in childhood meaning women have fewer babies over their lifetime
- Wider access to contraception
- More women in education and work
The report was published in the medical journal, The Lancet.