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Why Am I Not Getting Pregnant?
High Stress Levels
You probably have at least one friend who, upon conceiving, said, “It happened right when I stopped worrying about it.” It’s annoying to hear, especially when
you’re not getting pregnant yourself—but it’s often true. High levels of stress can 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 them more stressed—like how being 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 other stress-lowering tools into your
life. Strategies such as meditation, yoga, journaling, or mindfulness can all help manage stress levels.
If you’re using sex to get pregnant, Dr. Curtis recommends having intercourse every day or every other day during your most fertile period. A menstruating person
has a fertile window of about six days, so your chances of getting pregnant are highest if you time sex to that time period.
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It’s usually a good idea to keep most personal care products out of the vagina, but especially so when you’re trying to conceive. For example, health experts don’t
recommend douching for a variety of health reasons from vaginal infections to sexually transmitted infections (STIs). And when it comes to getting pregnant,
douching can act like a spermicide, altering the pH of the vagina. “This has been shown to impair fertility,” Dr. Curtis says.
Ditto for personal lubricants as some brands can impair sperm function and mobility, so if you use it, look for one that’s specifically marked as sperm-friendly.
Your Partner’s Health
People tend to blame the person with the uterus for fertility issues. But in fact, Dr. Curtis says, cases of infertility are about 40% male-related, 40% female,
and 20% a combination of both partners: “Frequently, the would-be mom rushes in to see her doctor at the first sign of a delay in getting pregnant. This is wrong,
since it’s really an even playing field in terms of diagnoses.”
And remember: It usually takes a healthy couple between 6 months and 1 year to conceive.
“Not understanding the timing of ovulation is a popular mistake,” Dr. Curtis says. “Most menstruating people ovulate 14 days before the beginning of their period.
So, for example, if you have a 24-day cycle, ovulation is around day 10.” But while this information seems straightforward at first glance, it can be confusing if you
have irregular periods or can’t remember when you last menstruated.
Another common mistake? Not counting from the real first day of your cycle. “Day one is the first day you bleed, not the day after or the day before,” Dr. Curtis says.
Because fertility can literally come down to a matter of hours, it’s important to know your cycle’s exact timing.
As a solution, Dr. Curtis suggests using ovulation predictor kits (OPKs), which are available over the counter. Keeping a calendar to track your cycle (and possibly other
fertility signs like cervical mucus quality) can also be helpful—and so can using an online ovulation predictor or a fertility tracking app on your phone.
As much as we try, pregnancy really can’t be planned. According to Dr. Curtis, the average healthy couple will take about one full year to become pregnant. And 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. Plus, keep in mind
that every person is different. So if you’ve recently stopped birth control, it could take a few cycles to conceive.
“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.”
His wise advice? Take your time. And if at least 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 (or you have questions about your fertility), then it’s a good idea to seek out the advice of a doctor.
How is infertility defined?
Infertility is defined as the inability to become pregnant after one year of unprotected sex for women under 35 and six months for women 35 and older.
to a year of trying — depending on a woman’s age — we recommend that a couple comes in for an infertility evaluation. At that point, it’s more likely that there’s a
problem preventing pregnancy.”
Medical Conditions Affecting Infertility
One or more factors may contribute to infertility. The most common problems include:
Fallopian tube obstruction
Blocked or scarred fallopian tubes that prevent sperm from reaching the egg are a frequent cause of infertility, especially among African Americans. A history of pelvic
infection, sexually transmitted disease or endometriosis increases your risk for fallopian tube obstruction.
Irregular uterine shape
An irregularly shaped uterus can make it difficult for a fertilized egg to attach to the uterine wall. Abnormalities can be caused by uterine fibroids (noncancerous growths
on the uterine wall) or scar tissue from surgery or infection. It could also be the way your uterus is shaped.
Sometimes women don’t ovulate regularly and consistently. Sporadic menstrual cycles can be caused by conditions such as polycystic ovary syndrome (PCOS), hormonal
imbalances or obesity. Ovulation can also be impacted by excessive exercise, stress or low body weight.
In more than 30 percent of infertility cases, there’s a problem with sperm such as low sperm count or abnormal sperm movement or shape. Male factor infertility can
be due to a number of reasons including trauma, medical conditions like diabetes and unhealthy habits such as heavy drinking and smoking.
Do I Need Infertility Treatment?
If you’re having trouble conceiving, an infertility specialist may be able to help. The first step after 12 months of trying to conceive (six months if you’re 35 or older) is to
schedule an infertility evaluation. This multipart assessment includes:
- Physical examination
- Pelvic ultrasound
- Blood work
- Semen analysis
- Evaluation of the uterus and fallopian tubes (by specialized x-rays or ultrasounds)
evaluated sooner. For example, if you know that both of your fallopian tubes are blocked, you’ll need to see an infertility specialist even before trying to get pregnant.
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