If you've been trying to get pregnant for a while, you may be wondering why it hasn't happened yet. Maybe you've been off birth control for months and keep getting your period despite having lots of baby-making sex or undergoing fertility treatments. Perhaps you've even gone a step further and timed sex during fertile days and still are not pregnant. The reason why you aren't conceiving despite trying isn't always simple, but research has revealed that certain lifestyle and biological factors might play a role in how quickly and easily a person becomes pregnant.
Ahead, learn about some possible reasons that are preventing you from becoming pregnant, from lifestyle factors to underlying health conditions and beyond.
Can You Get Pregnant on Your Period?
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It's important to know that the following are general guidelines, and concerns about your fertility should always be addressed with an OB-GYN or health care provider. You should also consider reaching out to a medical professional about your fertility if:
- You're 35 years or older and have been trying to conceive for at least six months
- You're younger than 35 and have been trying to conceive for at least one year
Certain Personal Products
It's usually a good idea to keep most personal care products out of the vagin*, but that's especially so when you're trying to conceive.
Health experts recommend against douching for a variety of health reasons, from vagin*l infections to sexually transmitted infections (STIs). And when it comes to getting pregnant, douching can act like a spermicide, altering the pH of the vagin*, which can impair fertility, says Glade B. Curtis, MD, co-author of Your Pregnancy, Week by Week.
Ditto for personal lubricants, as some brands can impair sperm function and mobility. If you use lube, look for one that's specifically marked as sperm-friendly.
Recent research also shows that high exposure to personal and household products containing perfluoroalkyl substances (PFAS) may impact fertility. People with high blood concentrations of PFAS are up to 40% less likely to become pregnant after one year than those with lower levels.
PFAS hide in many products, but some experts are especially concerned with menstrual pads, given how much close exposure menstruating people have to these products. Choosing menstrual products with a PFAS-free label may help reduce your exposure, according to the Environmental Working Group.
High Stress Levels
You probably have at least one friend who, upon conceiving, said, "It happened right when I stopped worrying about it." That can be annoying to hear when you're not getting pregnant yourself, but there may be some truth to it.
High levels of stresscan have a very real role in hindering conception as elevated levels of cortisol, a stress hormone, can negatively affect ovulation and fertility. But when it comes to fertility, we're talking about high levels of chronic stress—not the everyday stress we all experience.
For some, learning about how stress can impact their chances of getting pregnant only makes themmorestressed—like howbeing told to "just relax"doesn't, in fact, help you relax. So if you're having trouble managing stress, it can be helpful to speak to a therapist and incorporate stress-lowering tools into your life. Strategies such asexercise, meditation, yoga, journaling, or mindfulness can all help manage stress levels.
Missing Your Fertile Window
Not being an expert about your own menstrual cycle can be a pitfall, since there are only a handful of days each cycle when you can conceive. The median cycle length is 28 days, but it's not uncommon to have cycles that are shorter than 20 days or longer than 35 days.
The first challenge is figuring out how long your cycle is. A common mistake Dr. Curtis has noticed among her patients is that they don't count from the "real" first day of their cycle. "Day one is the first day you bleed, not the day after or the day before," she says. (Keeping a menstrual cycle calendar can help, as can using a period or ovulation tracker app, many of which can help illustrate fertile windows. Consider using an online ovulation calculator as well.)
From there, you can estimate when you'll ovulate by counting backward from the first day of your next expected period. "Most menstruating people ovulate 14 days before the beginning of their period," says Dr. Curtis. "So, for example, if you have a 24-day cycle, ovulation is around day 10."
Timing Baby-Making Sex
If you're trying to get pregnant with penis-in-vagin* sex, timing sex with your most fertile days is key. A menstruating person has a fertile window of about six days (the five days leading up to ovulation and the day of ovulation), so your chances of getting pregnant are highest if you time sex to that time period. Dr. Curtis recommends having sex every day or every other day during those days you are most fertile.
