When the Road to Pregnancy is Rocky

Why you may be having a hard time getting pregnant

You’ve been thinking about trying for a baby for quite a while. You’ve analysed the pros and cons, found the right partner or decided on taking the plunge solo, you’re financially prepared, and took into consideration your career. You’re all set and ready to experience the most joyous time of all. It’s baby on the brain and it seems that everywhere you look, pregnant bellies abound and cute babies are everywhere.

Taking the plunge to start trying for a baby is no easy decision, and taking the step towards parenthood can be quite a challenge. Unfortunately though, the ‘trying for baby’ part is not always as straightforward as we might wish it to be. Fertility can become an issue when you’ve been trying for a year and are still unable to get pregnant. Whilst this in no way means that pregnancy is impossible, it is wise to try to pinpoint the reason behind these fertility issues. This article provides an overview of possible diagnoses and what they exactly mean.


Many a times, it’s simply the lifestyle we lead or the point we are in our lives that’s preventing pregnancy. From high levels of stress, to constant sleep deprivation, age, unhealthy eating, and weight issues, the answer to our fertility issues may be a cause of the life we pursue.


The figures are staggering. Doctors estimate that stress, or simply trying too hard, plays a role in up to 30% of infertility cases. It has been pointed out that when stress-reduction techniques are applied, women’s chances of conceiving increase.

Sleep Deprivation

There’s an added reason why you should get your 8 hours of sleep. Not only does the quantity – and quality – of your sleep affect health and mood, it also has a say in terms of hormones and fertility. Fertility hormones including progesterone, estrogen, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are all affected by the amount of sleep you are getting.

From high levels of stress, to constant sleep deprivation, age, unhealthy eating, and weight issues, the answer to our fertility issues may be a cause of the life we pursue

Weight Issues

Your menstrual cycle provides indications as to whether or not your weight is affecting fertility. Overweight or obese women may experience hormonal imbalances that affect the menstrual cycle, preventing ovulation and hence making it harder to conceive. In men, being overweight or obese affects sperm quality. Male obesity may lower testosterone levels and increases the risk of erectile dysfunction, reducing fertility in the process.


Experts agree that, biologically, women are at their most fertile in their 20s. In your mid-20s, there is a 33 percent chance of getting pregnant with each cycle. This reduces to 20 percent in your thirties and continues to speedily decline after 35. At 40 years of age, a woman only has a 5% chance per month of becoming pregnant. Although a differing general perception prevails, a man’s age also matters. As males become older, and particularly after the age of 40, their fertility starts to decline. As sperm quality decreases, it takes longer for their partners to get pregnant and the risk of miscarriage heightens.

Body knowledge

Remember those classes at school explaining how the reproductive system works? Back then, we may have not taken much care to really understanding how it all works. Knowledge of a woman’s monthly cycle and body awareness related to ovulation are key in ensuring that intercourse is taking place in that window where it can yield results. This is not to say that the rest of the month shouldn’t be fun of course!

Monitoring ovulation and having sex at the right time is key.

Know your cycle

It’s common for women not to understand their own cycles. Every women’s cycle is different and varies in length. Many believe that ovulation takes place two weeks after the first day of your period, but this is only so if you have a textbook four-week cycle. Essentially, this means that there is no exact universal timing for ovulation. Monitoring ovulation and having sex at the right time is key. Ovulation monitoring tools available make tracking easier. Read more about tracking your most fertile period here.

Incorrect knowledge

Asking about sperm life may trigger blanks. Sperm can live for three days in the cervix, so sex on the specific ovulation day is only optional. Intercourse can take place the day before and still lead to conception. Another lesser known fact is that lubricant affects sperm motility, so try to do without when trying for a pregnancy.

Medical Issues

Infertility concerns both men and women. One-third of infertility cases are due to male reproductive issues, one-third due to female issues and another third attributed to both or to unknown factors. If pregnancy cannot be achieved after one year of having intercourse without using birth control, and when two or more failed pregnancies are experienced, then infertility comes into play. It is estimated that after one year of unprotected sex, 15 percent of couples are unable to conceive. After two years, 10% of couples still find it problematic to have a successful pregnancy. A number of medical conditions can be the cause of this and individual cases can have either a single cause or several. In some situations, the reason behind infertility is unidentifiable.

