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Why am I not pregnant after 2 years of trying?

Natural pregnancy is what exactly every married couple is trying to start a family. But trying for more years, they feel exhausted and hopeless. It is not about your potential to get pregnant, but your awareness related to reasons for not getting pregnant after trying natural pregnancy is crucial.

A fertility checkup can be helpful to understand the causes and their effective ways to resolve them. It can be the solution for your long waiting. Your fertility specialists are there to help you identify the cause and answer your questions about why this might not be happening.

Are you thinking you are infertile?

Do you think that you are not fertile enough to conceive? Stop your negative thinking about questioning your fertility potential. A simple solution along with the right treatment can change this situation. When a couple tries to conceive naturally without having any supplements or fertility treatment, it is considered a natural way of trying to conceive. 

But what can you do when this process doesn’t give hands to you? Women are most likely to conceive in their late 20s and early 30s. However, studies show that about 12% to 15% of women aged 32 to 35 experience infertility. The main cause is age, and other consequences may prevent them from getting pregnant. Recognizing infertility warning signs—such as irregular periods, hormonal imbalances, or underlying medical conditions—can help identify potential issues early. It is a wise decision to get the guidance of a fertility physician to understand the issues early to resolve them quickly.

Identify the Causes of Infertility

When you consult your fertility doctor, they will think of the connection between your bodily functions and their effects on fertility. Finding the reasons is crucial to starting your fertility treatment. In that case, your physician will examine the condition of both male and female partners. In rare cases, couples may not be identified for the right causes of infertility. During that time, assisted reproductive methods can be helpful.

Factors Affecting Fertility in Women

There are several factors involved in causing infertility for women in many ways. Let us find them one by one for your better understanding.

Age:

If you are in your late 30s, then you must understand the truth that age defines your fertility potential. The quality and quantity of eggs may decrease when you are reaching your late 30s. If you want to achieve pregnancy, start early in your late 20s or early 30s. 

Fallopian Tube Disorder

Checking the condition of the fallopian tube is vital in fertility treatment. Issues such as blocked fallopian tube or scars reason for not allowing the sperm and egg to meet together and suppressing the embryo from implanting in the uterine wall, preventing fertilisation. 

Why does it occur?

  • If you have a history of pelvic infections, you may have fallopian tube disorder.
  • Sexually transmitted diseases also create fallopian tube issues.
  • Endometriosis 
  • A past ectopic pregnancy
  • A ruptured appendix
  • Inflammation caused due to tuberculosis or inflammatory bowel disease.

Irregular Ovulation

Understanding ovulation time is crucial to getting to know about the fertile window of women for positive pregnancy outcomes. But what will happen if there is no way to identify the right time of ovulation? The time may get confused and result in not achieving what you expected. 

An egg must come out from the ovary for fertilisation. Some issues can prevent the egg from being released into the fallopian tubes, making it hard to predict the best time for fertility. The ovulation disorders may be caused by the following conditions:

  • Irregular or missed periods
  • Polycystic ovary syndrome (PCOS)
  • Hormonal imbalances
  • Uncontrolled stress
  • Low or high body weight

Uterine Abnormalities

You must know what barricades the fertilised egg to attach the uterine wall effectively. Some of the uterine abnormalities that may cause infertility are as follows:

  • The unusual and common uterine growths (uterine fibroids)
  • Scar tissues
  • Endometrial polyps
  • Abnormal uterus shape

Male Infertility

Like females, male partners are also facing fertility issues due to several reasons like lifestyle changes, the environment they are living in, food habits, etc. But they need to rectify it and take ideal treatment to achieve their dream of parenthood. Let us see some disorders as follows to understand what problems your male partner may have.

Sperm Disorders

Sperm disorders may also be the reason for not achieving pregnancy. Male infertility can be caused by below reasons:

  • Low sperm count
  • Abnormal shape of sperm
  • Low motility of sperm
  • No sperm at all (Azoospermia)

Varicoceles

This condition is caused due to the swollen veins in the scrotum that leads to male infertility. The blocked veins may raise the temperature of the scrotum which is not ideal for sperm to thrive. This may also be the reason for low sperm count. Here you may find some other causes of varicoceles that cause infertility in most men.

  • Issues with sperm delivery
  • Premature ejaculation
  • Retrograde ejaculation (semen flows backwards into the bladder instead of out)
  • Erectile dysfunction
  • Blockages in the testicles

Methods and Procedures for Determining Causes of Infertility Problems:

Test Purpose Applicable To
Ultrasonography
Pelvic examination.
Women
Hysteroscopy
Identifies menstrual-related issues and examines the endometrial lining.
Women
HSG (Hysterosalpingogram)
Examines the uterus shape, blockages, and scars in the fallopian tubes.
Women
Laparoscopy
Detects fibroids or endometriosis.
Women
Semen Analysis
Checks sperm count and movement.
Men
Blood Tests
Assess hormone levels and genetic issues.
Men
Scrotal Ultrasound
Detects testicular problems, such as varicoceles.
Men

Treatment

Infertility assessments aid in directing the course of treatment. There are two ways frequently used to treat certain infertility issues in both men and women.

Oral Medications or Injections
Either you may be given oral medications or injections can be suggested to control your ovulation process to track the right time of egg release and regularise your menstrual cycle for increasing the likelihood of pregnancy.

Technology for Assisted Reproduction (ART):

Intrauterine Insemination (IUI):
At the time of ovulation, sperm are inserted straight into the uterus to increase the pregnancy rate. The sperm is directly meets the egg to fertilise and ready to implant in the uterine wall.

In Vitro Fertilisation (IVF):
Your overall menstrual cycle can be regularised by using the method and the healthiest embryo is implanted in the uterus after sperm and eggs are mixed in a lab. You can freeze extra embryos for later cycles.

Like these two, you have more advanced assisted reproductive technologies to solve your infertility issues and support your dream of achieving pregnancy. Your fertility specialist is there to help you by suggesting the right method for you by understanding the cause of your infertility.

Conclusion

In conclusion, your year of waiting is over now. Choose your fertility specialist to understand your difficulties in conceiving for nearly two years. Follow the instructions as advised by your healthcare provider and support the process by taking prescribed medicines and tests.

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Dr Niveditha

Dr. Niveditha is the co-founder of The Hive Fertility and Research Centre. She is a young and passionate fertility expert who aims to provide high-quality fertility treatments to her patients. During her 10+ years of service as a fertility expert, she has helped several hundreds of patients overcome their infertility and become parents. She also specializes in the fields of obstetrics, gynecology, and reproductive endocrinology

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