Problems with Becoming Pregnant

By Whitney Arana

For many couples, becoming pregnant is just a matter of deciding it's time and discontinuing the use of contraception. For some couples, though, conceiving can be a real struggle. This can affect the individuals and their relationship with each other. Women expect they can get pregnant because "it's what women do." Men expect they can impregnate their partners because "it's what men do." When things don't go according to plan, couples can become emotionally and physically drained. The individuals may blame themselves, developing a strong feeling of guilt, or they may blame each other, resulting in resentment. To avoid these problems, it is important to understand from the start that becoming pregnant is a complicated process that requires several processes to coincide. If one small step is missed, conception won't happen. Everything from age to stress to physical activity may affect a couple's ability to get pregnant.


According to the American Society for Reproductive Medicine, the man can be held solely accountable for difficulty conceiving in about one-third of infertility cases. While age is not as important a factor for men as it is for women, considering the fact that pregnancy requires considerably less physical effort from a man's body. However, increasing amounts of evidence suggest that men begin losing their fertility at around 35 years of age due to weaker, less mobile sperm. The American Society for Reproductive Medicine reports that "fertilization rates are usually over 60 percent for men under 39, but for those over that age, the rates fall to slightly over half." Additionally, smoking and excessive alcohol consumption may have a negative impact on male fertility. For the most part, male factors are more difficult to identify than female factors. These may include problems with sperm or certain anatomical issues.

Spermatogenic Disorder

Spermatogenic (or sperm) disorder is a major cause of male fertility problems. This includes deficiencies with regard to: sperm count (the total number of sperm released with each ejaculation), sperm motility (the number of sperm with the ability to move and the quality of that movement), and semen volume (the actual amount of semen the man produces). While sperm count is important, it is likely that the ability of these sperm to move effectively is the primary factor in determining whether attempts at conception will succeed. If you have a low sperm count but high quality, mobile sperm, you have a good chance of impregnating your partner. Factors that contribute to sperm disorder include an enlargement of the veins that drain the testes, advanced age, hormone problems, immune disorders, STDs, cancer treatment, and genetic abnormalities. Semen analyses performed over a few months can help determine whether spermatogenic disorder is a problem.

Anatomical Issues in Men

There are a few anatomical issues that can affect a man's fertility. One of the most common and easily identifiable problems is called scrotal variococele. The variococele is a varicose vein around a testicle with the potential to hamper sperm production by raising the testicle's temperature. This most commonly occurs on the left side or on both sides at the same time. Another possible issue is retrograde ejaculation, which is when ejaculate with flow backwards into the bladder instead of forward out of the penis due to a problem with the sphincter (a ring-shaped muscle that controls the flow of semen and urine between the urethra and bladder by contracting, sending the sperm outward). This obviously prevents ejaculate from making it into the woman's vagina, thus foiling conception. Retrograde ejaculation can be a complication of diabetes, a side effect of some medications, or a result of trans-urethral resection of the prostate (used to treat prostate cancer). An undescended testicle is one that hasn't succeeded in moving from its initial position within the abdomen to its intended position in the scrotum. This prevents the testicle from functioning normally, meaning that it can't make sperm and, in turn, hinders conception.

Another possibility is that the seminal tract (the tube through which ejaculate travels) has become obstructed through some malformation, resulting in ineffective ejaculation. Obstruction of the seminal tract may be a birth defect or may be the result of an accident or vasectomy. Finally, STDs or other infections may cause inflammation in and damage to structures that should convey sperm through the reproductive tract.


Women's bodies are hugely complex with regard to fertility. The menstrual cycle and hormonal fluctuations that accompany it mean a number of minor, treatable conditions can inhibit conception. A variety of issues related to lifestyle can further impact these hormone fluctuations. Additionally, factors related to the uterus are frequently problematic, in that they can prevent the egg from implanting in the uterine wall.

Lifestyle Factors

First of all, age plays a major role in female fertility. Once a woman has reached 35, her chances of conceiving naturally are significantly lowered. This isn't to say that it's impossible. It clearly isn't. However, if you are over 35 and having trouble conceiving, you should ask your doctor for advice. Women with extremely high or low body mass may also have trouble conceiving, mainly due to disruption of the menstrual cycle. Eating an appropriate amount of vitamin-rich foods may be the difference between pregnancy and infertility. In the same vein, consuming alcohol and smoking are both hindrances for conception.

Ovulation/Menstruation problems

According to Fertility Lifelines, about 25 percent of infertile women have ovulation issues. This is because the ovarian cycle is heavily nuanced so tiny changes can stop ovulation. These issues can usually be attributed to hormonal imbalances, which can stem from significant weight fluctuations. This can usually be treated successfully with medication.

Anatomical Issues in Women

There are a number of anatomical problems that may cause infertility in women. One of the most common is damage to or blockage of the fallopian tubes, which can stop the union of sperm and egg or, if not, can prevent implantation in the uterus. This type of damage is often asymptomatic (with the exception of infertility) and can occur in a number of ways, include past infection, a ruptured appendix, or STDs. Depending on the situation, specialized surgery may be in order. Another possible problem is an irregularity of the mucus in the cervix. When a woman is ovulating, this thick mucus should become less acidic and easier for sperm to pass through. If this change doesn't occur, it can keep the sperm from reaching the egg or even kill sperm. A post-coital test (after intercourse) can determine whether this you have a cervical mucus irregularity. If so, it can be bypassed through intrauterine insemination.

Polycystic ovarian syndrome (PCOS) is another leading cause of infertility. With PCOS, abnormal hormone levels cause cysts to form in the ovaries, causing the ovaries to enlarge. If you have problems getting pregnant in addition to irregular or no periods, high blood pressure, excess hair on your face, acne, or weight problems, you may be dealing with PCOS, a condition for which treatment varies by individual case. Yet another possible obstacle to pregnancy is endometriosis, a condition that occurs when the cells that should line the inner wall of the uterus displace to the outer wall of the uterus or onto other pelvic organs. According to Fertility Lifelines, this condition is found in about 35 percent of women with no other known fertility issues, about 7 percent of all women in the United States. Possible treatments include surgery and medication. Finally, if you are undergoing or have undergone cancer treatments like chemotherapy and radiation, you may have problems becoming pregnant.

About the Author

An American living in Prague, Whitney Arana holds a Bachelor of Arts in English language and literature from Davidson College. Currently, she works as a teacher of advanced business and exam-prep English plus conversational Spanish. She contributes regularly to both Czech and American publications on topics including health, literature, food, and travel.