Almost every couple dreams of building a family. They dream of bearing a child and nurturing it with the best of their abilities. However, at times, medical or lifestyle reasons can hinder the process and stand in the way of conceiving. This article will provide in-depth knowledge of the reasons why one may not conceive.
If you have been trying unsuccessfully for a while and the thought of “why am I not getting pregnant” disturbs you, here are some of the possible reasons behind the problem:
Surprisingly, this is one of the main reasons for not conceiving. The timing of intercourse should be such that it is 1 to 2 days before the fertile period of ovulation. It is not enough to just enjoy the act during this window but rather enjoy it every other day. Too much or too little is cutting it too close. While too much sex can lead to burnout and a loss of interest in intercourse during the fertile period, too little sex can also lead to missing the fertile period as you may not always be able to correctly assess when you are ovulating.
If you are not enjoying the act, then your body is stressed and will not go through the natural processes. Somewhere, there may be a glitch, and your body will end up not desiring the act and negating it. It is important that you enjoy and let your instincts take over.
When a body is stressed, it seeks rest and a way to relax. Intercourse, being a physical process, hinders this desire of the body. Rather than relaxing it, it makes you more irritable and exhausted. Under such circumstances, the body is in no condition to receive and aid in growing a baby in the uterus.
It is natural to feel the need to wash up once you are done or just relieve yourself. It is important, however, that you don’t rush into this but rather stay in bed for a minimum of 20 minutes. This gives the sperms enough time to stay in your uterus and swim up to find the egg. It increases the probability of multiple sperms reaching the fallopian tubes where the egg is located and fuse with it. If you are running into the washroom soon after sex, the sperms have no time to reach the egg but rather are pulled out of the body due to gravity and during the wash.
Smoking or drinking greatly reduces your ability to produce germ cells (eggs in the females and sperms in the males). Smoking or drinking pulls down the body’s ability to produce healthy germ cells.
When you subject yourself to strenuous workout routines, the uterus goes through a lot of pressure, and this disrupts the natural cycle and lowers the chances of a pregnancy. You can continue your routine but not as extensively. Jog at a lower speed than usual or do a cardio work-out but with fewer repeats and strain.
Water flushes out all the toxins in the body, keeps you fresh, and regulates the metabolism to function perfectly. Not being hydrated enough can interfere with your ability to conceive.
There could also be medical conditions behind problems in conceiving. Either of the individuals in a couple could be affected by conditions that could cause trouble getting pregnant. A few of the factors have been named in the table and discussed in detail in the article.
In Males | Sperm morphology, semen diseases, hormonal imbalance, diseases, previous surgeries, genetic factors, etc. |
In Females | Irregular periods, low number of eggs, hormonal imbalance, anatomical abnormalities, previous surgeries, genetic factors, etc. |
A couple is considered to have primary infertility only if they are unable to conceive naturally after trying for a year. As mentioned earlier, infertility could be due to various reasons. These conditions can be diagnosed by an andrologist (male) or a gynaecologist (female) and can be corrected accordingly.
Male infertility happens when:
In order to understand where the problem lies, your doctor will subject you to a physical exam, and ask you personal questions about your sex life, eating habits, and various other questions. In case the need arises, they will ask you to undergo a semen and sperm analysis test. Based on the results, further specific tests will be done.
The doctor checks for any abnormalities in the sexual organs. For example – undescended testicles (a condition where the testicles have failed to enter the scrotum after birth. This could hamper the sperm production), tumours, and abnormal growths which hamper the proper functioning of the organ
Testosterone is the main male sex hormone. This regulates the growth and production of sperms. If the body has an abnormal level of this hormone, sperm production does not follow the normal cycle.
This test checks for the number of sperms, number of motile sperms, the morphology of sperms, amount of semen present in one ejaculate, and consistency of the semen. If these differ from the normal grade, various other tests are done to pinpoint exactly what is causing the issue.
In some cases, the body makes abnormal antibodies which attack sperms once ejaculated. These antibodies kill the sperms and do not allow them to penetrate and fertilise the egg.
This is a common condition which occurs mostly in the legs of those who continue to stand throughout the day. Veins swell up and cause obstructed blood flow leading to muscular damage to that area. This also occurs in the veins present in the testis. A varicocele in the testis lowers the sperm quality. This condition can usually be reversed.
Tumour growth in the reproductive tract can damage the functioning of the system. These malignant tumours can affect the glands that release the sex hormone, affect the production of cells, or obstruct the passageway. Sometimes, this condition can be corrected through chemotherapy. However, chemotherapy may also cause the organs more damage, and the germ stem cells may acquire genetic flaws.
