Fertility • May 14, 2018

Reasons that can make it difficult to get pregnant

Terje Sordal

Fertility specialist dedicated to helping patients expand their family and stay informed through evidence-based insights.

Are you finding it difficult to get pregnant? You are not alone. Approximately 10% of couples of childbearing age will experience difficulty getting pregnant. There can be many reasons, but fortunately there is good help available.

Advanced age of the woman

Age is normally the most important factor when it comes to fertility in women. Over time, genetic changes occur in the eggs, so that the proportion of normal eggs decreases. It can then be more difficult to get pregnant, and several of the pregnancies will stop due to genetic defects. Fertility decreases from the age of 35, and even more from the age of 40.

Reduced sperm quality

Reduced sperm quality in men is one of the most common reasons why a couple cannot get pregnant. It may be that the number is too low, the swimming ability is too poor, the shape is abnormal or it is genetically abnormal. The age of the man also plays a role here, after the age of 45 the proportion of genetically abnormal sperm increases.

Ovulation disorders

Some women have infrequent or no ovulation. This can be due to being overweight, underweight, stress or a genetic cause such as in women with PCOS. PCOS is a condition characterized by many small egg sacs (follicles) in the ovaries, irregular and infrequent menstruation and increased levels of male sex hormones. To check whether you are ovulating, you can take blood samples throughout a cycle or test with ovulation tests. Ovulation usually occurs 12 days before the next menstruation starts. If necessary, many can be treated relatively easily with a pill regimen.

Blocked fallopian tubes or fallopian tube damage

Damaged or blocked fallopian tubes are another possible reason why couples may experience difficulty getting pregnant. This can be the result of infectious diseases such as chlamydia. The challenge here is that the egg released during ovulation will not meet the sperm. The job of the fallopian tubes is, as you can understand from the name, to guide the egg down to the place where the egg meets the sperm. It is a good idea to have your fallopian tubes checked when you are at the gynecologist. This is done using an ultrasound examination with contrast medium.

Premature menopause

Some women are genetically predisposed to early menopause. They will often have shorter cycles and heavier bleeding in the period before menopause. This has an impact on the capacity and function of the ovaries, and thus the ability to get pregnant. It is possible to find out about this through hormone tests on cycle days 1 – 2 and measuring the hormone AMH (Anti-Müller Hormone), which measures the egg reserve.

Body weight and lifestyle

Women who are underweight or overweight (19 < BMI > 35) may struggle to get pregnant due to hormonal changes due to no or infrequent egg development and ovulation. After normalizing body weight, the cycle will usually normalize. Some will still need help to get pregnant. All women who are trying to get pregnant should take folic acid supplements to protect the fetus from malformations. Physical activity reduces stress and improves self-esteem, which can be important during a trying period. Remember that it is just luck when some people get pregnant right away. Give yourself 12 months before you start to worry. Avoid people who only stress you out with questions about pregnancy or tell them that you are working on the matter, but are not in a hurry, and the hassle will probably end. Factors such as a healthy and varied diet, low or no use of tobacco and alcohol are also good for "trying".

Muscle knots and polyps

Muscle knots and polyps can occur in the uterus and uterine cavity. Sometimes this can affect the chance of getting pregnant. The gynecologist can examine the uterus using ultrasound and the uterine cavity using a water scan.

Endometriosis

Endometriosis is a condition in which the same type of cells as those in the lining of the uterus (endometrium) grow outside the uterus, in the peritoneum, on the ovaries, or elsewhere. Endometriosis irritates the peritoneum and creates an environment that is unfavorable for a fertilized egg. Endometriosis in the ovary is often associated with reduced egg quality. Endometriosis can lead to adhesions and blocked fallopian tubes, making it difficult to get pregnant.

Through a fertility assessment We investigate whether there are any reasons why you have not become pregnant – and we suggest what you should do to succeed.

Reasons that can make it difficult to get pregnant

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