Why can’t I get pregnant is a question that troubles countless individuals and couples around the world. Whether you’re trying for the first time or facing difficulty conceiving again, understanding the underlying causes can be the first step toward finding hope and a solution.
When someone says, “I can’t get pregnant”, it often marks the beginning of a frustrating and emotionally exhausting journey. Infertility can result from various factors, both physical and environmental. Understanding these causes helps identify where the problem may lie and what steps can be taken next.
Many women experience difficulty conceiving due to underlying medical conditions. One of the most common reasons is ovulation problems. Without regular ovulation, there are no eggs to be fertilized, making pregnancy nearly impossible. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt hormone levels and prevent ovulation altogether. Additionally, hormonal imbalances can lead to irregular periods and reduced fertility. These are treatable with proper medical intervention, but often go unnoticed without specific testing.
Another major factor is blocked fallopian tubes, which can result from past infections, surgeries, or sexually transmitted infections (STIs). When the sperm cannot meet the egg due to this blockage, fertilization doesn’t occur. Endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, can also damage reproductive organs and impair implantation. If you’re wondering “how come I can’t get pregnant” despite regular cycles, these hidden medical issues might be the answer.
Common medical causes of infertility in women include:
Infertility is not just a female issue—male factor infertility accounts for roughly 40–50% of all infertility cases. If a partner is saying, “why can’t I get pregnant”, and female evaluations show no issues, a semen analysis is usually the next step. One of the most common causes is a low sperm count, meaning there are too few sperm available to reach and fertilize the egg. Even if the count is normal, motility issues—how well the sperm can swim—can prevent successful fertilization.
Lifestyle choices also significantly impact male fertility. Habits such as smoking, excessive alcohol consumption, drug use, and even tight underwear can reduce sperm quality. Environmental factors like prolonged exposure to heat or toxins at work may also play a role. Addressing these issues early on can increase the chances of conception naturally or through assisted reproductive methods.
Key contributors to male infertility:
Age is a crucial factor in fertility for both men and women, but particularly for women. As women age, especially after 35, the quality and quantity of their eggs decrease significantly. This decline not only reduces the chances of getting pregnant but also increases the risk of miscarriage and chromosomal abnormalities. If you’re in your late 30s or 40s and saying, “why can’t I get pregnant”, age might be playing a larger role than expected.
Men also experience a decline in fertility with age, although it’s more gradual. Sperm quality can diminish, and genetic mutations in the sperm may increase, potentially affecting embryo development. For couples trying to conceive later in life, medical support such as IVF or egg/sperm preservation might be necessary.
Age-related fertility considerations:
For many women, getting pregnant the first time might have happened naturally or even quickly. So when difficulties arise the second time around, the question “why can’t I get pregnant again” can be particularly confusing and emotionally distressing. This condition is known as secondary infertility, and it affects a surprising number of couples. It can be caused by changes in reproductive health, age, or even lifestyle changes since the last pregnancy.
Secondary infertility is just as real and challenging as primary infertility. Health conditions like uterine scarring from a previous C-section, new hormonal imbalances, or undiagnosed endometriosis may have developed over time. Even stress, weight gain, or changes in your partner’s sperm quality could now be influencing your ability to conceive. It’s important to remember that just because you got pregnant before doesn’t guarantee it will happen easily again. If you’re saying, “I can’t get pregnant again,” it’s time to take that concern seriously and explore the reasons.
In some cases, secondary infertility is linked to age. If you’ve waited several years between pregnancies, your egg quality may have declined, especially if you’re now over 35. Infections or complications from the previous delivery can also create physical barriers to conception. Whether due to new medical issues or changes in your body, seeking medical insight is crucial.
One of the most common mistakes people make when facing fertility issues is waiting too long before seeking help. If you’ve been trying to conceive for over 12 months (or 6 months if you’re over 35) without success, it’s time to consult a fertility specialist. This is especially true if you’re saying “why can’t I get pregnant again” despite having had a successful pregnancy in the past.
Delaying medical consultation can sometimes make matters worse, especially if age or progressing conditions are factors. A fertility evaluation typically includes hormone testing, ultrasounds, and possibly an HSG (hysterosalpingogram) to assess the fallopian tubes. For your partner, a semen analysis will be necessary. These assessments help pinpoint any changes or problems that could be preventing pregnancy. Remember, infertility is a shared issue, and both partners should be evaluated.
Here are some signs it’s time to seek professional help:
Seeing a fertility specialist can help you understand the exact reasons why you can’t get pregnant and begin a personalized treatment plan. Early action can significantly improve your chances of success.
Experiencing a pregnancy complication can be emotionally and physically traumatic. What many don’t realize is that these complications can also have long-term effects on fertility. Whether you’ve had an ectopic pregnancy, a miscarriage, or an abortion, you might now be asking yourself, “why can’t I get pregnant” even though you were pregnant before. Understanding how these events can impact your reproductive system is essential to finding answers and moving forward.
Complications may result in scarring, hormonal imbalances, or emotional stress, all of which can affect your ability to conceive again. The road to recovery is often different for everyone, and it’s important not to compare your experience to others. Each of the following scenarios presents its own challenges, but also paths to hope and healing.
