Fertility Challenges Causes & Concerns Why Am I Not Getting Pregnant? 8 Possible Reasons You Can't Conceive By Rachel Gurevich, RN Rachel Gurevich, RN Facebook LinkedIn Twitter Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles. Learn about our editorial process Updated on June 09, 2020 Medically reviewed Verywell Family articles are reviewed by board-certified physicians and family healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Leyla Bilali, RN Medically reviewed by Leyla Bilali, RN Leyla Bilali, RN is a registered nurse, fertility nurse, and fertility consultant in the New York City area. Learn about our Medical Review Board Print Illustration by Joshua Seong. © Verywell, 2018. Table of Contents View All Table of Contents Not Trying Long Enough Not Ovulating Problem Is With Him Age-Related Infertility Blocked Fallopian Tubes Endometriosis Underlying Medical Issues Unexplained Infertility So, you've been trying to get pregnant for awhile, but nothing is happening. Why are you not getting pregnant? There are many possible reasons, including ovulation irregularities, structural problems in the reproductive system, low sperm count, or an underlying medical problem. While infertility can have symptoms like irregular periods or severe menstrual cramps, the truth is that most causes of infertility are silent. Male infertility rarely has symptoms. Here are eight possible reasons you haven't conceived yet. Not Trying Long Enough The first thing to consider is how long have you been trying. It may feel like you've been trying forever—and maybe you have!—but it's important to know that many couples won't conceive right away. About 80% of couples conceive after six months of trying. Approximately 90% will be pregnant after 12 months of trying to get pregnant. This assumes you have well-timed intercourse every month. When to Call a Doctor Doctors recommend that you see a doctor about your fertility ifYou're 35 years or older and have been trying for at least six monthsYou're younger than 35 and have been trying for at least one yearIf either of these fit your situation then see a doctor, even if you have no symptoms of a fertility problem. Not Ovulating Human conception requires an egg and sperm. If you're not ovulating, you won't be able to get pregnant. Anovulation is a common cause of female infertility and it can be triggered by many conditions. PCOS is one possible cause of anovulation. Other possible causes include being over or underweight, primary ovarian insufficiency, a thyroid dysfunction, hyperprolactinemia, and excessive exercise. Most women who are experiencing ovulation problems have irregular periods. However, regular menstrual cycles don't guarantee that ovulation is occurring. If you have irregular cycles, talk to your doctor, even if you haven't been trying for a year yet. Anovulation and Ovulatory Dysfunction Problem Is With Him, Not You Women may carry the baby, but it takes two to tango. Twenty to 30% of infertile couples discover fertility factors on the man's side. Another 40% find infertility factors on both sides. Another thing you need to know: male infertility rarely has symptoms that are observable without a semen analysis, which is a test that measures the health of the semen and sperm. When you do see the doctor, make sure you are both tested. Male Infertility Diagnosis and Treatment Age-Related Infertility For women after age 35, and for men after age 40, it can take longer to get pregnant. Some women assume if they still get regular periods their fertility is fine, but this isn't true. Age impacts egg quality as well as quantity. Also, if your partner is five or more years older than you are, this can further increase your risk of fertility problems after age 35. 5 Tips for Getting Pregnant After 35 Blocked Fallopian Tubes Ovulatory cause accounts for about 25% of female infertility cases. The rest can have problems with blocked fallopian tubes, uterine structural problems, or endometriosis. In case you don't know, the fallopian tubes are the pathway between your ovaries and the uterus. The fallopian tubes do not directly attach to the ovaries. Sperm must swim up from the cervix, through the uterus, and into the fallopian tubes. When an egg is released from the ovaries, hair-like projections from the fallopian tube draw the egg inside. Conception takes place inside the fallopian tube, where the sperm and egg finally meet. If anything prevents the fallopian tubes from working properly, or if scarring blocks the sperm or egg from meeting, you won't be able to get pregnant. There are many possible causes of blocked fallopian tubes. While some women with blocked tubes experience pelvic pain, many others have no symptoms. Only fertility testing