However, if you have irregular periods, with longer or shorter cycles sporadically, targeting your ovulation day is not easy. For patients with cycles that are hard to pinpoint, Dr. Curtis suggests using ovulation predictor kits (OPKs), which are available over the counter.
There are other clues that you may be ovulating, including a change in your cervical mucus to an "egg-white-like" texture and a spike in your basal body temperature. Talk to your doctor about checking these subtle changes in your body while you're trying to get pregnant.
Older Age
Unfair as it may seem, older age can impact a person's ability to get pregnant. Simply put, once you hit 30, your fertility starts to decline, and it continues to decline with each passing year. According to the American College of Obstetricians and Gynecologists (ACOG), "By 45, fertility has declined so much that getting pregnant naturally is unlikely."
Being aware of the increased challenges of getting pregnant as you age can help you set expectations and game plan for the future. While there is no medical technique to keep you fertile into your late 30s and 40s, you can look into in vitro fertilization (IVF). You can also have eggs and/or embryos harvested and frozen for possible IVF in the future if you are unsure if and when you want to start a family.
Your Chances of Getting Pregnant at Every Age
Your Partner's Health
Although people tend to blame the person with the uterus for pregnancy delays, fertility issues don't discriminate. Dr. Curtis says cases of infertility are about 40% male-related, 40% female-related, and 20% a combination of both. There's also the instance of unexplained infertility (more on that in a bit), which affects approximately 15% of cases. "It's really an even playing field in terms of diagnoses," she says.
For example, just as advanced age can affect fertility for people with uteruses, it can also affect people with testes. Sperm volume and motility—both important for conception—decline as people age.
One simple way a person may be able to improve sperm quality is to make healthy sleep a priority. Research shows that males who got less than six or more than nine hours of sleep per night had lower-quality sperm than those who got seven or eight hours of sleep per night.
Hormonal Birth Control
If you've recently stopped using hormonal birth control, it could take some time before your cycle to return and regulate. Research shows that some types of hormonal birth control (such as the birth control shot) are associated with longer delays in fertility returning than others.
"Many women take about six months or more just to start having regular cycles when they first quit contraception altogether," explains Dr. Curtis. "Ovulation isn't likely to be happening until your periods are getting more regular."
Dr. Curtis's advice? Take your time. And if six months have passed since you stopped hormonal birth control and you haven't been getting regular periods or you're not sure if you're ovulating, then it's a good idea to seek out the advice of a health care provider.
What It Really Takes to Get Pregnant After Birth Control
Certain Lifestyle Choices
It's well-documented that smoking can impact both male and female fertility. Long-term smoking can speed up the rate of egg loss, decrease sperm count, and make sperm less healthy. There's also some evidence that heavy drinking is associated with lower fertility rates.
If you or your partner regularly smoke or drink and hope to conceive soon, it may be a good idea to talk to a professional about quitting. Avoiding smoking and cutting back on drinking can help your health and your future baby's.
Underlying Health Conditions
Health concerns like irregular periods, diabetes, obesity, or a thyroid disorder can impact your ability to get pregnant. So if you have any chronic health concerns, you'll want to do your best to ensure they are under control before trying to conceive.
Additional medical concerns, like endometriosis or blocked fallopian tubes, can also create issues when it comes to trying to conceive. It's estimated that up to 50% of people with endometriosis will have difficulty getting pregnant.
Whether you have known health issues or not, a check-up is in order before you try to get pregnant. As soon as you can, schedule a pre-conception check-up. A health care provider can screen for any medical conditions that may need to be addressed and help you make a plan for conceiving. And if you find yourself with a positive pregnancy test sooner than you thought, you'll be ready to take the next steps and find a pregnancy care provider too.
Unexplained Infertility
Between 10% and 30% of hopeful parents never find out why they can't get pregnant. This is called unexplained infertility, or more accurately, lack of good diagnosis. However, not having answers doesn't mean you can't be treated. You can still receive treatment for infertility even if your diagnosis is unexplained. Be sure to discuss any concerns or questions you have with an OB-GYN or health care provider, and together, you can determine the right path forward for you.
Additional reporting by Rachel Gurevich, RN.
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