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What makes getting pregnant hard?

5 reasons why you’re not getting pregnant

Keep getting negative results every time you pee on a stick? Here are five fertility saboteurs that could be the reasons you’re not getting pregnant.

Updated Jul 13, 2021

You already know the drill—when you’re trying to conceive you can’t leave the house without seeing pregnant bellies. Every time you turn on the TV there’s a sweet baby in a diaper commercial staring back at you. You always seem to spot at least four newborns snuggled up in carriers perched on top of grocery carts when you run into the supermarket, but it seems like you can’t get pregnant.

Whether you’re a few months into trying or are thinking about starting a family soon (here are nine things to do before you conceive), you know doubt have babies on the brain. By now you likely know that many of us don’t get pregnant the first time we try. But what might be surprising news is that there are fertility myths that can wreak havoc on your chances of conceiving. Here’s how to deal with five possible reasons you’re not getting pregnant.

1. Stress

When you mention to friends and family that you’re “trying,” you’ll almost guaranteed to hear someone say, “Just relax and it will happen.” Easier said than done. Stress, good or bad, is going to take its toll on you both physically and mentally. According to naturopathic doctor Via Bitidis, co-director of the North Toronto Naturopathic Clinic, balance and calm are a crucial part of trying to conceive. “When you’re stressed your adrenal system takes a hit. Your body isn’t going to say, ‘Okay, let’s get pregnant.’ Learning to say no and to take time for yourself is important for improving your chances of having a baby.” Megan Karnis, medical director of The ONE Fertility Clinic in Burlington, Ont., agrees with a word of caution: “A lot of women think the best thing to do when you’re stressed is to take time off work. In my experience, that doesn’t help, because it makes a woman feel she has to get pregnant in that time and then the stress to get pregnant is so much higher,” she says. Instead of altering your day-to-day routine entirely, Karnis recommends counselling, art therapy, meditation and exercise to reduce stress levels.

2. Sleep deprivation

You already know that catching an adequate number of zzz’s makes that morning department meeting more bearable, but here’s another reason to get yourself to bed before the wee hours. Sleep deprivation puts stress on the body (there’s that pesky s-word again) and when you’re tired, you don’t run on all cylinders. “For people who don’t get enough sleep, their immune systems are down a little bit and they’re more likely to get infections, which will affect the reproductive cycle,” Karnis says. “This applies to men as well. Infections can cause fever and that excess heat can damage the sperm temporarily,” she says. “Women who don’t get enough sleep can also start to feel anxious, which may cause missed periods.” Keeping yourself healthy is the baby bottom line, so set the PVR to record Mad Men and enforce a new bedtime.

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3. Weight issues

A woman who is underweight or overweight may have some difficulty conceiving a baby. “An undernourished body may not ovulate properly,” says Bitidis. On the other hand, excess weight can have a significant effect on fertility. “Just being over your ideal weight decreases your chance of getting pregnant even if you are ovulating regularly,” says Karnis. “The further you stray above 25 on the Body Mass Index, the worse it gets.” Maintaining a healthy diet and developing a reasonable exercise routine will do wonders for your mind and body,” Bitidis adds.

4. Cycle confusion

“A lot of women don’t understand their own cycles,” says Bitidis. Most of us were taught the typical 28-day cycle in health class back in high school, but every woman is different and cycles vary in length. “The biggest thing is timing,” Karnis says. “We teach women that ovulation is two weeks before your period. Most people think that it’s two weeks after, but that’s only if you have a four-week cycle,” she says. You’ll have better luck conceiving if you monitor ovulation and start having sex at the right time. “We also teach people about sperm life—they can live for three days in the cervix, so you don’t have to have sex on the day of ovulation, it could be the day before. We also find that a lot of people don’t know that lubricant decreases sperm motility and transfer, so you shouldn’t use lubricant when you’re trying to get pregnant,” says Karnis.

