The decision to try for a baby can feel like a momentous moment in your life, whether for an individual or couple. When the desired pregnancy fails to materialise, in most cases the solution is simply a matter of more time. However, sometimes there are causes for the failure to conceive which need to be dealt with. In this article we look at the most common reasons for not getting pregnant and what you can do to address them.

How Long Should It Take To Get Pregnant?

Out of every 100 couples trying for a baby, 80 to 90 will get pregnant within 1 year. The rest will take longer, or may need help to conceive.

Approximately 1 in 6 people worldwide experience infertility, according to the World Health Organization. Therefore for both men and women, you are far from being alone in your situation. Once you’ve consulted a medical specialist, it will become clear that this is a very common situation. 

How Long Should I Wait Before Seeking Help?

At IVI, our standard advice is to seek medical assistance if you have not managed to conceive after one year of trying for a baby. However, depending on your age and that of your partner, you could reach for expert advice to start the process after 6 months.

What Tests Should You Consider?

Necessary tests depend on age, duration of trying, menstrual regularity, prior pregnancies or surgeries, and partner history. These are some of the initial core tests:

• Confirmation of ovulation: mid‑luteal progesterone or serial ovulation tracking to verify that ovulation is occurring. 
• Semen analysis for the partner: at least one standard semen analysis to assess concentration, motility, and morphology. 
• Basic hormonal profile: follicle‑stimulating hormone (FSH) and estradiol (usually early follicular phase), anti‑Müllerian hormone (AMH) for ovarian reserve, thyroid‑stimulating hormone (TSH), and prolactin as clinically indicated.
• Transvaginal pelvic ultrasound: assesses antral follicle count, uterine anatomy (fibroids, polyps), and ovarian morphology (e.g., polycystic ovary features).

At IVI all the patients undergo a first consultation and a fertility balance, to get all the medical information and tests, so that the specialists can define the following steps and an individualised protocol.

Lifestyle Factors That May Affect Fertility

Health and lifestyle factors are important for fertility. Before or alongside specialist referral, adopting evidence‑based healthy habits can support reproductive health and improve the chances of conception. These healthy habits that may benefit fertility:

• Maintain a healthy weight. Aim for a BMI in the recommended range; both underweight and obesity can affect ovulation and reproductive outcomes.
• Follow a balanced, nutrient‑rich diet. Emphasize whole grains, lean proteins, healthy fats, fruits, vegetables, and sources of folate and iron.
• Reduce or avoid alcohol while trying to conceive; it’s associated with better reproductive outcomes.
• Stop smoking and avoid recreational drugs. Tobacco and toxic substances negatively affect ovarian reserve, sperm quality, and pregnancy outcomes.
• Moderate caffeine consumption. Keep caffeine intake within commonly recommended limits while attempting conception.
• Engage in regular, moderate physical activity. Exercise supports metabolic and hormonal health; avoid extreme training that may disrupt menstrual cycles.
• Manage stress and prioritize mental health. Psychological support, mindfulness, and stress‑reduction techniques can improve coping and adherence to treatment plans.
• Optimize sleep and circadian health. Consistent, restorative sleep supports hormonal balance.
• Minimize exposure to environmental toxins. Reduce contact with known reproductive toxins (certain pesticides, endocrine disruptors, and occupational exposures) when possible.
• Include partner evaluation and healthy habits. Male factors contribute substantially to infertility; encourage both partners to adopt healthy behaviors and complete semen analysis when indicated.

Common reasons you’re not getting pregnant

Difficulty conceiving can result from a variety of medical, lifestyle, and male‑factor causes. Understanding common contributors—such as ovulatory disorders, tubal pathology, diminished ovarian reserve, and sperm abnormalities—helps guide timely evaluation and treatment.

Anovulation

Anovulation is the most common of infertility symptoms in women, but the reason you are not getting pregnant is just as likely to be to do with the male partner or other health factors or a combination of these things.

Anovulation is the medical term for when the ovaries do not release an oocyte during a menstrual cycle. This is sometimes but not always signalled by a complete lack of periods, a condition known as amenorrhoea.

This is one of the most obvious infertility symptoms and one of the signs you can’t get pregnant. Chronic anovulation is a common cause of infertility, however a woman who does not ovulate at each menstrual cycle is not necessarily going through the menopause. Among its causes are stress, significant weight gain or loss, excessive production of prolactin (the hormone responsible for producing breast milk) and polycystic ovaries. These are particularly important due to their complexity and widespread nature. Approximately 35% of women experience anovulation at some time during their lives, so the condition is not uncommon. It is also frequently reversible.

