Can’t get pregnant? 5 surprising reasons for infertility

Infertility affects approximately 6.7 million women in the United States and if you’re trying to get pregnant, you know how disappointing it can be every month to get a negative pregnancy test. But before assuming that in vitro fertilization (IVF) may be your only option, it’s important to rule out some of the very common—and often treatable—causes of infertility.

Here, read on for five possible reasons why you might be struggling with infertility and what you can do about it.

1. You don’t ovulate.
Polycystic ovary syndrome, which can cause irregular menstrual cycles and an increase in male hormones, affects about 5 to 10 percent of women and is one of the most common reasons women don’t ovulate. In addition, being overweight, obese or underweight, as well as having a thyroid imbalance, can affect ovulation.
What to do: One of the best ways to improve your fertility is to have a healthy weight, according to Dr. Jennifer Hirshfeld-Cytron, a reproductive endocrinologist with Fertility Centers of Illinois.
It’s also important to be screened for polycystic ovary syndrome and rule out other medical conditions. If you already know you don’t ovulate, talk to your doctor as soon as possible about treatment.

2. It’s his problem.
Male factor infertility is responsible for up to a third of infertility cases. If your guy is overweight, obese or a smoker, it could be affecting your chances of getting pregnant. An infection or inflammation of the prostate glands might also be the cause, according to Dr. Mark Surrey, co-founder of the Southern California Reproductive Center.
What to do: Losing weight and quitting smoking are key, but it’s also important for your guy to see his doctor for a physical and a semen analysis. Medication, Intrauterine insemination (IUI) or IVF are options depending on the problem.

3. You don’t have enough healthy eggs.
You’re born with a fixed number of eggs but the number and health of your eggs declines as you get older. In fact, a healthy and fertile 30-year-old has only a 20 percent chance of getting pregnant each month, according to the American Society for Reproductive Medicine.
What to do: Optimizing egg health is key, so get to a healthy weight and if you smoke, quit now, Hirshfeld-Cytron said. Talk to your doctor about IUI, IVF, and or using a donor egg.

4. Endometriosis.
Endometriosis is a disorder that causes the lining of the uterine cavity to appear in the abdominal cavity, which can cause painful periods, heavy bleeding, and infertility in 30 to 50 percent of women.
What to do: Getting pregnant is already a challenge with endometriosis, so seek treatment as soon as you plan to get pregnant,  Hirshfeld-Cytron said. If your fallopian tubes are open, Clomid, a medication that causes you to ovulate in combination with IUI, is the best approach. If you’ve been trying for 3 months or your tubes are blocked, IVF might be the best option.

5. Your fallopian tubes are blocked.
When the fallopian tubes are blocked or damaged, tubal factor, which accounts for about 35 percent of infertility, occurs. Tubal factor infertility can be caused by a previous surgery, endometriosis or an STD. “Sexually transmitted diseases, especially chlamydia, years later will contribute to tubal factor infertility,” Hirshfeld-Cytron said.
What to do: “We have to make sure that the tubes are open, otherwise there’s no way for sperm and egg to communicate,” Hirshfeld-Cytron said. Your doctor can screen for tubal factor with an x-ray and if the tubes are blocked, IVF is the best treatment.