It can be disheartening and stressful when you’re trying to start a family and conception doesn’t happen as quickly as you’d hoped. You’re not alone; infertility is more common than many realize. In fact, around 1 in 7 couples globally experience difficulties when trying to conceive. If you’ve been trying to get pregnant through regular unprotected sex, and it hasn’t happened yet, you might be asking yourself, “Why can’t I get pregnant?”
It’s important to understand that for couples under 40 engaging in regular unprotected intercourse (every 2 to 3 days), over 80% will conceive naturally within a year. However, if you’ve been actively trying for over a year without success, it’s wise to seek advice and explore potential reasons and solutions. For those who have been trying for more than three years, the chances of natural conception within the following year decrease to 1 in 4, or even less.
Seeking Professional Guidance for Fertility Concerns
While some couples conceive very quickly, for others, the journey can take longer. If you haven’t conceived after a year of actively trying, consulting a healthcare professional, such as a General Practitioner (GP), is a recommended first step. For women aged 36 and over, or individuals who are already aware of potential fertility issues, seeking medical advice sooner is advisable.
A GP can conduct initial checks to identify common causes of fertility problems and suggest appropriate treatments or further investigations. It’s crucial to remember that infertility is typically diagnosed after a couple has been actively trying to conceive for a year without success.
Infertility is categorized into two main types:
- Primary Infertility: This refers to individuals who have never conceived before and are currently facing difficulties in conceiving.
- Secondary Infertility: This applies to those who have had one or more pregnancies in the past but are now experiencing challenges in conceiving again.
Understanding the type of infertility and seeking timely diagnosis are crucial steps towards finding appropriate support and treatment.
Exploring Treatment Options for Infertility
Fortunately, there are various effective treatments available to address infertility. These range from medical interventions to assisted conception techniques, tailored to the specific needs of each individual or couple. Fertility treatments can include:
- Medical Treatments for Ovulation Issues: Medications are often prescribed to women who experience irregular or absent ovulation, helping to regulate their cycles and increase the chances of egg release.
- Surgical Procedures: Surgery may be recommended to correct structural issues that hinder fertility. This can include procedures to treat endometriosis, repair damaged fallopian tubes, or remove scar tissue within the uterus or abdominal cavity.
- Assisted Conception Technologies: When other treatments are not sufficient, assisted reproductive technologies (ART) like Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) offer advanced options to facilitate conception. IUI involves placing sperm directly into the uterus, while IVF involves fertilizing eggs with sperm in a laboratory and then transferring the embryo(s) into the uterus.
The specific treatment plan will depend on the underlying causes of infertility, and the availability of services within your local healthcare system. Both public and private treatment options exist. Private clinics offer alternative pathways, but it’s essential to be aware that these can be costly, and success isn’t guaranteed. When considering private treatment, consulting your GP for advice and ensuring the clinic is licensed by the Human Fertilisation and Embryology Authority (HFEA) for quality and safety standards is strongly recommended.
It’s also important to be informed about potential complications associated with some fertility treatments, such as IVF. These can include:
- Multiple Pregnancy: IVF treatments, particularly when multiple embryos are transferred, increase the chance of conceiving twins or higher multiples. While this might seem desirable to some, it significantly elevates the risks of pregnancy and birth complications for both the mother and babies.
- Ectopic Pregnancy: There’s a slightly increased risk of ectopic pregnancy (where the fertilized egg implants outside the uterus) associated with IVF procedures.
Being fully informed about the benefits and potential risks of each treatment option is a vital part of the decision-making process.
Uncovering the Causes of Infertility
Pinpointing the exact cause of infertility can be complex. Fertility issues can arise from factors affecting either partner, and in approximately 25% of cases, the cause remains unidentified even after thorough investigation. However, there are several common factors known to contribute to infertility:
- Ovulation Disorders: Irregular or absent ovulation, meaning the monthly release of an egg, is a frequent cause of infertility in women.
- Semen Quality Issues: Problems with sperm count, motility (movement), and morphology (shape) can significantly reduce male fertility.
- Fallopian Tube Damage or Blockage: Blocked or damaged fallopian tubes prevent the egg from traveling to the uterus and sperm from reaching the egg, hindering fertilization.
- Endometriosis: This condition involves tissue similar to the uterine lining growing outside the uterus, which can disrupt the function of the ovaries, fallopian tubes, and uterus, leading to infertility.
Identifying Risk Factors Affecting Fertility
Beyond direct causes, several lifestyle and environmental factors can negatively impact fertility in both men and women. Being aware of these risk factors and making necessary adjustments can improve your chances of conceiving. These include:
- Age: Fertility naturally declines with age in both sexes, but particularly significantly for women from their mid-30s onwards.
- Weight: Being overweight or obese (BMI of 30 or higher) is associated with reduced fertility in both men and women. In women, both being overweight and being severely underweight can disrupt ovulation.
- Sexually Transmitted Infections (STIs): Certain STIs, such as chlamydia and gonorrhea, can cause pelvic inflammatory disease and damage the reproductive organs in both men and women, leading to infertility.
- Smoking: Smoking, including passive smoking, impairs fertility in both men and women. It reduces the chances of conception and negatively affects sperm quality.
- Alcohol Consumption: Excessive alcohol intake can harm both sperm quality in men and fertility in women. Health guidelines generally recommend limiting alcohol intake when trying to conceive.
- Environmental Factors: Exposure to certain environmental toxins like pesticides, solvents, and heavy metals has been linked to fertility problems, especially in men.
- Stress: While stress is a common part of life, high levels of stress can indirectly affect fertility by impacting relationships, reducing libido, and potentially disrupting ovulation and sperm production in severe cases.
Understanding these risk factors empowers you to make informed choices about your health and lifestyle, potentially improving your fertility and chances of conception. If you are concerned about your fertility and asking “Why can’t I get pregnant?”, seeking medical advice is the most important step to take. A healthcare professional can provide personalized guidance, investigate potential causes, and discuss the most appropriate treatment options for your individual situation.
