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Common causes of difficulty getting pregnant
Struggling to get pregnant is more common than many people realise. In the UK, fertility problems can affect people of any age or background, and there is often more than one factor involved.
Sometimes the cause is obvious, but in many cases it is a mix of medical, lifestyle, and age-related factors. A GP or fertility specialist can help identify what may be affecting conception.
Ovulation problems
One of the most common causes is irregular or absent ovulation. If an egg is not released each month, there is no egg available for sperm to fertilise.
Conditions such as polycystic ovary syndrome (PCOS), thyroid problems, and very high stress levels can affect ovulation. Significant weight loss, excessive exercise, or being underweight can also disrupt the menstrual cycle.
Age-related fertility decline
Fertility naturally declines with age, especially for women. Egg quality and the number of eggs available both decrease over time, which can make conception take longer.
Male fertility can also be affected by age, although often less dramatically. Age may not stop pregnancy from happening, but it can reduce the chances each month.
Problems with the fallopian tubes or uterus
Blocked or damaged fallopian tubes can stop the egg and sperm from meeting. This can happen after pelvic infections, endometriosis, or previous surgery.
Issues with the womb, such as fibroids, polyps, or a scarred lining, may also make it harder for an embryo to implant. Endometriosis can cause pain as well as fertility difficulties.
Male fertility factors
Fertility problems are not only linked to women. Low sperm count, poor sperm movement, or abnormal sperm shape can reduce the chance of pregnancy.
These issues may be caused by varicoceles, infections, hormone problems, certain medications, smoking, alcohol, or heat exposure. In some cases, no clear cause is found.
Lifestyle and health factors
Smoking, heavy drinking, and recreational drug use can all affect fertility in both men and women. Being overweight or underweight may also interfere with hormone balance and ovulation.
Long-term conditions such as diabetes, untreated coeliac disease, and some autoimmune disorders can play a part too. Certain medicines may also affect fertility, so it is worth reviewing them with a doctor.
When to seek help
If pregnancy has not happened after 12 months of regular unprotected sex, or after 6 months if the woman is over 35, it is sensible to speak to a GP. Help should be sought sooner if periods are irregular, very painful, or absent.
Getting assessed early can save time and reduce worry. Many causes of fertility problems can be treated, and support is available through the NHS and fertility services.
Frequently Asked Questions
Common causes include ovulation problems, blocked fallopian tubes, endometriosis, uterine abnormalities, age-related decline in fertility, low sperm count or motility, and lifestyle factors such as smoking, excess alcohol, or obesity.
If ovulation does not happen regularly or at all, there may be fewer opportunities for an egg to be fertilized. Conditions such as PCOS, thyroid disorders, and high prolactin can disrupt ovulation.
Fertility naturally declines with age, especially after 35. Egg quantity and quality decrease over time, which can make conception take longer and increase the risk of miscarriage.
Yes. Blocked or damaged fallopian tubes can prevent sperm from reaching the egg or stop a fertilized egg from traveling to the uterus. Infections, surgery, or endometriosis can contribute to tubal damage.
Endometriosis can cause inflammation, scarring, and adhesions that affect the ovaries, fallopian tubes, and pelvic anatomy. This can interfere with ovulation, fertilization, or implantation.
Yes. Polycystic ovary syndrome, or PCOS, often causes irregular ovulation or no ovulation, which makes conception harder. It can also be associated with insulin resistance and hormone imbalances.
Both hypothyroidism and hyperthyroidism can disrupt menstrual cycles and ovulation. Proper thyroid hormone levels are important for regular reproductive function and early pregnancy support.
Yes. Low sperm count, poor motility, or abnormal sperm shape can reduce the chance of fertilization. Male factor issues are a common contributor to fertility difficulties.
Stress can affect hormone regulation, sleep, sexual function, and sometimes ovulation or sperm production. While stress alone is rarely the only cause, it can make conception more difficult.
Yes. Being significantly underweight or overweight can disrupt hormone balance and ovulation in women and may also affect sperm quality in men. A healthy body weight can improve fertility in some cases.
Untreated sexually transmitted infections can cause inflammation and scarring in the reproductive tract, especially the fallopian tubes. This can interfere with fertilization and increase the risk of ectopic pregnancy.
Some fibroids can affect fertility, especially if they distort the uterine cavity or interfere with implantation. Not all fibroids cause problems, but location and size matter.
Diminished ovarian reserve means there are fewer eggs available or egg quality is lower than expected for age. This can make it harder to conceive naturally and may reduce response to fertility treatment.
Yes. Irregular cycles often indicate irregular ovulation or hormonal imbalance, both of which can make it harder to time intercourse with ovulation and become pregnant.
Smoking, excessive alcohol use, recreational drugs, poor nutrition, lack of exercise, and exposure to certain toxins can reduce fertility in both partners. Lifestyle changes may improve the chance of conception.
Yes. In some cases, standard testing does not identify a clear reason for infertility. This is called unexplained infertility and may still involve subtle egg, sperm, tubal, or implantation issues.
Problems with the cervix, such as scar tissue, mucus issues, or prior procedures, can make it harder for sperm to move through the reproductive tract. This can reduce the chance of fertilization.
Some autoimmune conditions can affect fertility by disrupting hormones, causing inflammation, or increasing miscarriage risk. The impact varies depending on the specific condition and how well it is controlled.
Certain medications can interfere with ovulation, sperm production, or hormone balance. If fertility is a concern, a clinician can review medicines to see whether any may be affecting conception.
Medical help is usually recommended after 12 months of trying if under age 35, after 6 months if age 35 or older, or sooner if there are irregular periods, known reproductive conditions, or a history of pelvic infection or surgery.
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