Why Am I Not Getting Pregnant?

If you've been trying to get pregnant for a while, you may be wondering why it hasn't happened yet. There are lots of reasons pregnancy doesn't always happen right away. Some common reasons include stress, not timing baby-making sex with ovulation, residual effects of hormonal birth control, and certain health conditions.

As much as we may try, pregnancy really can't really be planned—but you can increase your chances by being aware of common pitfalls. From avoiding the doctor's office to not getting to know your menstrual cycle, here are eight things that can impact your ability to get pregnant.

High Stress Levels

High levels of stress can have a very real role in hindering conception as elevated levels of cortisol, a stress hormone, can negatively affect ovulation and fertility. But when it comes to fertility, we're talking about high levels of chronic stress, not the everyday stress we all experience.

You probably have at least one friend who, upon conceiving, said, "It happened right when I stopped worrying about it." It's annoying to hear, especially when you're not getting pregnant yourself—but there may be some truth to it.

For some, learning about how stress can impact their chances of getting pregnant only makes them more stressed—like how being told to "just relax" doesn't, in fact, help you relax. So if you're having trouble managing stress, it can be helpful to speak to a therapist and incorporate other stress-lowering tools into your life. Strategies such as meditation, yoga, journaling, or mindfulness can all help manage stress levels.

Timing Sex

If you're trying to get pregnant the "old-fashioned" way with penis-in-vagina sex, timing sex with the days you are most fertile is key. Glade B. Curtis, M.D., co-author of Your Pregnancy, Week by Week, recommends having intercourse every day or every other day during your most fertile period. A menstruating person has a fertile window of about six days, so your chances of getting pregnant are highest if you time sex to that time period.

Personal Products

It's usually a good idea to keep most personal care products out of the vagina, but especially so when you're trying to conceive. For example, health experts don't recommend douching for a variety of health reasons, from vaginal infections to sexually transmitted infections (STIs). And when it comes to getting pregnant, douching can act like a spermicide, altering the pH of the vagina. "This has been shown to impair fertility," Dr. Curtis says.

Ditto for personal lubricants, as some brands can impair sperm function and mobility, so if you use it, look for one that's specifically marked as sperm-friendly.

Your Partner's Health

Although people tend to blame the person with the uterus for fertility problems, fertility issues don't discriminate. Dr. Curtis says cases of infertility are about 40% male-related, 40% female-related, and 20% a combination of both: "Frequently, the would-be mom rushes in to see her doctor at the first sign of a delay in getting pregnant. This is wrong since it's really an even playing field in terms of diagnoses."

And remember: It usually takes a healthy couple between 6 months and 1 year to conceive.

Ovulation Knowledge

When it comes to not getting pregnant, not knowing when you ovulate is a major pitfall. "Not understanding the timing of ovulation is a popular mistake," Dr. Curtis says. "Most menstruating people ovulate 14 days before the beginning of their period. So, for example, if you have a 24-day cycle, ovulation is around day 10." But while this information seems straightforward at first glance, it can be confusing if you have irregular periods or can't remember when you last menstruated.

Another common mistake? Not counting from the real first day of your cycle. "Day one is the first day you bleed, not the day after or the day before," Dr. Curtis says. Because fertility can come down to a matter of hours, it's important to know your cycle's exact timing.

As a solution, Dr. Curtis suggests using ovulation predictor kits (OPKs), which are available over the counter. Keeping a calendar to track your cycle (and possibly other fertility signs like cervical mucus quality) can also be helpful—and so can using an online ovulation predictor or a fertility tracking app on your phone.

Birth Control

Research shows that some types of hormonal birth control (such as the birth control shot) are associated with longer delays in fertility returning than others. Plus, keep in mind that every person is different. So if you've recently stopped birth control, it could take a few cycles to conceive.

"Many women take about six months or more just to start having regular cycles when they first quit contraception altogether," explains Dr. Curtis. "Ovulation isn't likely to be happening until your periods are getting more regular."

Dr. Curtis's wise advice? Take your time. And if at least six months have passed since you stopped hormonal birth control and you haven't been getting regular periods, or you're not sure if you're ovulating (or you have questions about your fertility), then it's a good idea to seek out the advice of a doctor.

Underlying Medical Issues

Health concerns like irregular periods, diabetes, or a thyroid disorder can impact your ability to get pregnant. So, if you have underlying health issues, you'll want to ensure they are under control before trying for a baby.

In certain situations, like the ones mentioned above, couples should seek out the help of a doctor or fertility consultant for a pre-conception check-up. The doctor can screen for any medical conditions that may need addressing and help you make a plan for conceiving. And, if you find yourself with a positive pregnancy test sooner than you thought, you'll be ready to take the next steps and find a pregnancy care provider too.

Lifestyle Habits

Smoking can impact both male and female fertility. Long-term smoking can speed up the rate of egg loss, decrease sperm count, and make sperm less healthy. There's also some evidence that even just moderate levels of drinking are associated with lower fertility rates. So, if you or your partner are regularly smoking or drinking and hope to conceive soon, it may be a good idea to talk to a professional about quitting.