Male Infertility

Male infertility can be associated with a blockage in the reproductive tract, ejaculation issues and problems related to response. Infertility in the male case is a
result of an inability to properly produce healthy sperm or a blockage that prevents sperm from joining semen. As has been outlined above, age can also present an issue.


An obstruction in the normal passage of sperm can take place in any section of the male reproductive tract. This prevents the transport of sperm. Such an obstruction can be due to a number of factors, including repeated infections, prior surgery, inflammation, and congenital conditions.

Ejaculation Disorders

Issues surrounding ejaculation can be of three types. Premature ejaculation is when ejaculation occurs before or very soon after penetration. Inhibited or retarded ejaculation occurs when ejaculation is slow to occur. Retrograde ejaculation is when sperm goes back into the bladder rather than through the urethra and out of the penis.

Repeated instances of erectile difficulties may signal a more profound health issue and should be given medical attention.

Poor Responder

An issue that is quite common is impotence. While an occasional bout is nothing to worry about, repeated instances of erectile difficulties may signal a more profound health issue and should be given medical attention.

Other Causes

Albeit rare, other causes of male infertility include hypogonadism and retrograde ejaculation, disorders that interfere with conception. Another reason might be antisperm antibodies which see the body developing an immune system response to sperm. Whilst the latter is also possible in the case of women, it is more common in men.

Female Infertility

Most common causes of female infertility concern issues with ovulation, damage to fallopian tubes or the uterus, or cervical problems. As outlined above, age also plays into this.

Polycystic Ovarian Syndrome (PCOS)

Albeit severely under diagnosed, PCOS is one of the main causes of infertility amongst women. Symptoms of PCOS include weight gain, irregular or absent periods, dermatological issues such as acne, infertility, and failure to ovulate.


Endometriosis is a condition where the uterus lining is found outside of the uterus. Endometriosis is most common amongst women in their 30s and 40s, and the condition may lead to conception issues. Scarring and adhesions result in blockage which prevents the egg from being fertilized or for it to travel properly along the fallopian tubes.

Ovulation Issues

Excessive weight loss, stress, thyroid problems, and hormone imbalances can all cause ovulation issues. Ovulatory disorders, such as irregular periods or a failure to ovulate account for 40% of female fertility issues.

Uterine Issues

Pregnancy may be difficult to achieve due to uterine fibroids, uterine didelphys, scar tissue, or an entirely missing uterus. Different treatments may be recommended depending on the diagnosis.

Premature Ovarian Failure (POF)

POF occurs when menstruation stops at an early age. It’s causes range from defects before birth to your ovaries becoming resistant to the body’s natural hormones. POF can also be triggered by pelvic surgery, chemotherapy and radiation.

Repeated Miscarriages

A miscarriage is not an easy event to go through. While the main cause of miscarriage is a defect with the fetus, there are other issues which may affect this. Problems with the uterus or cervix, atypical hormone levels, or infections can all lead to a miscarriage. Multiple miscarriages may hint at fertility problems which should be granted attention.

Luteal Phase Defect (LPD)

LPD is attributed to inadequate secretion of progesterone by your ovaries or an endometrium that is not responding appropriately to progesterone stimulation. This means that the endometrium is not properly prepared for pregnancy, hence leading to fertility problems or an early miscarriage.

Secondary Infertility

Secondary Infertility is when issues with conceiving occur after you and your partner have already had a child or two. The truth is that infertility can occur at any point in your life. It might have been easy to conceive first time round, but this does not mean that it will continue to be so. Interestingly, secondary infertility is even more common than primary infertility experienced by people who have never had a child.

Unexplained Infertility

Receiving a diagnosis that your infertility is unexplainable may be quite frustrating. Around 20 to 30 per cent of infertile persons receive such a diagnosis. This basically means that the testing available did not identify the particular reason behind your infertility. So far, the testing that exists is incapable of identifying all causes that impede fertility.

A will and commitment to appropriately address the issue is the first in a series of steps towards achieving your dream of becoming a parent.

Way forward

Dealing with infertility is not easy. Nonetheless, a will and commitment to appropriately address the issue is the first in a series of steps towards achieving your dream of becoming a parent. Identifying a way forward and making informed decisions are key in this process. Together with a positive outlook, the medication and treatments available today will assist you in your journey towards parenthood.

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