You’ve been trying to fall pregnant but haven’t. Here are some possible reasons.

Trying for a baby and not being able to fall pregnant can be extremely stressful. Suddenly, you find yourself wondering how long it should take to fall pregnant, what you could be doing differently, and if starting a family is in your future.

Fertility experts recommend you don’t panic, with several reasons not necessarily requiring intervention.

Being informed, and seeking medical assistance is always best.

Gynaecologist and fertility specialist Dr Georgiana Tang of City Fertility Centre, shares the most common reasons a couple may have trouble getting pregnant despite trying.

1. Your age

We all know egg quality, and therefore fertility, decreases in women after a certain age — about 37. Dr Tang says because of this, your age also plays a “very important” factor when you might want to consider getting help.

Aged under 37? It could still take several months to fall pregnant naturally, even if you and your partner are both perfectly healthy. If you’ve been trying for nine to 12 months, Dr Tang advises you to have a chat to your doctor.

Your age plays a huge factor in fertility.

If you’re between 37 and 40 and have been trying for six to nine months, it might be time to seek professional advice; while if you’re female and over 40, then seeking help is recommended after six months, as IVF success after 44 is almost zero.

2. Whether you’re ovulating

This may seem like an obvious reason for infertility, however what you may not know is that it’s possible to get your period regularly and still not be ovulating – even when you’re not taking any form of birth control.

Dr Tang says, “even people who have monthly bleeds, may not be ovulatory”, so it’s important women look for other signs, such as changes in discharge or by using an over-the-counter ovulation test.

3. Lifestyle factors

According to Dr Tang, the following lifestyle factors can negatively affect fertility in both men and women:

  • Smoking
  • Being overweight
  • Eating an unhealthy diet
  • Being stressed.

Lifestyle factors like your diet and exercise habits can play a role.

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(Image via iStock.)

4. When you’re having sex

Dr Tang says having sex too infrequently – or even too often – can affect your chances of getting pregnant. She says people might wrongly assume the more sex the better, when it comes to trying for a baby; and that doing it too often, such as every morning and night, can reduce the sperm count.

Similarly, if you have sex too few times, you might miss your ovulation window that month.

“The sperm lasts for about three days in the system, so you don’t need to do it daily. Every second or third day is adequate,” Dr Tang says.

For your best chances of getting pregnant, calculate the 14th day of your cycle and have sex every two to three days that week. So if you will be ovulating on a Wednesday – aim to have sex on the Sunday or Monday, again on the Tuesday or Wednesday and then also on Friday.

5. Medical conditions

If you have been diagnosed with polycystic ovarian syndrome (PCOS) or endometriosis you already know these conditions can affect your fertility. But you could also have these conditions without knowing it.

Dr Tang advises seeing your GP or gynaecologist if you experience heavy painful periods – as this could be a sign of endometriosis. PCOS symptoms include irregular periods, excess hair growth and acne.

6. Blocked fallopian tubes, cysts or fibroids

These three complications in a woman’s reproductive organs can prevent you from falling pregnant.

“People can have an infection without realising, or their fallopian tubes may be blocked,” Dr Tang says.

Meanwhile, fibroids are benign growths found in the uterus, which could have no symptoms or result in heavy periods. Sufferers of ovarian cysts may feel pain on one side of their lower abdomen.

7. Male fertility issues

With much of the infertility conversation focused on women, it can be easy to forget the male partner, and that their reproductive health may also be a contributing factor.

Dr Tang says if men have abnormal sperm readings – either there are too few of them or they’re not swimming properly – they will likely have no symptoms.

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(Image via iStock.)

You could be having sex too regularly or not enough.

She says men’s sperm production and quality can be affected by lifestyle factors such as stress, a poor diet, smoking and a lack of exercise.

Having a sperm analysis done prior to trying to fall pregnant can provide critical answers, particularly around motility, morphology and fertility rates. Results may also prompt lifestyle changes or using alternative treatments such as acupuncture and supplements, if necessary, to improve chances.

Finally, a man’s age does play a role in fertility, although not as strongly pronounced as for women (where there is a sharp decline after a certain age).

If you’ve been trying for a few months and are concerned about your fertility, Dr Tang recommends you seek medical advice, but also assures that getting pregnant can just sometimes take time, explaining only one in five young couples will get pregnant after one month, while about 90 percent of these couples will achieve pregnancy after a year of trying.

“You don’t want to be super anxious and start to wonder if you’ve got fertility problems after trying for a month.”

Dr Georgiana Tang is a gynaecologist and fertility specialist. She practices at City Fertility Centre