Top signs you can't get pregnant and what to do
Baby-making should be fun, but when couples trying to get pregnant fail to see that second line on the pregnancy test, despite their best and most timed efforts for months, many begin to question their bodies.
Is something wrong?
Am I infertile?
Were my irregular periods one of the signs of infertility?
Sometimes, even the stats don’t help!
Approximately 85% of couples trying to get pregnant conceive in the first year, leaving 15% of couples to sit outside of that relatively normal conception window.
Understanding an infertility diagnosis
Infertility is defined as trying to get pregnant with frequent, unprotected sex for at least a year with no success. It’s usually diagnosed if a couple has been trying to conceive for one year and hasn’t succeeded.
While big celebrations happen to mark pregnancy, gender reveals, births, and first birthdays – infertility still very much sits in the shadows.
“It was some of the darkest two years of my life”, mother, photographer and We Don’t Have Time for This podcaster Gemma Peanut told Kiindred. “It’s this weird thing where you feel really abandoned by your body, like, you feel let down”, she said.
The good news is that in many cases where a couple is struggling to conceive, infertility is treatable. With conventional treatment such as IVF, 85 to 90 percent of infertile couples are able to get pregnant, according to the American Society of Reproductive Medicine. So, a diagnosis of infertility doesn’t necessarily mean you won’t be able to have a baby. Fertility treatments, including assisted reproductive technology (ART) and medications to stimulate ovulation, are available to increase the odds of pregnancy.
There are a lot of reasons women experience infertility problems and many risk factors for their reproductive health.
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Issues that affect fertility in women
Blocked fallopian tubes Obstructed or scarred fallopian tubes can prevent sperm from getting to the egg, making it a big cause of infertility. Having a history of pelvic infections, sexually transmitted infections, pelvic inflammatory disease or endometriosis can raise the risk factor. If you’ve experienced an ectopic pregnancy before, this could also weigh in.
Ovulation disorders: Some women have irregular ovulation, often due to polycystic ovary syndrome syndrome (PCOS) or hormonal imbalances. Premature ovarian failure can happen when the ovaries stop functioning normally before the age of 40, meaning they don’t produce typical amounts of estrogen or release eggs efficiently.
Uterine abnormalities: Certain conditions can make it really tricky for a fertilised egg to attach to the uterine wall. Things like scar tissue, endometrial polyps, or an unusually shaped uterus can affect fertility. Heavy periods may be a result of uterine fibroids, which can make it difficult for a pregnancy to implant normally in the uterus.
Endometriosis: This can cause hormonal imbalances and problems with fertility by causing tissue that resembles the lining of the uterus to grow outside of the uterine wall. This causes painful periods for women who have it.
Hormonal imbalance: Hormonal fluctuations resulting from thyroid disorders, abnormal prolactin levels, stress, or an unhealthy lifestyle can impair fertility and cause problems with ovulation.
Medical treatments: Occasionally, certain drugs and medical procedures can hurt a woman’s ability to become pregnant. Often, women undergoing chemotherapy experience issues with their fertility. Surgery for endometriosis or ovarian cysts, for example, can also have an impact on reproductive organs.
Advanced age: Research proves that at 32, fertility in women starts to decrease and affects the quality of eggs, reducing the chances of pregnancy. Around 1 out of 4 women in the 20s or early 30s age bracket have a chance of pregnancy in a single cycle. However, the drop is significant after 37, and only 1 out of 10 women has a single-cycle chance of pregnancy.
How is female infertility diagnosed?
Multitudes of tests and examinations exist to understand what might be causing fertility challenges in women. A blood test checks hormone levels like FSH, LH, and AMH to see the overall health of the ovaries and how they are performing.
Transvaginal ultrasound can help give a clearer picture of the reproductive organs to spot issues like cysts or fibroids.
Hysteroscopy gives an insight into the inside of the uterus with a tiny camera to find any problems there. Moreover, other examination procedures like saline sonohysterogram (SIS) and sono hysterosalpingogram (HSG) that use ultrasound to check the uterus and fallopian tubes by putting a special liquid in the uterus can also be helpful in a clear diagnosis. X-ray hysterosalpingogram (HSG) is another test where contrast dye and X-rays are used to see if there are any blockages.
Male infertility symptoms
Sperm disorders: A lower sperm count, abnormally shaped sperm, or sperm with low motility (meaning they have trouble reaching the egg), can cause an increased risk of infertility.
Varicoceles: Blocked or swollen veins in the scrotum make it hard for sperm to thrive, creating a low sperm count.
Poor sperm delivery Male infertility increases with issues like premature ejaculation, erectile dysfunction, or blockages in the testicles, which lower the chances that healthy sperm make it to the egg.
Gynecomastia: This is a condition where, due to hormonal imbalances, men experience abnormal growth of their breasts.
Erectile dysfunction: Complimentary to infertility issues and complications, this condition causes men to struggle to ejaculate properly and instead release a very small fluid quantity. There’s also reduced libido and problems maintaining an erection.
How is male infertility diagnosed?
A combination of physical examinations and patient history can be used to diagnose infertility in men.
One of the main methods for evaluating a man’s overall fertility health is to analyse his semen. Another way to find structural abnormalities is through tests such as ultrasound scans, testicular biopsies to examine sperm production and blood tests for hormone levels.
6 signs you can't get pregnant
If you are wondering about your fertility, it’s important to be aware of and pay attention to warning signs of reproductive health. If you notice any of the five symptoms listed below, give your doctor a call. They’ll determine whether you have a condition that affects fertility and may refer you to a reproductive endocrinologist.
1. Unable to impregnate: Trying to get pregnant for at least a year – having frequent unprotected sex – with no success is one of the signs of not being able to have a baby without assistance.