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. This condition is dangerous and requires immediate medical attention, often leading to the removal of the affected tube. After experiencing this, it’s common to wonder, “why can’t I get pregnant after ectopic pregnancy”, especially if one tube remains intact.
The primary reason for fertility challenges after an ectopic pregnancy is damage or blockage in the fallopian tubes. If both tubes are affected or if the remaining one is scarred, natural conception becomes difficult. Inflammation, infections, or prior pelvic surgeries can also contribute to tubal damage, even if they were unrelated to the ectopic pregnancy itself.
If you’re trying to conceive again, your doctor may recommend procedures like HSG (hysterosalpingogram) to check for tubal patency. In cases where both tubes are damaged, IVF becomes a viable option since it bypasses the fallopian tubes entirely. Having one ectopic pregnancy doesn’t always mean future infertility, but it does mean you may need close monitoring and proactive care.
Miscarriage is a heartbreaking experience, and for many women, the grief is compounded by ongoing struggles with fertility afterward. You might be asking, “after miscarriage I can’t get pregnant—why?” In most cases, a single miscarriage doesn’t affect long-term fertility. However, if you’ve had more than one, or if complications occurred during the miscarriage, there may be deeper issues at play.
One possible reason is retained tissue or uterine scarring, especially if you had a D&C (dilation and curettage) procedure. This can lead to Asherman’s Syndrome, a condition characterized by adhesions inside the uterus, which can prevent implantation. Hormonal imbalances or autoimmune responses that contributed to the miscarriage might also be affecting your ability to conceive again.
Emotional trauma and stress are additional factors that shouldn’t be overlooked. High cortisol levels can disrupt your cycle and ovulation patterns. If you find yourself in this situation, consult a fertility specialist who can perform a thorough evaluation of your uterus, hormone levels, and overall reproductive health.
Many women worry that a past abortion could be the reason they’re struggling to conceive later in life. If you’re saying, “after my abortion I can’t get pregnant”, it’s important to understand both the medical and emotional aspects of this concern. In most cases, a legal and medically supervised abortion does not affect long-term fertility. However, complications like infection, uterine perforation, or cervical trauma—although rare—can lead to issues that make it harder to get pregnant.
Repeated surgical abortions may also increase the risk of uterine scarring, which can interfere with embryo implantation. Another overlooked factor is psychological stress, which may influence ovulation and overall reproductive health. If the abortion was followed by infection or if you experience irregular cycles, pain, or other symptoms, it’s crucial to seek medical evaluation.
Possible reasons for infertility after abortion include:
Understanding the reasons why you can’t get pregnant after pregnancy complications can help you seek the right care, emotionally and medically.
If you’re facing ongoing fertility struggles and saying, “why can’t I get pregnant” despite multiple attempts and medical evaluations, In Vitro Fertilization (IVF) might be the solution. IVF is a form of assisted reproductive technology (ART) that involves fertilizing an egg with sperm outside the body and then implanting the embryo into the uterus. It bypasses many natural barriers to conception, making it ideal for a range of infertility causes.
IVF can be particularly effective if you’ve had blocked fallopian tubes, male factor infertility, endometriosis, or unexplained infertility. It’s also the go-to option when age is a factor, especially for women over 35. Even if you’ve tried for years and feel like giving up, IVF offers a path forward. For those saying, “how come I can’t get pregnant,” IVF provides not only hope but often a high success rate when performed by experienced fertility clinics.
The IVF process typically involves:
Success rates vary based on age, health, and fertility history, but IVF remains one of the most effective treatments for couples who can’t get pregnant naturally. Financial cost and emotional toll are factors to consider, but many find it a life-changing journey.
One of the most critical steps in your fertility journey is knowing when to seek specialized help. Often, people delay this step due to denial, hope, or lack of information. If you’ve been trying to conceive for over a year (or six months if over 35), it’s time to consult a fertility specialist. Saying “I can’t get pregnant” shouldn’t just be a worry you carry alone—it’s a sign to take action.
A fertility specialist can conduct in-depth assessments that general practitioners or gynecologists may overlook. These include hormone panels, genetic testing, ovarian reserve tests, and advanced semen analysis. The specialist will also guide you through potential treatments like IUI (Intrauterine Insemination), IVF, or hormone therapy based on your specific diagnosis.
Consider seeing a fertility specialist if:
Early intervention improves outcomes and gives you more options on your journey to parenthood.
Being “healthy” doesn’t always mean your reproductive system is functioning optimally. You may have silent issues like mild endometriosis, hormonal imbalances, or low ovarian reserve. Male fertility factors could also be a hidden cause. If you’ve been trying for months with no success, it’s important to explore all potential reasons with a specialist.
Yes, especially for women. Fertility declines significantly after age 35 due to decreased egg quality and quantity. For men, fertility also declines, though more gradually. Age also increases the risk of miscarriage and genetic disorders, so early intervention is ideal.
Yes. IVF is often successful for those who’ve had ectopic pregnancies, as it bypasses the fallopian tubes entirely. After multiple miscarriages, IVF can also be used alongside genetic screening (PGT-A) to ensure healthier embryo selection and reduce risk. If you’re wondering “after miscarriage I can’t get pregnant” or struggling post-ectopic pregnancy, IVF may offer a promising next step.
