Trying to conceive can be confusing and painful when months of efforts don’t lead to a positive pregnancy test. You’re not alone. Many couples ask the same question: “Why can’t I get pregnant?” This guide explains the most common reasons, what tests to request, and practical next steps (including local options in Hyderabad).
Quick fact: Infertility affects a significant number of couples worldwide; many estimates put it around 1 in 6 couples who experience difficulty conceiving.
1. Timing & Ovulation — are you missing the fertile window?
Even small timing errors can reduce your chances. The fertile window is roughly 6 days per cycle (5 days before ovulation + day of ovulation). Using ovulation predictors (OPKs), basal body temperature tracking, or fertility apps can help identify the best days to try.
2. Age and diminished ovarian reserve
Female fertility declines with age — both egg quantity and quality tend to fall after the early 30s and more sharply after 35. If you’re over 35, consider earlier evaluation and fertility options. This age-based guidance for seeking help is standard in fertility care.
3. PCOS and hormonal causes
Polycystic ovarian syndrome (PCOS) is a leading cause of ovulation problems. PCOS can cause irregular cycles, insulin resistance, and higher androgen levels — all of which can make conceiving harder. Managing weight, insulin resistance, and using ovulation induction therapies often improves outcomes.
4. Tubal & uterine factors (endometriosis, blockages, fibroids)
Blocked fallopian tubes, endometriosis, and significant uterine fibroids or polyps can prevent fertilization or implantation. Diagnostic tests such as HSG (hysterosalpingography), transvaginal ultrasound, hysteroscopy or laparoscopy help find and sometimes treat these issues.
5. Male factor infertility
Male factors (low sperm count, poor motility, abnormal morphology) are involved in roughly half of all infertility cases — so evaluating the partner is essential. A simple semen analysis is the first step and is painless and inexpensive.
6. Unexplained infertility & subtle problems
Sometimes, standard testing returns “normal” — yet conception doesn’t occur. This is called unexplained infertility and may hide subtle problems (egg quality, sperm function, implantation issues, immune factors). Many couples with unexplained infertility still achieve pregnancy using tailored approaches such as timed cycles with stimulation, IUI, or IVF.
7. Lifestyle & environmental factors you can change
Smoking, excessive alcohol, extreme BMI (too low or too high), chronic stress, poor sleep, and environmental toxins can all reduce fertility for both partners. Small changes in diet, exercise, sleep, and stress management often improve outcomes and response to treatment.
What tests should you ask for first?
If you’ve been trying to conceive without success, ask your doctor about these initial tests:
- Semen analysis (partner)
- Hormone panel: FSH, LH, TSH, prolactin, AMH (ovarian reserve)
- Transvaginal pelvic ultrasound (uterus/ovaries)
- Hysterosalpingography (HSG) to check tubal patency
- Ovulation confirmation (mid-luteal progesterone or ovulation tracking)
If these basics are normal but pregnancy still doesn’t happen, a fertility specialist can advise on advanced tests and targeted treatments.
When should you see a fertility specialist?
General guidance: if you’re under 35 → seek evaluation after 12 months of trying; if you’re 35 or older → seek help after 6 months. Earlier consultation is advised if you have irregular cycles, known reproductive conditions (PCOS, endometriosis), previous pelvic infections/surgeries, or recurrent miscarriage.
Treatments that commonly help couples move forward
- Lifestyle changes (first-line)
- Ovulation induction & monitoring (letrozole or clomiphene)
- IUI (intrauterine insemination) for mild male factor or unexplained cases
- IVF / ICSI for tubal factor, severe male factor, or when other methods fail — IVF success depends heavily on age and clinical factors. For patients under 35, modern clinic data show the highest per-cycle success rates; exact numbers vary by clinic and region.
Practical next steps (a checklist)
- Track cycles and fertile window for 3 months (apps or OPKs)
- Get a semen analysis for your partner this month
- Ask your GP or OB/GYN for baseline hormone tests including AMH (if you’re planning ahead)
- If you’re over 35 or have risk factors — book a fertility specialist consult sooner rather than later
- Consider lifestyle changes (smoking cessation, healthy BMI, sleep, stress management)
Why local expertise matters (Hyderabad)
Choosing a well-equipped clinic with experienced embryology and reproducible outcomes matters. If you’re in Hyderabad and searching terms like “IVF clinic Hyderabad”, “fertility specialist Hyderabad”, or “IVF cost Hyderabad”, look for transparent success rates, strong lab standards, and patient testimonials, look no further. MHRT Hospitals in Hyderabad is the trusted center for infertility treatment with great success rates and expert team of specialists.
Realistic expectations & emotional support
Infertility is physically and emotionally challenging. Many couples need more than one treatment cycle or a combination of approaches. Counseling and support groups can reduce stress, improve coping, and sometimes improve treatment adherence and outcomes.
If you’re asking “Why can’t I get pregnant?” — don’t wait in uncertainty. Book a comprehensive evaluation with Dr. Roya Rozati at MHRT Hospitals, Banjara Hills, Hyderabad for a personalized plan based on modern diagnostics and compassionate care.