2. Menstrual cycle and no period: Normally, it will take your body a few months to regulate after stopping birth control. But if you don’t get a period after three months, you should see your doctor. The absence of periods might indicate that a woman isn’t ovulating and therefore will have trouble conceiving without assistance. Early intervention with oral medication to stimulate ovulation, such as Clomid, can be successful.
3. Irregular periods: A menstrual cycle that’s too long (35 days or more), too short (less than 21 days), irregular, or absent can mean that you’re not ovulating. There might be no other signs or symptoms.
Irregular and missed periods are also signs of polycystic ovary syndrome (PCOS). PCOS, which affects 1 in 10 women, is a reproductive hormonal imbalance that affects ovulation. If you are experiencing irregular periods, we recommend you talk to your doctor.
4. Bleeding between periods: Generally, you should only bleed when you have your period. Intermenstrual bleeding is an infertility warning sign. Infertility symptoms aside, bleeding mid-cycle may also be a sign of something more serious, so we recommend you see your doctor if you are experiencing this symptom.
5. Very heavy periods: While many women complain of heavy periods – at least in the first few days of menstruating – very heavy periods may be an early sign of infertility.
If your period is so heavy that you have to change your pad, tampon, or menstrual underwear every hour for several hours, bleed for more than seven days, or pass blood clots, your period is considered very heavy.
Again, see your doctor or a reproductive endocrinologist to discuss the cause and understand the health implications.
6. Pelvic pain: Painful periods, pain throughout your menstrual cycle, and discomfort after sex are all indicators of endometriosis. Although endometriosis is characterised by pelvic pain and infertility, 20–25% of endo patients are asymptomatic. And because it’s a condition that poses a risk to a woman’s egg supply, and therefore a risk factor of female infertility, a faster-paced evaluation and treatment are recommended. If you are experiencing pelvic pain, we recommend talking to healthcare professionals.
A board-certified reproductive endocrinologist can diagnose infertility and will be able to advise you of your fertility treatment options.
Reproductive medicine and support, such as stimulating oral medications, injectables, IUI, and IVF are some solutions. A fertility specialist can treat fertility issues, both female and male fertility because it’s important to address both, while also guiding you on assisted reproductive technologies.
6. Pelvic pain
Painful periods, pain throughout your menstrual cycle, and discomfort after sex are all indicators of endometriosis. Although endometriosis is characterised by pelvic pain and infertility, 20–25% of endo patients are asymptomatic. And because it’s a condition that poses a risk to a woman’s egg supply, and therefore a risk factor of female infertility, a faster-paced evaluation and treatment are recommended. If you are experiencing pelvic pain, we recommend talking to healthcare professionals.
A board-certified reproductive endocrinologist can diagnose infertility and will be able to advise you of your fertility treatment options.
Reproductive medicine and support, such as stimulating oral medications, injectables, IUI, and IVF are some solutions. A fertility specialist can treat fertility issues, both female and male fertility because it’s important to address both, while also guiding you on assisted reproductive technologies.
How can I prevent infertility?
While it’s not always possible to prevent infertility, there are steps you can take to help maintain your reproductive health.
It is important that men and women, both, remain conscious of lifestyle factors and any medical conditions, like PCOS, ED, etc., that can contribute towards infertility. Maintaining a healthy weight, avoiding drugs and alcohol, and reducing stress to maintain regular menstrual cycles, can all aid in preventing infertility.
Men need to avoid smoking and intoxicant consumption to ensure sperm health. Moreover, reaching out to a healthcare professional in case of any doubt can provide you with a clearer direction. Infertility is something that can curbed or prevented with a timely diagnosis, so keeping your healthcare provider in the loop can be a good idea.
Understanding terms: PCOs and PIDS
Polycystic ovary syndrome (PCOS): Polycystic Ovary Syndrome, or PCOS, is a hormonal condition that affects 10% of women in their childbearing and fertile age bracket. It includes ovarian cysts, abnormal menstrual cycles, and high levels of male hormones. Weight gain, acne, and irregular periods are common symptoms.
Unexplained infertility: When a couple has no obvious reasons for infertility, has good health, a sustainable lifestyle, and no apparent medical conditions, but still fails to conceive, it is called unexplained infertility. However, unexplained infertility doesn’t mean that a couple may never be able to conceive. Other options for conception are still possible and can reap results if a couple is unable to conceive through the traditional route.
What is pelvic inflammatory disease (PID)?
Sexually transmitted diseases and bacteria can cause PID in women, which is a female reproductive organ infection.
PID can cause the uterus to become inflamed and scarred, and it can also negatively impact the fallopian tubes and ovaries, increasing the chances of infertility in women. PID can also cause chronic pelvic pain and even ectopic pregnancies.
Wrapping it up
So now you know!
While the process can be hard, it’s important to remember that, for reasons beyond logic, many infertile couples will go on to conceive a baby without treatment. So, if you and your partner are trying to have a baby, hang in there and keep trying.
You never know when that second line will show up.
Sources
Bulletti, C., Coccia, M.E., Battistoni, S. et al (2010). Endometriosis and infertility. J Assist Reprod Genet 27, 441–447. Available at: https://doi.org/10.1007/s10815-010-9436-1
Female infertility – Symptoms and causes. Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/female-infertility/symptoms-causes/syc-20354308
How Long Does It Take to Get Pregnant? Kinfertility Blog. Available at: https://kinfertility.com.au/blog/how-long-does-it-take-to-get-pregnant
Infertility – Symptoms and causes. Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317
Serour, G. I., Aboulghar, M. A., & Mansour, R. T. (2019). ‘Advanced maternal age in IVF: Still a challenge? The present and the future of its treatment’. Journal of Advanced Research, 15, 1–6. Available at: PMC6391863.
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