can determine if your tubes are open. An HSG is a specialized X-ray used to determine if your fallopian tubes are open. This can be ordered by your OB/GYN. What You Need to Know About Blocked Fallopian Tubes You Have Endometriosis Endometriosis is when endometrium-like tissue (which is the tissue that lines the uterus) grows in places outside of the uterus. It's estimated that up to 50% of women with endometriosis will have difficulty getting pregnant. The most common symptoms of endometriosis include painful periods and pelvic pain at times besides menstruation. However, not all women with endometriosis have these symptoms. Some women who discover they have endometriosis as part of an infertility work-up. Endometriosis is commonly misdiagnosed or simply just missed. Endometriosis can't be diagnosed with a blood test or ultrasound. It requires diagnostic laparoscopic surgery. Because of this, proper diagnosis takes an average of 4.4 years. Underlying Medical Problems Underlying medical conditions can lead to infertility in both men and women. For example, a thyroid imbalance or undiagnosed diabetes can lead to infertility. While it's not well understood, depression is associated with infertility. Some autoimmune diseases, like lupus and undiagnosed sexually-transmitted diseases, can cause infertility. There are prescribed medications that may impact fertility. But never stop taking a medication without talking to your doctor first. Make sure both your doctor and your partner's doctor know you're trying to get pregnant. Also, an undiagnosed sexually transmitted illness can cause infertility. You may not have any symptoms of the disease. Unexplained Infertility Between 10% and 30% of infertile couples never find out why they can't get pregnant. Some doctors say this is a lack of good diagnosis. They say there is no such thing as unexplained infertility but only undiscovered or undiagnosed problems. The fact remains, though, that some couples don't get answers. However, not having answers doesn't mean you can't be treated. You can (and should) still receive treatment for infertility even if your diagnosis is unexplained. How to Get Pregnant Despite Unexplained Fertility A Word From Verywell If you're having difficulty getting pregnant, know that there is help available. Many couples put off testing and treatment, waiting for a miracle or thinking they should just "try a little longer" first. This is a mistake. Some causes of infertility worsen with time. The sooner you get help, the more likely fertility treatments will work for you. Another reason couples sometimes delay testing is they feel and seem to be in perfect health. It's true that you and your partner may have no signs or symptoms of a fertility problem. You may have a textbook 28-day menstrual cycle, but that doesn't mean you're guaranteed fast and smooth results when trying to get pregnant, and that doesn't mean you may not have a fertility problem. The reasons for infertility aren't always observable to the lay person. For this reason, if you've been trying to conceive for one year (or six months if you're 35 years or older), please get help. Don't wait. What to Do When You Can't Get Pregnant Was this page helpful? Thanks for your feedback! Get diet and wellness tips to help your kids stay healthy and happy. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 7 Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gnoth C, Godehardt D, Godehardt E, Frank-Herrmann P, Freundl G. Time to pregnancy: results of the German prospective study and impact on the management of infertility. Hum Reprod. 2003;18(9):1959-1966. doi:10.1093/humrep/deg366 Hanson B, Johnstone E, Dorais J, Silver B, Peterson CM, Hotaling J. Female infertility, infertility-associated diagnoses, and comorbidities: a review. J Assist Reprod Genet. 2017;34(2):167-177. doi:10.1007/s10815-016-0836-8 Leaver RB. Male infertility: an overview of causes and treatment options. Br J Nurs. 2016;25(18):S35-S40. doi:10.12968/bjon.2016.25.18.S35 Crawford NM, Steiner AZ. Age-related Infertility. Obstet Gynecol Clin North Am. 2015;42(1):15-25. doi:10.1016/j.ogc.2014.09.005 Sasaki RS, Approbato MS, Maia MC, Fleury EA, Giviziez CR, Zanluchi N. Patients' auto report of regularity of their menstrual cycles. Medical history is very reliable to predict ovulation. A cross-sectional study. JBRA Assist Reprod. 2016;20(3):118-122. doi:10.5935/1518-0557.20160027 Macer ML, Taylor HS. Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility. Obstet Gynecol Clin North Am. 2012;39(4):535-549. doi:10.1016/j.ogc.2012.10.002 Gunn DD, Bates GW. Evidence-based approach to unexplained infertility: a systematic review. Fertil Steril. 2016;105(6):1566-1574.e1. doi:10.1016/j.fertnstert.2016.02.001