Why Can’t I Get Pregnant? Here are 8 Reasons Why it Might Not be Happening

For those actively trying to conceive, once you’ve made the choice to get pregnant, every negative test result can lead to disappointment. Everyday activities, like a stroll through your neighbourhood, can bring reminders of pregnant bellies and seemingly happy smiling families. The same goes for whenever you tune in to your favourite streaming program or social media accounts… Suddenly, there are happy pregnant people everywhere but you. Frustrating to deal with for sure but don’t worry just yet — you are not alone.

Allow me to break down some possible reasons why you might be having trouble conceiving. The key to reviewing this list is for you to remember that more than one of these possibilities can be going on in your body, at the same time :

1. Endometriosis — This condition affects between 10% and up to 20% of persons born with ovaries and often manifests as chronic pelvic pain with periods or during intercourse. Moreover, endometriosis can be overlooked or misdiagnosed in many while causing issues with diminished ovarian reserve (low egg counts) and fallopian tube scarring. This diagnosis is only formally made via surgery but a skilled gynaecologist or fertility specialist can often help you figure out if you fall into this category.

2. No Ovulation — You will not get pregnant if you are not ovulating. While this is a common fact, persons with ovaries experience the absence of ovulation for different reasons. Reproductive conditions such as dysfunctional thyroid, polycystic ovary syndrome (PCOS), prolactin tumours, primary ovarian insufficiency (aka premature menopause) and weight issues (overweight or underweight) can contribute to this type of anovulatory infertility. Seeing a gynaecologist or fertility specialist can help you determine if any of these issues are at play for you.

3. Male (sperm factor) Infertility — 50% of cases of infertility in couples, where one partner makes sperm and the other makes eggs involve something going on with the sperm! Yes, sperm factor infertility is a big deal but most people do not look into it early enough. In fact, many people just assume that sperm is normal because the person making sperm feels healthy or has sired pregnancies in the past.

However, many medical conditions, environmental factors (e.g. smoking) and simply getting older, can have a direct impact on someone’s ability to make healthy sperm.

If this is the case, diagnosis for sperm factor infertility should take place earlier rather than later! The most straightforward first step in evaluating for sperm factor is to have a semen analysis performed to identify potential issues such as low sperm counts, sperm movement issues, and other sexual related problems. There are different and very successful treatment options available to treat sperm factor infertility if it is identified.

4. Blocked Fallopian Tube — Fallopian tubes are the place in the body where sperm and egg are supposed to meet to start an embryo. The tube(s) also help transport the fertilized embryo to the uterus, where it can implant to form a pregnancy. If one or both tubes become blocked, conception can become more difficult, as chances of egg and sperm meeting go to slim or zero. Endometriosis, history of chlamydia infection or pelvic inflammatory disease (PID), and surgeries on the fallopian tubes (e.g. tubal ligation) are the leading cause of blocked fallopian tubes. Getting a hysterosalpingogram (HSG) dye test to help determine if one or both fallopian tubes are open or blocked is important when assessing your attempts to conceive.

5. Your Vices — The fun and recreational things that humans sometimes indulge in can take a toll on your fertility. Drinking alcohol in excessive amounts, smoking/ingesting cigarettes or marijuana (THC) products can directly impact your egg or sperm counts and also negatively affect how they function. Certain foods, certain packaging/storage containers and certain cosmetic ingredients can also negatively impact your hormonal functioning and your egg/sperm counts and quality. Consider talking to your fertility specialist to get more details on this.

6. Age — For the person born with ovaries, age is the BIGGEST determinant of your chances for successfully conceiving and going on to deliver a liveborn baby! This is because you are born with all the eggs that you are destined to have and those eggs age with you, while their total numbers decline with age. If you have ovaries and are under the age of 35, you should speak with a fertility specialist after 1 year of trying to conceive; if you are 35 or older, you should seek out a fertility specialist after 6 months of trying to conceive. For those born with testicles, as mentioned above, you should get a semen analysis to start.

7. Uterine Fibroids (aka Myomas) — When it comes to fibroids, it’s about Location! Location! Location! Knowing the exact location of fibroids is critical to determining if they are impacting your fertility. In fact, a small fibroid sitting within the cavity of the uterus (where a baby is supposed to implant and grow) can have a major negative impact on your ability to get pregnant and stay pregnant while a large fibroid that sits outside of the uterus will have little to no impact. Similarly, a small fibroid pressing against the point where your fallopian tubes meet the uterus can also negatively impact your ability to get pregnant.

8. Stress — Although we do not directly link stress to infertility, we understand that it is hard to relax and calm down when you’re high in emotion due to the frustrations of not being able to conceive. This can in turn lead to behaviours that undermine your efforts to conceive or lead to shifts in hormones, such as cortisol, that do not favour ovulation or implantation. Therefore, we encourage seeking out ways to manage stress while you work on looking into everything else listed above.

If you are struggling to get that positive pregnancy test, the first step to do is to identify if any of the above potential roadblocks exist for you. Start by evaluating your lifestyle habits and your health history. If the months keep passing and the sign of pregnancy is still out of reach, consult a fertility specialist to further address any underlying issues.

