You are not alone in asking “why am I not getting pregnant?” and it’s a serious, very personal topic, so I’ll keep this practical, clear, and medically grounded.

Why you might not be getting pregnant

There are many possible reasons, and often more than one is involved at the same time. Only a doctor who knows your history and can examine you can tell what applies to you , but these are the most common medical categories.

1. Ovulation and hormone issues

If you don’t release a healthy egg regularly, it’s very hard or impossible to conceive.

Common causes include:

  • Polycystic ovarian syndrome (PCOS), which often leads to irregular cycles or no ovulation.
  • Thyroid problems (overactive or underactive) that disrupt your cycle.
  • High prolactin or high stress hormones (like cortisol) affecting the menstrual cycle and estrogen levels.
  • Premature ovarian insufficiency (early menopause) where the ovaries stop working earlier than usual.

Signs can include very irregular cycles, very light or very heavy periods, or no periods at all, but sometimes cycles look “normal” while ovulation is still irregular.

2. Problems in the uterus or fallopian tubes

Even if ovulation is fine, the egg and sperm must meet and the embryo must attach inside the uterus.

Possible problems:

  • Blocked or damaged fallopian tubes, often from past infections (like chlamydia), endometriosis, or previous surgery.
  • Fibroids or polyps inside the uterus that distort the cavity or reduce space for the embryo.
  • An unusually shaped uterus, or scar tissue from previous surgery or miscarriage, that interferes with implantation.
  • Endometriosis, where tissue similar to the uterine lining grows elsewhere and can affect tubes, ovaries, and implantation.

These issues often require scans (ultrasound, HSG, hysteroscopy) to detect.

3. Sperm and male‑factor issues

About one‑third of infertility cases are mainly due to problems on the male side, and another third are mixed (both partners).

Possible male factors:

  • Low sperm count, poor movement (motility), or abnormal shape (morphology).
  • Problems with ejaculation or erections, or blockages that prevent sperm from entering the semen.
  • Hormone issues or testicular damage from infections, injury, or surgery.
  • Heat, toxins, or medications (saunas, hot tubs, certain blood pressure, depression, or infection medicines, some chemotherapy, environmental chemicals).

A semen analysis is the basic test to check this.

4. Lifestyle, age, and general health

Sometimes everything looks “normal” on basic tests, but everyday factors still reduce the chances of pregnancy.

Important influences:

  • Age: Female fertility falls gradually in the early 30s and more steeply after 35; egg quality declines even with regular periods.
  • Weight: Being significantly overweight or underweight (high or very low BMI) can disrupt ovulation and lower sperm quality.
  • Smoking and alcohol: Both smoking (including passive smoke) and heavy drinking reduce fertility in men and women.
  • Poor sleep and chronic stress: Linked to hormonal disruption and reduced fertility, and they often worsen other health problems.
  • Unmanaged health problems like diabetes, high blood pressure, and high cholesterol.

Improving these doesn’t guarantee pregnancy, but it can significantly increase your chances and make treatments more effective.

5. Timing and frequency of sex

It is possible to be healthy but simply miss the fertile window.

Key points:

  • You are most fertile in the few days before ovulation and the day of ovulation itself.
  • Sperm can live inside the female reproductive tract for up to 5 days, but the egg lives only about 12–24 hours.
  • Having sex every 2–3 days throughout the cycle or once a day in the fertile window usually covers the timing.

If cycles are irregular, it can be hard to predict ovulation without ovulation predictor kits, basal body temperature tracking, or ultrasound monitoring.

6. “Unexplained” infertility

Sometimes all standard tests come back “normal” and doctors still do not find a clear cause.

This is called “unexplained infertility” and can be extremely frustrating because nothing obvious is “wrong,” but pregnancy still isn’t happening. Even in these cases, many couples eventually conceive naturally or with treatments like ovulation stimulation or IVF.

7. When to seek medical help

General medical advice (which may vary slightly by country) is:

  • If you are under 35: See a doctor if you have been trying with regular unprotected sex for 12 months without success.
  • If you are 35 or older: See a doctor after 6 months of trying.
  • Go sooner if:
    • Your periods are very irregular, extremely painful, or absent.
* You already know you have conditions like PCOS, endometriosis, or pelvic infections.

* Your partner has a known sperm or testicular problem, or history of chemotherapy, major groin surgery, or undescended testes.

8. What doctors usually do next

A fertility work‑up typically looks at both partners.

For you, doctors may suggest:

  • Blood tests for hormones (FSH, LH, estrogen, progesterone, thyroid, prolactin, sometimes AMH).
  • Pelvic exam and ultrasound to check ovaries and uterus (for cysts, fibroids, uterine shape).
  • Tests for infections such as chlamydia.
  • Hysterosalpingogram (HSG) or similar tests to see if tubes are open.

For your partner:

  • Semen analysis for count, movement, and shape.

Depending on results, options can include lifestyle changes, medication to stimulate ovulation, surgery (for fibroids, endometriosis, or tubes), intrauterine insemination (IUI), or in vitro fertilisation (IVF).

9. Emotional and social side (very real and valid)

Feeling worried, guilty, or “broken” is sadly common when pregnancy doesn’t happen quickly, but none of this is your fault.

Online trying‑to‑conceive (TTC) communities often warn against “unhelpful clichés” like “just relax” because they dismiss real medical and emotional struggles. If you’re finding this mentally heavy, talking to a counsellor, therapist, or support group that understands fertility issues can take some weight off your shoulders.

10. What you can do right now

This is general information, not a diagnosis, but these steps are usually sensible while you arrange proper medical advice.

  1. Track your cycles
    • Note period dates, bleeding pattern, and any ovulation predictor kit results or cervical mucus changes.
  1. Optimise basic health
    • Aim for a healthy weight, stop smoking, limit alcohol, sleep regularly, and manage chronic conditions with your doctor’s help.
  1. Check timing and frequency
    • Aim for sex every 2–3 days, or daily during the fertile window if you can.
  1. Book a medical review
    • If you already meet the timelines above, or if you have worrying symptoms, schedule an appointment with a gynaecologist or fertility specialist and take your partner for evaluation too.

Very important safety note

If you have any of these, seek urgent care or prompt medical review:

  • Severe pelvic pain, pain with fever, or foul‑smelling vaginal discharge.
  • Very heavy bleeding (soaking pads every hour) or bleeding with dizziness or fainting.

These can signal infection, ectopic pregnancy, or other emergencies and need immediate attention.

Information gathered from public forums or data available on the internet and portrayed here.

If you tell me your age, how long you’ve been trying, and whether your periods are regular, I can help you think through which of these areas might be most relevant to ask your doctor about.