Signs You’re Having Trouble Getting Pregnant
Infertility in Women and Men
Medically reviewed by Matthew Wosnitzer, MD
Signs you can’t get pregnant easily vary from person to person. In females, they may include irregular periods, severe pain during menstruation or vaginal sex, or physical symptoms like hirsutism (excess hair growth on the face and body).
Many factors can affect fertility. Your age, weight, lifestyle habits, and underlying health conditions may all play a role.
This article will go into detail about symptoms associated with infertility in females and males. It will so provide information about solutions that may help.
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A Note on Gender and Sex Terminology
Verywell Health acknowledges that sex and gender are related concepts, but they are not the same. In this article, terms such as “female,” “male,” “woman,” and “man” refer to sex assigned at birth and/or terms used in the sources cited.
Indicators That Suggest Infertility in Women
Infertility has a wide range of potential causes. It's also possible to have more than one underlying cause at a time. Note, too, that pregnancy is often possible even if you've been diagnosed with infertility.
If you're having trouble getting pregnant, certain symptoms may indicate infertility. However, symptoms associated with infertility are not always apparent or present.
Symptoms of conditions that could be associated with infertility in females include:
Irregular periods
Vaginal bleeding that is not caused by menstruation
No periods (amenorrhea)
Pelvic pain
Heavy periods
A History of Reproductive Health Issues
Symptoms associated with infertility often result from reproductive or other health conditions. Perimenopause, the period before menopause, may also cause infertility symptoms like irregular menstruation.
You may have received a diagnosis for a reproductive health issue in the past. Or, you may have a condition that has been silent (asymptomatic).
Common reproductive health issues that may make it harder to get pregnant include:
Polycystic ovary syndrome (PCOS): PCOS is a hormonal disorder earmarked by an excess production of androgens (sex hormones such as testosterone usually associated with male characteristics) by the ovaries. Symptoms may include irregular or no periods, hirsutism, and problems with weight gain.
Endometriosis (endo): Endo is a disease in which tissue resembling the uterine lining (endometrium) grows outside the uterus. Symptoms may include very painful and heavy periods.
Uterine fibroids: Fibroids are noncancerous growths in or around the uterus. They can be asymptomatic. Symptoms may include irregular menstrual bleeding and pelvic pain.
Pelvic inflammatory disease (PID): PID is an inflammatory infection. Symptoms may include pelvic pain or achiness and pain or bleeding during or after vaginal sex.
Hypothyroidism (underactive thyroid): Your thyroid gland helps regulate ovulation and menstruation. An underactive thyroid may cause vague symptoms like fatigue, brittle nails, and muscle cramps. It may also cause heavy or irregular periods.
Primary ovarian insufficiency (POI): People with POI have ovaries that stop working as they should before the age of 40. POI causes irregular or stopped periods. However, people with this condition may occasionally ovulate.
Celiac disease: This condition is earmarked by an immune system reaction to eating gluten. Several studies have linked undiagnosed celiac disease to infertility and miscarriage. Symptoms include chronic diarrhea, gas, and constipation. Missed periods may also occur.
An Inability to Get Pregnant After One Year
The Centers for Disease Control and Prevention (CDC) defines "infertility" as the inability to get pregnant after one year or longer of having regular, unprotected sex.
Fertility in people assigned female at birth declines with age. So, infertility specialists urge people age 35 or older to get evaluated sooner if they're having trouble conceiving.
If you're in your mid-to-late-30s, it is OK to seek medical support after six months of trying to get pregnant. If you're 40 or over, it makes sense to see an infertility specialist sooner rather than later. You can seek medical care and advice as soon as three months of trying to conceive.
A Word About Timing
You may have heard the adage, "Timing is everything." However, if you're trying to conceive, this may or may not hold true for you.
Over 50% of male-female couples who don't have infertility get pregnant within six months of trying. But it's important to know when you're ovulating, so you can have sex during that most fertile time.
If you ovulate regularly, your best time to conceive will start around five days before ovulation (release of an egg from the ovary) and include the day you ovulate plus the day after. For people with regular clockwork cycles, this "fertile window" starts around 12 to 14 days before your period.
If you regularly have sex during this time but are still not pregnant, you may have an infertility issue, even if you don't have any symptoms.
Indicators That Suggest Infertility in Men
Male-factor infertility is more common than often thought. In fact, around 50% of all male-female couples with infertility have a male-factor problem.
