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Why am I not getting pregnant?

Leading causes of female infertility:

  • Tubal infertility

  • Ovulation disorders like PCOS, hypothalamic dysfunction, premature ovarian failure, excess production of prolactin

  • Uterine or cervical causes

  • STD’s, particularly chlamydia and gonorrhea

  • Pelvic inflammatory disease (PID)

  • DES Exposure

  • Thyroid disorder

Woman in distress about infertility

They say infertility is the worst club to be a part of. For those trying to fall pregnant and not succeeding, it might just seem like nothing in the world works! No matter what position, supplements, or whatever dosage of folic acid your friend advised you to get, it might just feel like the most impossible thing to achieve.

However, not being able to fall pregnant can usually be associated with a range of underlying health conditions that need to be addressed, which can be attributed to either the female or the male reproductive system, but in this post we will be focusing on female infertility only.

Normally, it is said that you need not worry until after at least a year of trying to conceive with no success. However, if you feel something might be up with your reproductive health hindering your ability to conceive, there's absolutely no harm in taking it up with your Ob/Gyn.

Obstetrician examining a patient

Possible health conditions affecting female fertility:

1. Tubal Infertility

Accounting for about 25%-35% of all female infertility cases, tubal infertility occurs when a woman's fallopian tubes are blocked, damaged or disfigured due to disease or tissue scarring. A pair of delicate, hollow tissue canals, the fallopian tubes connect the ovaries to the uterus. If these tubes get obstructed or damaged, they might prevent the sperm from reaching the egg resulting in infertility. In some cases, the damaged tubes can still allow the sperm to reach the egg and fertilize it yet the resulting embryo cannot successfully reach the uterus for implantation (ectopic or tubal pregnancy).

2. Endometriosis

One reason behind the scarring or disfiguring of the fallopian tubes can be attributed to Endometriosis. It is a condition where the lining of the uterus or endometrium grows outside of the uterus. This abnormal overgrowth of the endometrium is a leading cause of infertility and can be extremely painful to endure as well.

3. Ovulation disorders

Ovulation disorders such as PCOS, hypothalamic dysfunction, premature ovarian failure or excess production of prolactin are also some of the potential causes of female infertility. These conditions directly impact ovulation thereby affecting your ability to conceive.

4. Uterine or cervical causes

Uterine fibroids or myomas are noncancerous growths in or around the uterus that can develop during a woman's childbearing years. Fibroids are almost never cancerous however, their existence can hugely impact the normal functioning of the uterus (hence affecting conception) along with causing abnormal bleeding during menstruation.

home pregnancy test

5. STD's particularly chlamydia or gonorrhea

If left untreated, STDs such as chlamydia and gonorrhea can interfere with your ability to have children. Both these diseases affect the fallopian tubes by damaging or scarring it, which in turn serves as a cause of tubal infertility.

6. Pelvic inflammatory disease (PID)

Pelvic inflammatory disease is caused by bacteria entering the female reproductive system through either the vagina or cervix. PID causes an infection in the uterus, fallopian tubes and/or other reproductive organs, which might lead to permanent damage to these organs. However, with early detection and appropriate treatment, many women with a history of PID can go on to successfully conceive naturally.

7. DES Exposure

Although rather rare currently, diethylstilbestrol, known as DES, introduced in the 1940s was a clinical compound supposed to prevent certain pregnancy complications. It proved not only to be ineffective but was also linked a rare type of cancer occurring in females who had been exposed to the drug while in utero. Although its use in humans is almost extinct now, millions of females who had been exposed to the drug while in the womb, had had their fertility compromised because of it.

8. Thyroid Disorder

Thyroid disorders, both hypothyroidism and hyperthyroidism can each negatively impact a woman's ability to conceive because abnormal TSH levels can interfere with normal ovulation. In other words, both too much thyroid hormone and too little thyroid hormone can cause disruptions of the menstrual cycle, increased risk of miscarriage as well as premature birth.


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