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Female – Why am I not falling pregnant

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Common reason for infertility in women:

– Age
– Blocked or damaged tubes
– Endometrics
– Miscarriages

If you see around you’ll notice everyone is conceiving so easily whereas you might have a very opposite experience regarding this, however don’t stress because you are not alone as nearly 15 couples out of 100 need infertility treatment and the good news is 90% of them are treated.
In medical terms infertility is defined as a couple being unable to conceive after 12 months of regular unprotected sex, or if you can’t carry the pregnancy to term.
Female infertility factors:
The most common infertility factors in woman are:

  • Age
  • PCOS
  • Blocked or damaged fallopian tubes
  • Endometriosis
  • Miscarriage
  • Weight


Your age is the single most important factor affecting your fertility.
Every woman is born with a finite number of eggs (1-2 million) and this number of eggs is all that she will ever have in her life. At Hope IVF we know that when she reaches her puberty she is left with three to four lakh eggs, chances of naturally getting pregnant starts declining gradually from 32 year of her age, 35 onwards this decline speeds up. Our research tells us that at 30, chances of conceiving naturally every month are around 20%, whereas at 40 it’s around 5 %.
The age is not only a hurdle in conceiving, it’s a major contributor in birth complications too like difficult labor, miscarriage and genetic abnormalities.
While there is no doubt that age is a factor, HOPE IVF has helped many couples to increase their chances of conceiving as the woman gets older.
Instead of waiting and loosing on precious time you should make the decision on having a baby now than later, for that discuss with our team at HOPE IVF so our fertility expert can find the best solution for you.


If you think now is not the right time to have a baby then you should discuss with your husband to freeze your eggs now to avoid the age related decline in egg quality and quantity. You should take advantage of the individualized fertility preservation program (egg freezing) at HOPE IVF.


Polycystic Ovary Syndrome (PCOS) is a hormonal disorder, affecting woman of reproductive age. Its cause is not very clear so far, it can be genetic, lifestyle or environmental.
The woman suffers with infrequent, prolonged and irregular menstrual periods, often also has high male hormone (androgen) level along with other symptoms like:

  • Weight gain
  • Acne
  • Mood swings
  • Excessive hair growth (face, stomach and back)
  • Fertility issues

At HOPE IVF we have special interest in PCOS, to diagnose it we use a multiple diagnostic aids like ultra sound, blood tests and review of medical history.
To be categorized under PCOS most women need to be having atleast two of the following conditions:

  • One or both ovaries are enlarged, with 12 (or more) cysts visible in the ovaries.
  • Menstrual dysfunction (irregular or no periods).
  • High level of male hormones (androgens).

PCO & PCOS are two similar sounding terms however there is a significant difference. PCO refers to having polycystic ovaries that can be identified via ultrasound and it does not affect fertility the way PCOS does.
PCOS is a syndrome, where you experience 2 of the symptoms mentioned above.
PCO often goes undiagnosed as there are no symptoms, even though it affects up to a third of women of childbearing age.


How does PCOS affect fertility ?

If you are diagnosed with PCOS, then it might be difficult for you to conceive naturally.
Since PCOS disturbs the period timings, so it’s hard to know when to try to conceive.
With PCOS women the appetite controlling hormones are also not regulated, which leads to weight gain.


What should I do if PCOS is diagnosed ?

Treatment options to help you have a baby can include:

  • Reducing weight & reducing the BMI
  • Drugs to induce ovulation, such as Chlomid
  • Insulin-sensitizing medications
  • IVF or another assisted reproductive treatment


If you haven’t been diagnosed with PCOS, but you are concerned about it affecting your fertility, talk to your HOPE IVF specialist about the best way forward for you.

Blocked or damaged fallopian tubes

Fallopian tubes connect your ovaries to uterus, it has finger like structures close to ovaries which catch the egg as it is released out of ovary. The egg is fertilised by sperm in this tube and then it travels down this tube to reach the uterus to get implanted. Any damage or blockage in this tube will not let the sperm reach the egg to fertilise hence this tube has a very important role in getting pregnant.
Common reasons for damaged or blocked tubes:

  • Blockage since birth
  • Accidental damage by a surgery
  • Infection in and around the tubes
  • Tubes tied (tubal ligation surgery)

Diagnosing the state of fallopian tubes:

Team at HOPE IVF will determine the state of your fallopian tubes using following procedures:

  • X Ray
  • Atubal patency test (Dye test)
  • Laproscopic surgery (if needed)




Endometrium is the layer that lines the uterus and in some cases this tissue grows out of uterus near the ovaries, bowel etc. Sometimes women have it without any symptoms or mild symptoms. Investigation for diagnosis is often done when the symptoms become unbearable.
Common symptoms are:

  • Painful periods
  • Painful intercourse
  • Pain in lower tummy and pelvic area
  • Bleeding in between periods
  • Reduced fertility

How endometriosis causes infertility ?
Endometriosis can damage the fallopian tube or ovaries; this would have direct significant detrimental effect on the lady’s chances of conceiving. If the tubes and ovaries are not damaged, still endometriosis can hamper the movement of sperms, egg, fertilisation, embryo growth and implantation.


What causes endometriosis ?
Cause of endometriosis is not yet clearly understood and it varies from woman to woman. One theory is that the uterus cells are spilled out backwards into abdominal cavity via fallopian tubes when the lady gets her periods.


Is endometriosis treatable ?
Yes, depending on the type and severity the treatment may include some simple medication. A laparoscopic surgery to remove the patch of endometriosis, many women conceive naturally after this removal but IVF is also a common option if infertility continues.


If you have been diagnosed or you are concerned about endometriosis, book a free discussion with HOPE IVF patient care coordinator.


Its defined as loss of pregnancy before 24 week of gestation.
It’s most likely to happen in the very early stages of the pregnancy and is uncommon after 10 weeks.
Many women who have a miscarriage go on and have a baby naturally.
If a woman has 2 or more miscarriages, without any successful pregnancies in between, than it is termed as recurrent miscarriage. If you have experienced recurrent miscarriage, its important to talk to a fertility specialist about potential causes.

Often no cause is found but common recognised causes include:

  • Advanced female age
  • Abnormal fetal development
  • Genetics related
  • Uterine or cervix in competency or abnormality
  • Hormonal disorder
  • Placental failure
  • Multiple pregnancy
  • PCOS
  • Infections
  • Poorly controlled diabetes and thyroid disease


What next

For recurrent miscarriage at HOPE IVF your specialist, depending on your individual case, may recommend advanced embryo selection treatment or tests for natural killer cells.


To find your reason for recurrent miscarriage give a call to book an appointment with fertility specialist at HOPE IVF.


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