Why Am I Not Getting Pregnant?
Why Can't I Get Pregnant?
It all seems so simple, you have unprotected intercourse during your fertile window, sperm meets egg, fetilizes, and there you go, bingo! However, of course for many people it is not this simple, but why not? OK there are a few people who get pregnant in the first month they try but really they are the lucky ones and most people have to try for a bit longer before they succeed.
So if you are asking yourself 'Why can't I get pregnant' then you really need to look behind the simplicity of the sperm meets egg situation and see that there are a whole lot of other scenarios. So first, whenever something does not work, it is like checking electricals that have failed, you need to go right back to square one to check the basics before you get more complicated tests going on.
Back to Basics
OK, if you are really sure that you have got this bit right then feel free to skip over it :-) I don't want to teach you to suck eggs after all.
There is only one essential basic - TO HAVE UNPROTECTED SEX DURING YOUR FERTILE WINDOW.
Unprotected - he ejaculates inside you (it is really very unlikely, maybe even impossible (but maybe with some kind of super sperm who knows), that ejaculation outside of the body could end up with you getting pregnant. It is hard enough for the sperm to swim past the cervix when it has a massive headstart of being inside already without having to find it's way up there first of all). Many people are worried that they may get pregnant without him 'finishing' but really this is highly unlikely.
Fertile Window - this is the major key thing. You can't always assume (even if doctors generally do!) that you will ovulate in the middle of your cycle. There are 2 parts to your cycle the first part when you menstruate and before you ovulate and then the second part (the Luteal Phase or LP) after you have ovulated. The LP is usually somewhere between 10 and 16 days. Usually it is 14 days but that is not true for everyone and an LP of 12 or 13 days can be common. If you have an LP of 10 days (or possibly even less) then you are venturing into the realms of a debatable subject known as Luteal Phase Defect which may hinder your chances of conception (although many people do get pregnant with a LP of 10 days so don't panic). So 'normal' cycles will involve a 14 day first phase and 14 day luteal phase, making it 28 days in total. However, most of us are not normal!
So, the important thing is to know when you ovulate (check out the linked article for more info on that) so that you know when to have unprotected sex. Ovulation is when the egg is released from your ovary and is ripe for fertilization. Once the egg is released it does not last too long (maybe 12 hours, maybe shorter) so it is best for the sperm to already be waiting for the egg when it is released. Sperm can last in the body for up to possibly 4 days so the best time to have sex is in the 4 days leading up to ovulation, the day of ovulation and possibly the day after.
Most doctors recommend that you have sex every other day or perhaps every 3 days if you have long cycles. In this way the sperm gets refreshed to a decent level and you have a great level of fresh sperm entering the cervix. If you know that your partner has a great sperm count (over 20 million) then it is possible to have sex every day and still have a good quantity and quality of sperm.
I Know I am Having Sex at the Right Time
So, you know all of this and you know for sure that you are having unprotected sex at the right time in your cycle but still you have not got pregnant. Although this seems unfair and crazy you have to think about the fact that you only get this one shot each month. Everything has to come together exactly. The sperm has to swim through the hostile environment of your cervix which immediately kills off a large number of them. If you are lucky a very small percentage make it through and up to the fallopian tubes and then they have to actually penetrate the egg. This is why doctors only give people a percentage chance each month of getting pregnant naturally (usually according to age). This percentage can range from around 5% (usually for over 40's) to about 25% (for under 30's). So if you are under 30 there is a big chance that you will conceive in the first 4 months. However, this means that everything must be perfect every month.
The majority of people will conceive within the first year (at least those under 35) and this is why doctors say to wait a year before going for any sort of tests.
I've Been Trying for More Than 6 Months
So, firstly I would say that if you have been trying for less than 6 months then I'm sorry but you will just have to be patient. There is every chance that absolutely nothing is wrong and it is just a matter of a few more tries before that perfect sperm meets that perfect egg and it is all systems go.
However, if you are nearing the one year mark then you may want to think about a few things that you can be doing. There are two sides to the coin, the sperm and the egg. You need to know that you are getting good quality sperm that has the ability to swim in the right direction and there are enough of them to get through. There are a few things that you can do to ensure that you are getting the best quality sperm - check out this article for more information. However, the only way that you can know whether the sperm is good and the quantities are reasonable is to have a semen analysis done. Doctors will check this along with the tests that they do on you but usually only after one year of trying. You can get home sperm tests which will give you a limited amount of information but may help determine if there is a problem.
It may be worth you both cutting down on alcohol and smoking if you haven't already and consider a healthier lifestyle in terms of food and exercise.
For the woman, there may be other problems, or again, it may just be a matter of time. If you are having regular periods then your chances are better as firstly you know when you are ovulating and secondly there are less likely to be issues than if you have very irregular cycles.
The first thing that a doctor will do is to take some blood and test certain hormone levels. Mostly these are to check that you are ovulating and to check your egg reserves. Egg reserves are not likely to be much of a problem if you are younger so it may be a question of whether you are ovulating or not. Although you may be getting positives on your ovulation tests this does not confirm that you are ovulating unfortunately. In conjunction with this you really need to take your temperature daily to see that there is a marked shift in temperature upwards after you ovulate (check out this article).
Blood Tests Are OK and SA is Fine
If your blood test results come out OK - hormone levels are good and you are ovulating - and your Semen Analysis results are OK then they may do another test to check whether your tubes are blocked or not. The test involves squirting dye through your fallopian tubes to check that they are clear. It is relatively painless and you should get a quick answer from the doctor.
The thing is that even if all of the tests are OK, it can still take some time for some peoplr to get pregnant. There may still be absolutely nothing wrong but you are still struggling. This happens to a lot of people and the worst case scenario that I have come across is someone who suddenly got pregnant after 5 years of trying with no real reason why it had taken that long. However, this is an extreme case so don't think that just because it has not happened in a year that it will take you 5 years!
What Should I Do?
So, the best idea is to have a plan in place so that you don't see this as a never ending situation. I would recommend the following:
Trying for 1-3 months
Just keep on going as you are, you may want to start temping so that you can check that you are ovulating or to use ovulation prediction kits to ensure you are having sex at the right time.
Trying for 3-6 months
When getting closer to the 6 month mark, as well as getting your timing spot on, make sure that your partner is doing what they can to get the best quality sperm and perhaps think about some lifestyle changes with regard to alcohol/food/exercise. You could also consider some supplements that may increase your egg quality.
Trying for 6-9 months
It may be worth taking a home sperm test to check for any issues so that you can be prepared if you need to take further action. Continue temping so that you have a record of your cycles if you need to go to see a fertility specialist. Expect that it might happen in this time though.
Trying for 9-12 months
Make an appointment to see your doctor near the 12 month mark if you have not got pregnant. Do not be too downhearted at this stage though as there is still every likelihood that it can happen for you.
Don't Get Downhearted!
Although it is easy to say, try not to get too obsessed and downhearted if you do not get pregnant immediately. It is not an instant process (for most) and there is more than likely nothing wrong with you if it doesn't happen straight away. The majority of people do get pregnant in the first year and although there are those that don't (varying stats but said to be around 25%), there are still things that can be done to increase your chances after this.
Good luck and lots of baby dust!
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