Why Am I Not Getting Pregnant?
Why Can't I Get Pregnant?
It all seems so simple: you have unprotected intercourse during your fertile window, sperm meets egg, fertilizes, and there you go! However, for many people, it is not that simple, but the question is—why not? You probably know people who get pregnant in the first month after they start trying but really they are the lucky ones and most people have to try for a bit longer before they succeed.
So if you are asking yourself, 'Why can't I get pregnant' then you really need to look beyond the simplicity of the sperm meets egg situation and see that there are a whole lot of other scenarios that could occur. So first, whenever something does not work, a good idea is to go right back to square one to check the basics before you start getting into more complicated causes.
Back to the Basics
If you are really sure that you have got this all right, then feel free to skip over it. I don't want to teach you to suck eggs after all.
There is only one essential basic thing that you are in control of—to have unprotected sex during your fertile window.
Your fertile window: This is a key thing. You can't always assume (even if doctors generally do!) that you will ovulate in the middle of your cycle, or specifically on day 14 of your cycle. There are two parts to your cycle—the first part when you menstruate and before you ovulate, which is known as the Follicular Phase, and then the second part (the Luteal Phase or LP) after you have ovulated.
The Luteal Phase is usually 12-14 days but can be up to 16 days. The most common length is 14 days but that is not true for everyone, and an LP of 12 or 13 days is also not unusual. If you have an LP of 10 days (or possibly even less) then you are venturing into the realms of a condition known as Luteal Phase Defect which WebMD among others say may hinder your chances of conception (although many people do get pregnant with an LP of 10 days so don't panic). So 'normal' cycles will involve a 14-day Follicular Phase and 14-day Luteal Phase, making it 28 days in total. However, most of us are not normal!
So, the important thing is to know when you ovulate, so that you know when to have unprotected sex. You could do what I did which is to use One Step which are easy to use and pinpoint when your fertile window may occur. Just dip a strip in some pee around your fertile time and when you are ovulating you will get 2 dark lines. However, when you get closer to ovulation you need to use them a couple of times a day in case you miss the sometimes very short window of a strong positive test. ovulation test strips
Ovulation is when the egg is released from your ovary and is ripe for fertilization. Once the egg is released it does not last too long (12-24 hours according to BabyMed) so it is best for the sperm to already be waiting for the egg when it is released. Sperm can last in the body for up to a maximum of 4 days so the best time to have sex is in the 4 days leading up to ovulation, the day of ovulation and possibly the day after.
Most doctors recommend that you have sex every other day or perhaps every 2 or 3 days if you have long cycles. In this way, the sperm gets refreshed to a decent level and you have a great level of fresh sperm entering the cervix. If you know that your partner has a great sperm count (over 20 million) then it is possible to have sex every day and still have a good quantity and quality of sperm.
I Know I am Having Sex at the Right Time
So, you know all of this and you know for sure that you are having unprotected sex at the right time in your cycle but still, you have not gotten pregnant. Although this seems unfair and crazy you have to think about the fact that you only get this one shot each month. Everything has to come together exactly. The sperm has to swim through the hostile environment of your cervix which immediately kills off a large number of them.
If you are lucky a very small percentage make it through and up to the fallopian tubes and then they have to actually penetrate the egg. This is why doctors only give people a percentage chance each month of getting pregnant naturally (usually according to age). This percentage can range from around 5% (usually for over 40's) to about 25% (for under 30's). So if you are under 30, there is a big chance that you will conceive in the first 4 months. However, this means that everything must be perfect every month. There are some graphs that show the probability of getting pregnant within the space of a year according to your age including this one from Discover Magazine. The majority of people will conceive within the first year (at least those under 35) and this is why doctors say to wait a year before going for any sort of tests.
I've Been Trying for More Than 6 Months
So, firstly I would say that if you have been trying for less than 6 months then I'm sorry but you will just have to be patient. There is every chance that absolutely nothing is wrong and it is just a matter of a few more tries before that perfect sperm meets that perfect egg and it is all systems go.
However, if you are nearing the one year mark then you may want to think about a few things that you can be doing. There are two sides to the coin, the sperm and the egg.
For the man: you need to know that you are getting good quality sperm that has the ability to swim in the right direction and there are enough of them to get through. There are a few things that you can do to ensure that you are getting the best quality sperm. However, the only way that you can know whether the sperm is good and the quantities are reasonable is to have a semen analysis done. Doctors will check this along with the tests that they do on you but usually only after one year of trying.
It may be worth you both cutting down on alcohol and smoking if you haven't already and consider a healthier lifestyle in terms of food and exercise.
For the woman: there may be other problems, or again, it may just be a matter of time. If you are having regular periods, then your chances are better since you know when you are ovulating and secondly there are less likely to be issues than if you have very irregular cycles.
The first thing that a doctor will do is to take some blood and test certain hormone levels. Mostly these are to check that you are ovulating and to check your egg reserves. Egg reserves are not likely to be much of a problem if you are younger so it may be a question of whether you are ovulating or not. Although you may be getting positives on your ovulation tests this does not confirm that you are ovulating, unfortunately. In conjunction with this, you really need to take your temperature daily to see that there is a marked shift in temperature upwards after you ovulate.
Blood Tests Are OK and Semen Analysis Is Fine
If your blood test results come out OK—hormone levels are good and you are ovulating—and your Semen Analysis results are OK then they may do another test to check whether your tubes are blocked or not. The test involves squirting dye through your fallopian tubes to check that they are clear. It is relatively painless and you should get a quick answer from the doctor.
The thing is that even if all of the tests are OK, it can still take some time for some people to get pregnant. There may still be absolutely nothing wrong but you are still struggling. This happens to a lot of people and the worst case scenario that I have come across as someone who suddenly got pregnant after 5 years of trying with no real reason why it had taken that long. However, this is an extreme case so don't think that just because it has not happened in a year that it will take you 5 years!
What Should I Do?
So, the best idea is to have a plan in place so that you don't see this as a never-ending situation. I would recommend the following:
Trying for 1-3 months
Just keep on going as you are, you may want to start temping so that you can check that you are ovulating or to use ovulation prediction kits to ensure you are having sex at the right time.
Trying for 3-6 months
When getting closer to the 6-month mark, as well as getting your timing spot on, make sure that your partner is doing what they can to get the best quality sperm and perhaps think about some lifestyle changes with regard to alcohol/food/exercise. You could also consider some supplements that may increase your egg quality.
Trying for 6-9 months
It may be worth taking a home sperm test to check for any issues so that you can be prepared if you need to take further action. Continue temping so that you have a record of your cycles if you need to go to see a fertility specialist. Expect that it might happen at this time though.
Trying for 9-12 months
Make an appointment to see your doctor near the 12-month mark if you have not got pregnant. Do not be too downhearted at this stage though as there is still every likelihood that it can happen for you.
Don't Get Disheartened
Although it is easy to say, try not to get too obsessed and downhearted if you do not get pregnant immediately. It is not an instant process (for most) and there is more than likely nothing wrong with you if it doesn't happen straight away. The majority of people do get pregnant in the first year and although there are those that don't (varying stats but said to be around 25%), there are still things that can be done to increase your chances after this.
Good luck and lots of baby dust!