Trying for a baby and not seeing a positive test month after month can be frustrating, confusing, and deeply emotional. You track your cycle, know your fertile window, have sex at the “right” times, and still nothing. At some point, it’s only natural to wonder why you’re not getting pregnant, especially when you’re doing everything right.
According to the CDC, about 1 in 5 women in the United States aged 15 to 49 with no prior births have trouble getting pregnant after one year of trying. That’s 20% of hopeful parents asking the same question you are.
Let’s walk through 12 common (and often overlooked) reasons why pregnancy may not be happening, even if you’re ovulating and timing things well. After that, we’ll cover 7 practical next steps you can take to move forward with clarity and hope.
Reasons You’re Not Getting Pregnant
Whether you’re not pregnant after 4 months of trying or it’s been a year, here are 12 reasons that could explain what’s going on behind the scenes.
1. Irregular or Delayed Ovulation
Ovulating doesn’t always mean you’re ovulating regularly. In fact, ovulating but not getting pregnant often traces back to ovulation timing issues. If your cycles are inconsistent or too short/long, your fertile window can shift unexpectedly.
Hormonal imbalances, stress, polycystic ovary syndrome (PCOS), and thyroid issues can all affect ovulation. Without consistent ovulation, fertilization becomes a hit-or-miss event.
2. Low Egg Quality
Age plays a major role in egg quality. As you get older, especially after age 35, your eggs may have more chromosomal abnormalities, which makes fertilization and healthy implantation harder.
Even if you’re having regular periods and had sex during fertile days and still not pregnant, poor egg quality might be the reason. You can still ovulate, but fertilization may not result in a viable pregnancy.
3. Blocked Fallopian Tubes
If sperm can’t meet the egg, fertilization can’t happen. Blocked or damaged fallopian tubes, often due to infections, endometriosis, or prior surgeries, can prevent the egg from traveling down to the uterus.
This issue typically has no symptoms. Many couples discover it only after months of trying. It’s one of the most common reasons why you might not be getting pregnant.
4. Male Factor Infertility
Up to 40–50% of infertility cases involve male partners. Poor sperm quality, low sperm count, or abnormal sperm movement can all make fertilization difficult.
Even if your cycles are clockwork, ovulating but not getting pregnant might have nothing to do with your body. A semen analysis is a simple but often overlooked step.
5. Poor Cervical Mucus
Cervical mucus helps sperm survive and swim toward the egg. During ovulation, your mucus should be stretchy, clear, and slippery (like egg whites). If it’s too thick or dry, sperm may not reach the egg.
This is especially relevant if you’ve been trying for a few months and are not pregnant after 4 months of trying, despite tracking ovulation closely.
6. Thin or Unreceptive Uterine Lining
Even if fertilization happens, the embryo still needs a healthy place to implant. A thin uterine lining or poor endometrial receptivity can prevent successful implantation.
Hormonal imbalances, low estrogen, or certain medications can affect this. You might get your period on time, but implantation never had a chance.
7. Endometriosis
Endometriosis causes uterine tissue to grow outside the uterus. It can lead to inflammation, scarring, and pelvic pain, and it’s strongly linked to infertility.
Some women with endometriosis have no symptoms at all, while others experience painful periods or pain during sex. Either way, it’s a known factor in unexplained infertility.
8. Polycystic Ovary Syndrome (PCOS)
PCOS affects how your ovaries release eggs. It often leads to irregular ovulation or none at all. It’s one of the top reasons people start to wonder, had sex during fertile days and still not pregnant, why is that?
Even if you think you’re ovulating, PCOS can disrupt the hormonal signals needed to make ovulation happen consistently.
9. Stress and Mental Load
Chronic stress is beyond emotional, it can physically interfere with your hormones. High cortisol levels can disrupt the release of reproductive hormones like LH and FSH.
If you’re doing everything “right” and are not pregnant after 4 months of trying, consider your lifestyle. Stress doesn’t cause infertility, but it may tip the balance for some.
10. Being Underweight or Overweight
Your body weight affects your hormone levels. Being significantly under or overweight can interfere with ovulation, even if you’re getting regular periods.
Healthy body fat is essential for estrogen production. If your BMI is outside the optimal range, your fertility may take a hit.
11. Uterine Fibroids or Polyps
These non-cancerous growths in or around the uterus can make it harder for an embryo to implant or grow. Many women don’t realize they have fibroids unless they get an ultrasound.
If you’re ovulating but not getting pregnant, and your periods are heavier or longer than usual, fibroids could be silently affecting your chances.
12. Unexplained Infertility
Sometimes, test results come back normal for both partners, but pregnancy still isn’t happening. This is called unexplained infertility.
Roughly 15–30% of couples fall into this category. It doesn’t mean you can’t get pregnant, only that the specific obstacle hasn’t been identified yet.
What to Do Next: Things That Can Actually Help
When you’ve been trying for a while, it’s completely normal to think, why are you not getting pregnant? Here are some realistic next steps to consider.”
1. Track Ovulation More Accurately
Use ovulation predictor kits (OPKs), basal body temperature charts, or fertility tracking apps. If you’ve had sex during fertile days and still not pregnant, you may be miscalculating your actual ovulation window.
2. Get Basic Fertility Testing
After 6 months to a year of trying (depending on your age), get both partners tested. Blood work, ultrasounds, and a semen analysis can uncover many of the issues above.
Even if you’re not pregnant after 4 months of trying, an early check-up can rule out major concerns.
3. Consider a Fertility Specialist
A reproductive endocrinologist can guide you through next steps like hormone treatment, IUI, or IVF. They’ll help you target the root cause, especially if standard methods haven’t worked.
4. Optimize Your Lifestyle
Focus on balanced nutrition, regular exercise, and reducing processed foods. Minimize alcohol and caffeine. Small changes in your daily habits can improve hormone function and fertility over time.
5. Manage Stress Actively
Chronic stress affects ovulation and your cycle. Consider therapy, meditation, or simply carving out time for yourself. Fertility yoga or acupuncture may also support hormonal balance.
6. Time Sex Strategically
It’s not just about frequency. Timing sex 1–2 days before ovulation often gives the best odds. Use your OPK results and symptoms like cervical mucus as guides.
7. Stay Patient, but Don’t Wait Forever
Some couples get pregnant after a year or more without intervention. But if you’re in your 30s or older and still wondering, why are you not getting pregnant, don’t hesitate to reach out for help
Early support can give you answers faster, and more options to work with.
You’re Doing More Than You Think
Trying to get pregnant can feel like you’re chasing something that should come naturally—but doesn’t. You do the research, track the data, and follow all the right steps, but the results still don’t show up. It’s hard not to take it personally. But fertility is rarely about effort alone. It’s a delicate mix of timing, biology, and factors you often can’t see without digging deeper.
What matters most right now is recognizing that this journey doesn’t define your worth. Whether it’s early in your journey or you’ve been trying for months, understanding why you are not getting pregnant can feel frustrating, but needing support is completely valid. Your body is doing the best it can, and so are you.
Answers may take time. Progress might be slower than you expected. But it’s okay to ask questions, push for clarity, and keep moving forward at your own pace. You’re not failing, you’re figuring it out.