There are various factors that affect sperms, rendering them abnormal and losing their ability to fertilise an egg.
In this case, there is a lowered level of sperm production. On a broad spectrum, this condition is caused due to hormonal anomaly, poor health, or anatomical irregularity.
This is a condition where the sperm motility is hampered. Sperm cells need to be highly active and motile in order to swim through the vast distance to reach the egg cell and fertilize it. If these sperms are “lazy” or not active enough, they are unable to do so and fail to aid in pregnancy.
This term refers to morphologically hampered sperms. If there are any damages to the structure of the sperm cell, it gets naturally aborted or the viability gets drastically reduced.
This is where the semen contains no sperms. It has varied forms, most of which can be medically corrected.
In this case, due to hormonal imbalance, the testicles do not receive a healthy dose of testosterone to produce sperm cells.
Here the organ itself is abnormal, damaged, or the sperm production is fully absent or not up to the optimum level.
In this case, sperm cells are produced but are not ejaculated into the semen. The main underlying cause is due to an obstruction or absence of a tubule. This condition is pretty rare and can be surgically corrected.
This condition defines a semen sample which contains a high number of white blood cells. There are cases of asymptomatic conditions which have an increased production of white blood cells in the semen. According to research, this could be due to an unhealthy lifestyle or an actual bacterial infection. Rarely, sperms from such samples have had a high probability of fertilization during artificial reproductive techniques but when it comes to the archaic way, such samples have been associated with borderline infertility. The condition can be fully reverted to antibiotic treatment.
Here, men experience a “dry ejaculate” where the semen with the sperms is not released from the penis but reverts to the bladder. This happens due to retrograde ejaculation or an obstruction. Both of these can be surgically corrected.
This is a condition where the sperms are non-motile. It refers to dead sperms in the ejaculate.
In this case, the ejaculate moves back into the bladder instead of exiting through the penis. This occurs either due to a previous pelvic surgery or when the vans deferens (tube connecting the testis to the penis) is missing because of a genetic condition.
There can be an obstruction anywhere from the testes till the penis, and this does not give a clear passage for the sperms to move out.
This occurs due to various reasons such as:
It is basically a digestive disorder due to sensitivity to gluten. One of the symptoms happens to be infertility. Adopting a gluten-free diet can reverse the condition.
Some medications can disrupt sperm production and lead to infertility. A few of them are –
Infertility could be a side-effect of surgeries previously undertaken by the individual. These can always be corrected through another corrective surgery. Some of the surgeries which could lead to such an effect are –
In common terms, this refers to a condition where the causal factor cannot be pinpointed to a particular trait or a missing element.
Due to some genetic factors, men are rendered sterile. The chromosome gets silenced or it goes missing or in some cases a microdeletion in the Y chromosome causes the testis to produce abnormal sperms. This being a birth defect has no cure or treatment course.
Certain environmental factors can also bring about infertility in males. These factors influence the traits with a force equal to that of genetic characters. Some of these are –
A woman’s body needs to be in good health in order to conceive since it has to undergo the physical changes to nourish a growing, healthy baby. Thus, your health needs to be checked if you are having problems in conceiving. Some issues women face may be because of the following reasons:
All these factors affect the working of a woman’s body towards a healthy pregnancy. The main factors that contribute to causes of infertility in females are –
In this case, the cycles are either too long (35 days or more), too short (less than 21 days), irregular, or not occurring. Under such conditions, a mature egg is not being released for pregnancy to occur.
This is related to the above disorder. This condition persists due to either of the factors stated below –
Due to hormonal imbalances, an egg is not released but rather persists inside the ovaries in the form of fluid-filled cysts.
Follicle stimulating hormone (FSH) and leutanizing hormone (LH), which are produced in the hypothalamus, are responsible for regulating the growth, maturation, and release of an egg every month. If there are any disruptions to these hormones, the proliferative stage gets disrupted.
This is a disorder where the premature eggs are lost in the ovary without ever maturing due to an autoimmune disorder, genetic factors, or hormonal causes.
A high amount of prolactin in the body reduces the production of oestrogen which is responsible for the maturation and proliferation of eggs. This could be caused due to a medication or an anomaly in the pituitary gland.
This condition refers to a physical obstruction or damage to the fallopian tubes which connect the ovaries to the uterus. Fertilisation occurs in these tubes after which the zygote travels down into the endometrium. Some of the reasons for this problem are:
This is a bacterial pelvic infection. Once the bacteria infect the lungs, it reaches the bloodstream and gets transported to various parts of the body. Fallopian tubes form the perfect area for these bacteria to reside. This causes inflammation and blocks off this segment of tissue from various other forms of response from the body.
