The Real Reasons You Can't Get Pregnant

Oct 24, 2021 10:38am

What causes difficulty getting pregnant?

With infertility on the rise, so many are asking what actually causes infertility. The answer can be one - or a mixture - of so many things.

Reasons why you might not be able to get pregnant fall into one of a handful of categories: genetic, physiological or lifestyle-related. Environmental concerns have also been shown to negatively impact fertility on an increasingly significant scale.

If you can't get pregnant and want to know why, it's a good idea to begin examining these categories in your life - and in your partner’s life - all at once. While lifestyle changes can be made at home, fully comprehending your genetic makeup and/or any pre-existing medical conditions can take a little bit more work.

Top Signs You Are Having Fertility Issues

On average, a man or woman has about a 10% chance of having fertility issues. But how can you tell if you are one of them? Well, the obvious answer is that you’ve been struggling to get pregnant for years with no luck. Or, perhaps you have already been diagnosed at a fertility clinic.

But times are changing. Women are not waiting “until it’s time” to learn what their bodies have in store for them. By proactively taking the opportunity to learn about their fertility, they are better able to plan for themselves, their careers and their future family.

In addition, many couples who want to start a family are no longer waiting… and waiting… and waiting, only to have their dreams dashed every single month. So many individuals used to let months and years go by, thinking that something might be up with their fertility, before doing anything about it. This is no longer the case.

So, whether you want to know what you are dealing with fertility-wise or you are pretty sure there’s a problem that needs to be addressed, there are some serious signs that should put you on high alert:

  1. You’ve been having unprotected sex, regularly, with no success. If you’ve been trying for more than 6 months while at the same time tracking your fertility through either natural methods or ovulation predictor kits with still no luck, that’s a double red flag.
  2. All of your friends are having the first, or second, babies. This seems silly, but it’s true. Initially, you are happy for all of your friends, cousins and even your sisters. But at some point, birth announcements and baby shower invitations make you cringe. What was once a cause for celebration has evolved into self-loathing and despair. Boundaries, they’re healthy! It’s totally OK to protect your mental health and decline those baby shower invitations, true friends will understand
  3. You are 35 or older. Listen, as annoying as it is, the proverbial ticking clock exists for a reason. After the age of 35, a woman’s egg quantity and quality essentially falls off a cliff. This, assuming that you have no pre-existing fertility conditions to begin with. Yes, we all know people who have gotten pregnant naturally later in life - planned or not. However, it’s important to realize that it is not common and it is certainly not something you can count on.

There’s no need for all of the above to apply. If just one of them does, then it’s a surefire sign that you need to get your fertility checked ASAP.

Causes

What are the reasons why I can’t get pregnant?

This is the million dollar question for so many women. The toughest part is that, in so many cases, there is no definitive answer as to why a woman can’t conceive. According to the CDC, about 12% of women aged 15 to 44 years in the United States have difficulty getting pregnant or carrying a pregnancy to term. In 10% of those cases, the diagnosis is “unexplained infertility,” which means that there is no clear reason why.

It is important to understand that a man’s fertility is just as crucial to the baby making process as a woman’s. So many couples struggle to build a family for years, automatically assuming that it is due to female factors. Because of this, we are covering both men and women’s infertility causes below.

Medical Reasons You Can’t Get Pregnant

Medical Causes of Infertility in Women

About 70% of miscarriages can be attributed to chromosomal abnormalities - 70%! If you are beating yourself up over the fact that you had a piece of unpasteurized cheese and think that must be the reason you lost a pregnancy, stop yourself right now. Other than possibly advanced testing, there is nothing you could have possibly done to prevent your loss.

Some of the more common medical causes of infertility in women include: 

Ovulation Disorders 

  • PCOS Polycystic Ovarian Syndrome is a hormonal disorder that causes irregular ovulation in women. An ovary that is “polycystic” features many small, fluid-filled sacs that can prevent a woman from releasing eggs.