Polycystic ovaries (PCO)

Polycystic ovaries (PCO) can be the reason why you’re ovulating but not getting pregnant. Again it is not uncommon, since around 20% of women have the condition. The term refers to an increase in the number of small cysts (antral follicles) that can be observed on the ovary’s surface when analysed in an ultrasound scan.

There are many women with PCO who have no problems ovulating and getting pregnant. However, some women who have this characteristic also have the condition known as Polycystic Ovary Syndrome (PCOS). These women have irregular menstrual cycles or even a lack of menstruation; therefore they have problems getting pregnant because they do not ovulate.

Male infertility

Malte infertility affects around 40% of couples who are finding it hard to get pregnant. A low sperm count or problems with the quality of spermatozoa is one of the most common reasons for not getting pregnant. Female factor infertility accounts for around 30% of couples struggling to conceive, with 20% of cases being unexplained. Therefore for any couple undergoing difficulties, the cause of the issue is equally likely to lie with either partner. 

The sperm count test is a simple procedure whereby a semen sample is analysed in a laboratory to check both quality and quantity. The analysis determines the number, activity level and shape of the spermatozoa. A commonly used benchmark for chances of conception that fall within the normal range is a sperm count of more than 39 million in the ejaculate. However it is not purely a matter of quantity, there is also the sperms’ ability to move around, referred to as motility. A good quality laboratory-based analysis will check for both of these factors.

Treatment Options for Infertility

Reproductive medicine offers a bunch of options por women and couples with infertility problems, However, every patient presents a different set of symptoms, history and current circumstances. For both individuals and couples who are finding it hard to get pregnant, the first step is to discuss the situation with a medical specialist in fertility and assisted reproduction.

Artificial insemination

For artificial insemination, a semen sample, which has been prepared in advance in the laboratory, is deposited inside the woman’s uterus to increase the potential of the spermatozoa and increase the chances of the egg being fertilised.

In Vitro Fertilisation

When undergoing an IVF, oocyte production is stimulated and a number of oocytes collected. These are mixed with prepared sperm in the laboratory to facilitate fertilisation. The resulting embryos are then selected for viability and put into the patient’s uterus for the pregnancy to proceed in the normal way. The sperm can come from the partner or from a donor.

ICSI is a technique which can be included within IVF treatment. It is commonly indicated for couples diagnosed with severe male factor infertility. The man needs to provide a semen sample (or undergo a testicular biopsy, if necessary). Then the most promising spermatozoa will be extracted and selected to fertilise the oocytes. Our video about IVF and ICSI gives a step-by-step explanation of these procedures.

MACS

MACS is a technique which allows the spermatozoa with the soundest characteristics to be selected before use in assisted reproduction treatments. It screens out the sperm which will die without achieving fertilisation and selects those with the most potential, thus increasing the possibility of conception.

MACS is often used for patients who are to be treated with artificial insemination, but can be used in many cases where the need for sperm selection arises.

Egg donation

Egg donation is the option choosed by 1 of 3 patients at IVI. It’s the process where a woman uses oocytes from a donor which are fertilised by spermatozoa from the recipient couple to obtain embryos. These are transferred to the recipient, following the steps of a conventional IVF.

Sperm donation

Sperm donation is used in cases of male infertility. 

Frequently Asked Questions concerning infertility

We know that when pregnancy doesn’t happen or takes longer than expected, questions and worries naturally arise. Below we answer some of the most frequently asked questions to help clarify common causes, diagnostic steps, and possible next steps.

Why am I not getting pregnant if I ovulate every month?

Even if you ovulate regularly, conception can still be impeded by a range of other factors:

• maternal age
• sperm abnormalities or low sperm count
• tubal blockage or pelvic adhesions that prevent egg–sperm meeting
• uterine issues such as polyps or fibroids that interfere with implantation
• diminished egg quality (which becomes more likely with age)
• endometriosis
• hormonal imbalances that affect the reproductive environment

Can stress stop me from getting pregnant?

Stress per se does not cause infertility, although prolonged chronic stress can make it harder to achieve pregnancy. Under normal circumstances, the body’s response to a stressful stimulus eventually subsides and physiological balance is restored. However, when this stress response is intense and sustained over time, significant physiological and metabolic imbalances can develop. This chronic stress produces physical and mental wear that may lead to serious illness, and its effects on fertility continue to be investigated.

How long should I try before seeing a doctor?

In general, these are the recommendations for consulting a fertility specialist:

• Under 35: seek evaluation after 12 months of regular, unprotected intercourse without conception.

• 35 and older: seek evaluation after 6 months of regular, unprotected intercourse without conception.

Contacting us at IVI

If you are experiencing concerns about fertility, do get in touch with us at IVI. You can use our online contact form and one of our specialist advisers will get back to you. We look forward to being able to help.

Dr. Javier Domingo

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