Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test – the first and only FDA-cleared test to confirm successful ovulation at home.
Written on 9/8/20
While some couples get pregnant the first try, the journey can last much longer for others. With so much information out in the fertility space it’s hard to know what you should try and what may not be worth your time. These are 5 common reasons you may be struggling to conceive — and how you can fix them!
Reason #1: You’re not timing intercourse correctly.
While sex ed may have taught us that we can get pregnant at any moment, we now know conception can only occur during our most fertile days, which is usually only about 5 days out of your cycle. Peak fertility occurs on the days leading up to and the day of ovulation. Tracking peak fertility is essential to timing intercourse in order to conceive. It can solve issues with tracking ovulation but not getting pregnant.
There are several different methods for tracking peak fertility, including LH tests, cervical mucus monitoring, or basal body temperature (BBT) tracking. Here’s a quick rundown:
LH Tests: Luteinizing hormone tests, often better known as ovulation tests, measure LH in urine to predict when ovulation is going to occur. An LH surge triggers the ovaries to release an egg, thus predicting ovulation.
Cervical mucus monitoring: CMM involves tracking changes in cervical mucus consistency. For the majority of your cycle, cervical mucus will be thick and a little sticky. Around ovulation, cervical mucus will change, becoming more “wet” and stretchy so sperm can thrive!
BBT tracking: BBT is the body’s lowest resting temperature. BBT tracking involves the slight changes in temperature that come when the body releases an egg. Your BBT will slightly dip before ovulation, then spike and remain elevated for several days after ovulation occurs.
Regardless of the method you choose, once you observe peak fertility, you can time intercourse correctly to ensure you have the best possible chance at conception.
Reason #2: You’re not ovulating properly.
If you and your partner are timing intercourse correctly but still not conceiving, it may be time to look at other factors that could be preventing you from getting pregnant. You can start with ovulation. In fact, ovulatory issues are the cause of infertility in 1 in 4 infertile couples.
It’s no secret that without an egg, conception is not possible. And while many women seem to have regular cycles, this doesn’t always mean they’re ovulating or that their ovulation is healthy.This is why confirming “successful” ovulation is so important!
Successful ovulation happens when an egg is released and post-ovulatory hormones remain at an adequate level for a long enough amount of time to allow for the best possible chance at conception. While you can confirm an egg was released via a progesterone blood test or BBT tracking, confirming successful ovulation involves tracking PdG (progesterone metabolite) levels over time.
Proov is the first and only FDA-cleared PdG test kit for ovulation confirmation. PdG only rises after ovulation has occurred and should stay elevated for several days. Ovulation is considered “strong” or “successful” when Proov tests are positive on days 7, 8, 9, and 10 after suspected ovulation.
If you're tracking ovulation and still not pregnant, look at your Proov tests. If you have anything less than four positive tests during the testing window, this could be a sign of “suboptimal” ovulation and could be making it more difficult to conceive. Then you may find yourself with confirmed ovulation but no pregnancy. Luckily, the fix for ovulatory disorders is often simple! You can try natural remedies, such as herbals or seed cycling, or consult your doctor for prescription-level medications.
Reason #3: His swimmers are struggling.
Don’t think we forgot about the men! Male factor infertility has to do with low sperm production, abnormal sperm function, or blockages that prevent the delivery of sperm. It accounts for about one-third of all infertile couples.
The quickest and cheapest way to check your partner’s sperm is through an at-home sperm test. While many sperm tests only measure sperm count (i.e. the amount of sperm in semen), sperm motility is just as important. Motility describes the ability of the sperm to move through a woman’s reproductive system — basically how well the little guys swim. A man can have plenty of sperm, but if they can’t reach the egg, it can be more difficult to conceive.
If you’re looking for an at-home sperm test that measures count and motility, we recommend checking out the Yo Home Sperm Test. (You can even save $5 at checkout with the code MFB5!)
But what can your partner do if his swimmers are struggling? He can try herbal supplements to help improve sperm count, such as maca root or tribulus terrestris. Remember to always consult your doctor before adding in any supplements. You can also check to make sure your lubricant is sperm-friendly; many lubricants contain ingredients or have a pH that can be harmful to sperm. Tight underwear can also impair sperm production so if your partner isn’t into boxers, now may be the time to switch!
Reason #4: Your cortisol levels are elevated
Cortisol is the stress hormone. We know — being told to “just relax” isn’t helpful. However, increased cortisol production can disrupt the production of other, less vital hormones.
Cortisol is produced in the hormone pathway, along with most other hormones. The hormones most vital to survival, such as cortisol, are prioritized over those less vital, such as reproductive hormones.
When your body is dealing with excess stress from work, excessive exercise, or just life in general, it increases cortisol production. When the body needs more resources to make cortisol, it “steals” progesterone from the reproductive system to do so. Without enough progesterone, it can be more difficult to get pregnant.
In fact, a study from 2007 showed that women who had stopped ovulating for 6 months had higher levels of cortisol than those who were ovulating. Of the women who weren’t ovulating, 7 out of 8 women who received stress management therapy began ovulating, compared to only 2 out of 8 who did not receive therapy.
Managing stress, however, is easier said than done. To start, try taking just 30 minutes out of your day to do something for you, whether that’s going for a walk, doing yoga, reading, or taking a bath. Be sure you’re taking care of yourself!
Reason #5: There are other underlying issues.
If you check all of the above boxes and are still having trouble getting pregnant, there may be underlying issues hurting your chances at conception.
Underlying issues such as uterine factor infertility, tubal factor infertility, or genetic issues are less common causes of infertility. These issues typically need to be diagnosed by a doctor and often require more invasive procedures.
Uterine factor infertility: Sometimes, anatomical abnormalities of the uterus can prevent pregnancy. Your doctor can perform a uterine ultrasound to determine the shape, size, and position of your uterus to determine if any of the factors are preventing you from conceiving.
Tubal factor infertility: After an egg is released, it hangs out in a fallopian tube and waits to be fertilized. From there, a fertilized embryo travels down the tube and into the uterus. If your fallopian tubes are blocked, sperm may never be able to reach the egg. If you’re concerned about blocked tubes, we recommend consulting your doctor who may be able to perform a tubal evaluation.
Genetic issues: Many women struggle to conceive due to genetic factors. This can include an inherited chromosomal abnormality or a single-gene defect. Similarly, conditions such as endometriosis, PCOS, or premature menopause can be passed down genetically. If you’re interested in genetic testing, we recommend consulting your doctor.
If you want to learn more about underlying issues that could be preventing you from successfully conceiving, you can check out the TUSHY method from Proov medical advisor Dr. Aimee. As always, if you suspect you have one of these issues or have specific questions, we recommend consulting your doctor.
Now that you are aware of common things that can prevent conception, you can use this information to help you get pregnant faster!