Male infertility is often asymptomatic. For that reason, unpartnered men or men in a same-sex relationship who wish to build their families through surrogacy are often surprised to find out they have issues like a low sperm count. Certain causes of male infertility, however, can cause symptoms.
Differently Sized Testicles
You may have a varicocele if one testicle is smaller than the other. Varicoceles are swollen, enlarged veins within the scrotum (ball sac). This condition may be asymptomatic.
But in some instances, it can cause differences between testicle sizes due to heat from the pooling of blood around the testicle. Variocele can lower sperm count, movement, and shape, and/or the production of testosterone.
Missing Testicle
Undescended testicles (cryptorchidism) is a congenital condition (present from early in life). It is usually diagnosed and treated surgically in infancy. Cryptorchidism is very rare in adults.
A smaller testicle or testes may result, with impaired function. This may lead to lower sperm quality or testosterone.
Small Testes and Other Symptoms
Klinefelter's syndrome is a chromosomal disorder that can affect genetic males. People born with this condition have an extra X chromosome. People with Klinefelter's syndrome often have no symptoms or very mild symptoms.
When symptoms occur, they may include:
Taller than average height for your biological family
Pear-shaped physique
Low muscle tone
Decreased bone density
Small testicles with impaired fertility and/or testosterone production
Enlarged breasts (gynecomastia)
Sparse body and facial hair
Problems With Sexual Function
Hormonal imbalances (with low testosterone or elevated estradiol, a hormone produced in the ovaries) can sometimes be a contributing factor to a low sex drive or to your ability to achieve or maintain an erection. Many other underlying causes can also result in erectile dysfunction (ED).
Hormonal issues such as low testosterone may also cause a reduction in the ability to have ejaculation. Obstruction (depending on the location of the blockage) within the reproductive tract may reduce or lead to no sperm in ejaculate or cause a reduction of the amount of seminal fluid you ejaculate.
If you wish to impregnate someone through sexual intercourse, finding out the underlying cause of ED and other issues with sexual dysfunction will be an important first step.
Infertility Without Cause
About 30% of infertile male-female couples are diagnosed with unexplained infertility. It refers to infertility that doesn't have a clear-cut, identifiable cause.
Often, individuals and couples who get this diagnosis report deep feelings of frustration and confusion. They know something is wrong but are unsure how to fix it.
Unexplained infertility does not mean there is no underlying cause, but rather that science has not yet determined all the possible causes of infertility.
For example, unexplained infertility was often the diagnosis for people with celiac disease wanting to get pregnant before this inflammatory condition was found to be a potential cause of infertility.
However, having unexplained infertility does not necessarily mean your condition is untreatable. Infertility specialists, such as reproductive endocrinologists (specialists in hormonal fertility issues), will be able to work with you to help achieve your goal of having a family.
The rate of spontaneous conception is also higher in people with unexplained infertility than it is in couples with other diagnoses.
Next Steps for Difficulty Getting Pregnant
Trying to get pregnant without success can be emotionally draining. If too much time has passed, or the process is weighing on you, seeing a specialist may make sense.
In some instances, it may be recommended that male-female couples see separate specialists, like a reproductive endocrinologist for the female partner and an andrologist for the male partner. Many infertility clinics have both types of specialists on staff.
You may also opt to see an alternative type of practitioner, such as an acupuncturist who specializes in hormonal issues and infertility.
Both partners will need to undergo an infertility workup that includes hormonal blood tests, physical exams, and, for the male partner, a sperm test.
Once the testing is done, your specialist will recommend treatments that may help. Lifestyle changes may be recommended, such as:
Weight loss or weight gain
Stress reduction
Reduction in alcohol use
Stopping smoking
Your specialist may also recommend that females take oral medications like Clomid (clomiphene citrate). In some instances, medical procedures such as intrauterine insemination (IUI) or in vitro fertilization (IVF) will be recommended.
Summary
Infertility has a wide range of underlying causes. If you're having difficulty getting pregnant, certain signs and symptoms may be a clue as to the underlying cause or causes.
Irregular periods are a common sign. However, many conditions that reduce fertility, such as fibroids or celiac disease, don't impact ovulation. Male factors may also result in reduced fertility, including differently sized testicles and erectile dysfunction.
If you've been having trouble getting pregnant for some time, seeing an infertility specialist may help.
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