This is a condition where the tissue growth occurs in sites other than where it is supposed to grow. It tends to outgrow into the surrounding area. Upon correction through surgery, the healing process leaves scars. These scars, if in the fallopian tubes, tend to block them. If in the uterus, they can disrupt the implantation of a zygote in the endometrium.
Several factors can disrupt the process of implantation or increase the chances of miscarriages.
A woman is born with a particular number of eggs in her ovaries. As she ages, these eggs mature every month and get reduced in number. If there are not enough premature eggs present in the body, the chances of pregnancy reduce drastically.
These conditions are those which persist in the body for a long time and disrupt the functioning of the other organ systems in the body.
Thyroid problems can cause unintentional weight loss leading to no ovulation.
Due to the reverberated chemical factors in the body, the eggs get affected and are killed off in this duration. Women can freeze their eggs before undergoing chemotherapy so as to implant them after for a pregnancy.
Different factors of your lifestyle greatly influence your fertility.
It has been observed that women with Type 1 Diabetes have an increased risk of delayed puberty, menstrual irregularities, hormonal imbalances, PCOS, low number of live births, and early menopause.
This is an autoimmune disorder triggered by gluten in the diet. Non-gastrointestinal symptoms of this disease are observed to be late puberty, menstrual irregularities, and a higher risk of pregnancy complications.
The drugs used to treat diseases also have the ability to cause infertility. A few of them are:
This is a factor that mostly results in a hormonal imbalance which leads to irregular periods.
These are substances present in the environment which are absorbed by the body through the skin. Once absorbed, they decrease the level of progesterone which reduces fertility. These substances are mostly present in car exhausts, plastics, pesticides, emulsifiers in soaps and cosmetics, etc.
The birth control pill (also prescribed for fertility issues such as PCOS or endometriosis) has been linked to fertility issues in some women.
Unexplained infertility is where the cause is never found. It could be due to several minor factors or a culmination of factors present in both individuals of a couple.
This is where the genes encode for abnormal anatomy, abnormal hormonal levels, etc., leading to sterility in an individual.
Anabolic steroids which are taken to increase body mass have been observed to shrink the testicles and lower sperm production
Alcohol lowers testosterone production which causes erectile dysfunction and sperm production
Stress hampers the normal hormonal cycle which in turn affects the sperm production
This has also been linked to problems in fertility due to reduced sperm production
Fertility tests help identify the issues that could be triggering problems in conceiving. They must be taken by both the man and the women if conception is taking time. Here is a list of the tests you may need to go for if you detect any signs that you can’t get pregnant.
These tests are used to image the anatomy of a man to deduce the anomaly present.
Semen analysis | Tests for sperm abnormalities, sperm count, sperm number, sperm mobility |
Hormone tests | Test for testosterone, FSH, LH, and prolactin |
Urinalysis | Test for presence of white blood cells indicating infection |
Vasography | X-ray exam to determine blockage or leakage of tubes |
Ultrasonography | Exam used to detect blockages in the reproductive tract, prostrate duct, seminal vesicles, ejaculatory ducts |
Genetic testing | A DNA analysis to determine any genes causing infertility |
These female infertility tests are used to image the anatomy of a woman to deduce the anomaly present.
Ovulation testing | Detects the surge of ovulation-inducing hormones to analyze a menstrual cycle |
Hysterosalpingography | Detects the abnormalities in the uterine cavity. X-ray contrast in injected and observed under X-ray exposure |
Ovarian reserve testing | Detects the number of good quality eggs present in the ovaries |
Hormone testing | Hormones related to ovulation, pituitary and thyroid are checked |
Laproscopy | Invasive technique where using a thin incision an optical tube is inserted to clearly view uterus, endometrium and fallopian tubes |
Ultrasound | Uterine and fallopian tube anomalies are deduced. This test may be conducted if the woman is ovulating but not getting pregnant |
Genetic tests | A DNA analysis to determine any genes causing infertility |
The duration for which you should try to conceive before consulting a doctor depends on your age. If the mother is less than 35 years old, the couple should speak to a doctor after 1 year of trying, but if she is older, it is advisable to see a doctor after 6 months of trying.
Advancements in science and applied medicine have resulted in synthesizing techniques of treatments to solve the above issues. If you are facing problems in conceiving, consult your doctor to get help through these rough patches.
Also Read: Fertility Treatment – Assisted Reproductive Technology