5. Biofeedback

“Keeping a positive attitude is incredibly important. There is a huge mind-body connection. Try not to listen to the negative stories and try to be patient,” Bitidis advises. Preparing for pregnancy up to a year in advance may be a good idea if you’re planning to start a family in the near future, that way you can focus on making lifestyle changes. If you’re trying now, remember that it can take time—experts say up to a year— to conceive. If you’re concerned that it has taken too long, speak to your healthcare provider about your options for fertility counselling and treatment.

Overview — Infertility

Around 1 in 7 couples may have difficulty conceiving.

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About 84% of couples will conceive naturally within a year if they have regular unprotected sex (every 2 or 3 days).

For couples who have been trying to conceive for more than 3 years without success, the likelihood of getting pregnant naturally within the next year is 1 in 4, or less.

Getting help

Some people get pregnant quickly, but for others it can take longer. It’s a good idea to see a GP if you have not conceived after a year of trying.

Women aged 36 and over, and anyone who’s already aware they may have fertility problems, should see their GP sooner.

They can check for common causes of fertility problems and suggest treatments that could help.

Infertility is usually only diagnosed when a couple have not managed to conceive after a year of trying.

There are 2 types of infertility:

  • primary infertility – where someone who’s never conceived a child in the past has difficulty conceiving
  • secondary infertility – where someone has had 1 or more pregnancies in the past, but is having difficulty conceiving again

Treating infertility

Fertility treatments include:

  • medical treatment for lack of regular ovulation
  • surgical procedures such as treatment for endometriosis, repair of the fallopian tubes, or removal of scarring (adhesions) within the womb or abdominal cavity
  • assisted conception such as intrauterine insemination (IUI) or IVF

The treatment offered will depend on what’s causing the fertility problems and what’s available from your local integrated care board (ICB).

Private treatment is also available, but it can be expensive and there’s no guarantee it will be successful.

It’s important to choose a private clinic carefully. You can ask a GP for advice, and should make sure you choose a clinic that’s licensed by the Human Fertilisation and Embryology Authority (HFEA).

Some treatments for infertility, such as IVF, can cause complications.

  • multiple pregnancy – if more than 1 embryo is placed in the womb as part of IVF treatment there’s an increased chance of having twins; this may not seem like a bad thing, but it significantly increases the risk of complications for you and your babies
  • ectopic pregnancy – the risk of having an ectopic pregnancy is slightly increased if you have IVF
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What causes infertility?

There are many possible causes of infertility, and fertility problems can affect either partner. But in a quarter of cases it is not possible to identify the cause.

Common causes of infertility include:

  • lack of regular ovulation (the monthly release of an egg)
  • poor quality semen
  • blocked or damaged fallopian tubes
  • endometriosis – where tissue that behaves like the lining of the womb (the endometrium) is found outside the womb

Risk factors

There are also several factors that can affect fertility.

  • age – fertility declines with age
  • weight – being overweight or obese (having a BMI of 30 or over) reduces fertility; in women, being overweight or severely underweight can affect ovulation
  • sexually transmitted infections (STIs) – several STIs, including chlamydia, can affect fertility
  • smoking – can affect fertility: smoking (including passive smoking) affects your chance of conceiving and can reduce semen quality; read more about quitting smoking
  • alcohol – the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum. Drinking too much alcohol can also affect the quality of sperm (the chief medical officers for the UK recommend adults should drink no more than 14 units of alcohol a week, which should be spread evenly over 3 days or more)
  • environmental factors – exposure to certain pesticides, solvents and metals has been shown to affect fertility, particularly in men
  • stress – can affect your relationship with your partner and cause a loss of sex drive; in severe cases, stress may also affect ovulation and sperm production

There’s no evidence to suggest caffeinated drinks, such as tea, coffee and colas, are associated with fertility problems.

Page last reviewed: 18 February 2020
Next review due: 18 February 2023

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Getting pregnant can be harder than you think—here’s why

Medically reviewed by Neka Miller, PhD on July 15, 2021. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Deciding to start a family is one of the most exciting steps that you can take with your partner. However, while the process can seem fairly straightforward, for some people getting pregnant can actually be more challenging than you might think. So why is getting pregnant so difficult for some?

