Are you surprised it’s taking longer than you expected to get pregnant? It’s not just you. Contrary to what we learned back in school or what’s shown in TV and movies, many people take months, if not years, to conceive, even if they do everything right. We’ll walk you through some of the factors that can impact the ability to conceive.

Age is the number one factor that impacts egg and sperm quality. Many people in their 30s and 40s do get pregnant and give birth — age just makes it harder. 

Why age impacts egg and sperm quality

As a woman ages, it gets harder to get pregnant because egg quality and quantity both decrease over time. When we say that egg quality decreases, it means that some eggs will have a harder time fertilizing with sperm. Other eggs that do fertilize and become embryos can have genetic abnormalities. Many of those embryos stop developing or growing before women even know they’re pregnant. There’s also an increased risk in stillbirths for women in their late 30s.

What are the key ages to know about?

Women’s ability to get pregnant generally declines in their late 30s. While you might have heard growing up that 35 is the point of no return, recent studies show that fertility decreases more significantly after age 37. On top of that, every person is different, and blanket statements about fertility aren’t helpful for anyone. 

Other factors that can impact conception

Often, problems conceiving can be due to structural problems in your, or your partner’s, reproductive system, many of which don’t have symptoms. While a doctor will be able to help with a diagnosis and a treatment plan, it’s incredibly frustrating to find out that something’s been going on internally and you never knew about it. A few examples of factors that can impact your ability to get pregnant:

Irregular ovulation or anovulation (meaning you don’t ovulate at all)

How it impacts fertility: If you don’t ovulate regularly, it’s hard to understand when your fertile window is

How you might address it: Your doctor might prescribe hormonal medication to regulate your cycle

Blocked fallopian tubes

How it impacts fertility: Sperm fertilizes an egg within the fallopian tube. If it can’t reach the egg, it can’t fertilize it. Blocked fallopian tubes can be as a result of endometriosis, a past ectopic pregnancy (where the fetus begins to develop into the fallopian tube instead of the uterus), or a past surgery.

How you might address it: It sometimes requires surgery to resolve it or IVF treatment to use the unblocked tube, but in some cases, there are less invasive options available.

Uterine issues

How it impacts fertility: If an embryo can’t implant into the walls of the uterus, it can’t grow and result in a healthy pregnancy to term. Some are caused by past fibroids, polyps, or scar tissue.

How you might address it: In this case, it totally depends on the person and the reason the embryo doesn’t stick. If you have uterine issues, your doctor will be the best person to ask (read: don’t WebMD it and self-diagnose without speaking to your doctor!)

Sperm issues - speed, count, and shape

How it impacts fertility: Abnormal sperm have a harder time meeting an egg and fertilizing it.

How you might address it: Sometimes, lifestyle changes, like quitting smoking or cutting back on alcohol or caffeine. Sometimes, it’s a matter of helping the sperm meet an egg, so a doctor can inject sperm directly into an egg in a procedure called ICSI (intracytoplasmic sperm injection). 

Wrapping up

We hope this has been a helpful overview. We’ll go more into individual diagnoses later, but for now, know that if you’re struggling to get pregnant, you’re not alone, and there are lots of options out there to address your concerns, whether physical or emotional.

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