Symptoms: Irregular periods, Weight gain, Fatigue, Excess body hair

  • POF/POI Premature Ovarian Failure or Insufficiency is the diagnosis for when a woman’s ovaries stop functioning regularly despite the fact that a woman is still in her reproductive years. When the normal levels of hormones are not produced, eggs will not be released. While POF/POI is associated with autoimmune diseases, it can also be caused by pelvic inflammatory disease, cancer treatment and chromosomal abnormalities.

Symptoms: Irregular periods, Difficulty conceiving, Hot flashes, Night sweats

10–20% of women with POF have a family member who went through premature menopause. 

  • Endometriosis. This condition is essentially defined as uterine tissue growing outside of where it belongs - resulting in all sorts of problems. When the tissue is shed monthly it can cause A LOT of pain along with inflammation, swelling and scarring.

Symptoms: Unusually heavy menstrual flow, Extremely painful periods, Lower back pain

  • Fallopian Tube damage/blockage. The fallopian tube is where sperm meets egg and fertilization occurs. If the tubes are damaged or blocked in any way, fertilization is unlikely to happen. Reasons for tubal blockage include endometriosis, pelvic inflammation, previous surgeries, ectopic pregnancy or tubal ligation.

Symptoms: Abdominal/pelvic pain, Unusual vaginal discharge, Infertility

  • Chromosomal Abnormalities. If embryos with chromosomal abnormalities do manage to implant, they often result in miscarriage or a baby being born with physical/mental delays. As a woman ages, the likelihood of this increases.

Symptoms: Infertility, Recurrent miscarriage

Medical Causes of Infertility in Men. According to the National Institute of Health, genetic factors account for 2-8% of male factor infertility cases. To make a baby, sperm has a lot of responsibility. There needs to be a sufficient quantity, it must be of a certain quality and its ability to travel is very important. A number of genetic conditions can impact one or all of these requirements.

The most common genetic causes for infertility in men include:

  • Cystic Fibrosis gene mutation. Up to 98% of men with Cystic Fibrosis are infertile because of an absence of the sperm canal (CBAVD). Because of this, the sperm never make it into the semen, making it impossible for them to reach and fertilize an egg through intercourse.

Symptoms: Persistent cough, Shortness of breath, Frequent lung infections and more.

  • Chromosomal Abnormalities - Chromosomal abnormalities in both men and women can impact one’s ability to conceive. Aneuploidy (an abnormal number of chromosomes) or chromosomal translocations (misplaced chromosomes) can ultimately go on to cause problems such as miscarriage and stillbirths in addition to genetic disorders in offspring.

Symptoms: Potentially none whatsoever

  • Noonan Syndrome. Noonan syndrome is a genetic disorder that prevents the body from developing normally. The majority of men (up to 75%) with Noonan Syndrome suffer from undescended testes which impairs the ability for sperm to mature appropriately. This, however, can be corrected through surgical procedures.

Symptoms: Significant and apparent physical development issues

  • Klinefelter Syndrome - In Klinefelter Syndrome, a condition that often goes undetected, males are born with an extra copy of the X chromosome which results in unusually small testicles.

Symptoms: Potentially none whatsoever.

If I’m having trouble getting pregnant, is genetic testing a good idea?

Yes! If you have been trying to get pregnant for 6 months or longer with no success, genetic testing for both you and your partner is something to consider. Doubly so if a genetic disorder runs in your family or if you are of the following descents:

  • Mediterranean
  • Jewish
  • African-American
  • Southeast Asian

Why? Individuals of these backgrounds are predisposed to Tay Sachs,  sickle cell, and thalassemia, respectively.

How does the genetic testing work?

Also known as “Carrier Screening” or “Gene Screening”, simple blood or saliva tests are able to detect genetic abnormalities in DNA. For many, this test can lend a lot of helpful insight as to the reasons why you may have difficulty getting pregnant or be suffering from recurrent miscarriage. If you're interested in a gene screen, you can kick off the process during your first visit to a fertility clinic.

What is the downside of genetic testing?

The number one reason couples often choose to forgo genetic testing is expense. Health Insurance rarely covers the costs which can range on average between $500 to a few thousand dollars depending on your coverage and the depth of the screening. On the plus side, many at-home kits have recently come to market which provide relatively good analysis for a fraction of in-office costs.