From a woman’s ovarian reserve to a man’s sperm health, the reasons can vary. Keep reading to learn more about these and other reasons why conceiving may be more difficult than anticipated.

While there are certainly couples who get pregnant after trying just one time, the reality is that most couples do not conceive right away. About 80 percent of couples get pregnant after six months of trying; roughly 90 percent of couples will conceive after a full year of trying.

There is no set-in-stone timeline for getting pregnant. It’s important to try regularly for at least a year before you get help from a fertility specialist.

It Takes Timing

Timing is everything when it comes to a woman’s fertility and getting pregnant. While it can seem as simple as introducing a sperm cell to an egg, there is a lot more going on. Your chances of getting pregnant are at their highest when you are ovulating and the days immediately prior, known as the fertility window or fertile days.

Ovulation refers to the process of the ovaries releasing a mature egg. That egg is fertile for up to one day, and sperm cells can live in the uterus and fallopian tube for about five days. This means that your average fertility window lasts about six days (the five days prior to ovulation and the day of ovulation).

Remember that this is merely when your chances of getting pregnant are at their highest. You can ostensibly get pregnant at any point of the month. While the chance is low, it’s even possible to get pregnant during your period. Enjoying a healthy sex life where you have sex at least three times per week is a good way to increase your chances and build up a healthy relationship with your partner.

Recent Birth Control

Birth control is a common part of modern living, and many people use it beyond just preventing conception. Birth control can help to reduce the side effects of menstruation, keep hormones under control, and potentially even prevent acne.

If you’ve been using birth control for any reason, immediately quitting won’t instantly eliminate the contraceptive chemicals from your body. So, if you just went off birth control and are wondering, “How fertile am I?” know that many women may take at least six months after quitting birth control before they even start having regular menstrual cycles. More regular cycles also mean more regular ovulation, so you may have to wait after quitting birth control before you can even expect to conceive.

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While a single person may carry the baby, getting pregnant still requires two parties. Far too many people blame infertility or fertility problems on the woman and her ovaries, but male fertility and a man’s sperm health are just as important to the equation. Male infertility, low sperm count, poor sperm motility, and abnormal sperm morphology all contribute to poor sperm quality and a reduced risk of conception.

Stress and Pressure

It can be annoying to hear, but many couples end up conceiving once they stop worrying so much about it. There is some science to that. Stress can have an immense impact on your health. Cortisol, the main stress hormone, can negatively affect ovulation or even disrupt regular menstrual cycles entirely. Excess stress can also reduce sperm count and quality.

Putting too much pressure on unexplained infertility and the procreative aspects of sex can also cause active harm to your relationship with your partner. Sex can and should be fun and enjoyable for all parties involved, whether you are trying to conceive or not.

The fact is, there are so many factors involved with pregnancy. If you have been trying to get pregnant for at least a year with no luck and suspect you might have fertility issues, it may be worth seeing a fertility treatment specialist with your partner for an infertility evaluation and consider trying an at-home fertility test for women.

1. Infertility FAQs. Centers for Disease Control and Prevention. URL. Accessed July 15, 2021.

2. Getting pregnant. Mayo Clinic. URL. Accessed July 15, 2021.

3. Birth control pills for acne? Mayo Clinic. URL. Accessed July 15, 2021.

4. Birth control pill FAQ: Benefits, risks and choices. Mayo Clinic. URL. Accessed July 15, 2021.

5. Male infertility. Mayo Clinic. URL. Accessed July 15, 2021.

6. Ilacqua A, Izzo G, Emerenziani GP, Baldari C, Aversa A. Lifestyle and fertility: the influence of stress and quality of life on male fertility. Reprod Biol Endocrinol. 2018;16(1):115. Published 2018 Nov 26. doi:10.1186/s12958-018-0436-9

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