All the best!

Sleep and Infertility: How Sleep Disturbance Can Hurt Your Fertility Journey

As adults who are busy in our everyday lives, we tend to forget that sleep plays a major role in our overall health and well being. Oftentimes, we are so overwhelmed by responsibilities that we forget to rest. However, we should never compromise quality sleep; especially if you are trying to boost your fertility. 

Yes, as surprising as it may seem, sleep and fertility link to one another! Sleeping not only regulates the maintenance of healthy cells, it also refreshes and restores your brain and organ systems, including balancing all of your hormones; especially your reproductive hormones. 

Beyond sleep’s impact on your overall health (and of course, the healthier you are, you get a better chance of conceiving), there have been studies which implicate that one’s sleep can greatly impact one’s fertility. For example, sleeping disorders usually contribute to a lot of other health problems. Specifically, for women, sleep deprivation can negatively affect their reproductive health. 

Numerous research studies have shown that poor sleeping habits are associated with weight problems, menstrual disorders, inflammatory dysfunction, and mood issues. For those struggling with infertility, irritability, or mood issues can, in turn, strain your intimate relationships and lead to fewer opportunities for conception. 

Sleep disturbance also greatly impacts the frequency and duration of menstruation, the health of pregnancies, incidence of postpartum depression, and menopausal transition, according to this research article from the US National Library of Medicine and National Institutes of Health. 

The hormones that are responsible for regulating reproduction, sperm production, and egg quality are closely related to your sleep cycle. In fact, one’s fertility is not only affected by the quantity and quality of their sleep, but also by their circadian rhythm! 

What is the Circadian Rhythm?

Ever noticed that you tend to feel sleepy or energized around the same time every day? If your answer is yes, then you know how the circadian rhythm works! Your circadian rhythm is basically a 24-hour internal clock that runs within a special gland in your brain (the pineal gland) and regularly cycles between when you are sleepy or when you are alert. Circadian rhythm is also commonly known as the “sleep or wake cycle“. 

Many of our body’s essential hormones peak while sleeping, especially during dawn or early morning hours. The United States’ Centers for Disease and Control (CDC) and Prevention has reported that people who are sleep deprived — a reality for more than one-third of Americans — tend to be more at risk of infertility. Research also suggests that women who are struggling with sleep, tend to be three to four times more likely to experience infertility. 

The Role of Melatonin in Your Circadian Rhythm, and Fertility

Melatonin, a hormone that regulates sleep, is also closely related to the circadian rhythm. In fact, melatonin helps in signaling your circadian rhythm that it is time to be resting. People who have sleep disorders, and those who work at night, have lower levels of melatonin. This is why melatonin supplementation for infertile patients may result in improved chances of conceiving.

Since melatonin greatly impacts your sleeping habits, I have come up with a list to help you increase your melatonin hormone levels, naturally.

  1. Get Some Sunlight – Sometimes, being chronically unexposed to the sun can confuse your sleep cycle, as the brain’s programming for our pineal gland and thus our circadian rhythm, is in part determined by being able to see the rise and fall (diurnal rhythm) of the sun.
  2. No Gadgets Before Sleep – Phones, tablets, and computers have blue light. Not only will blue light affect your eyesight, it also blocks melatonin release, by interfering with your body’s normal circadian rhythm. This is why scanning through your phone before bed, does not really help. 
  3. Eat Melatonin Rich Food – Eating food that is rich in tryptophan will definitely help increase your melatonin levels. Tryptophan is found in protein, oats, chicken, and many more. 

These small adjustments might be able to help you get better sleep which, can boost your chances of conceiving. 

In a nutshell, quality sleep is highly essential in one’s overall health. The healthier you are, the higher your chances of conceiving. This is why you should never compromise your sleep. Sleeping does not only “refresh” your thoughts and your muscles but it restores your cells, allows your body systems to reboot and leaves room for your key reproductive hormones to begin to peak when they should. Lack of sleep, however, does the total opposite of this. 


Knowledge is like gold for any individual or couple who is in the process of trying to conceive. It is imperative to explicate the effects of sleep on your own fertility journey, by assessing your lifestyle habits. If you believe that you or your loved one may have a sleep disorder, especially if you are also struggling to conceive, addressing the sleep disorder is critically important. This includes being evaluated by a sleep specialist and completing a sleep study.

The success of your fertility journey is dependent on various lifestyle factors such as diet, physical activity, vices, stress management, and the most basic one, quality of sleep. Start winning on these checklists so that you can optimize not only your fertility but also your overall well-being!

OMG, the Positive Pregnancy Test – What This Doctor Wants You to Know!

When infertile patients, who have been trying for some time, get the positive pregnancy test result, they go through a roller coaster of emotions where their fear of “Will I get pregnant?” quickly turns into “How do I stay pregnant?”. 

These fears and mixed emotions are totally understandable. A lot of infertile patients that get a positive pregnancy test result usually feel anxious about what they can do to help keep the pregnancy. This is why most of these patients often turn to spending hours diving down the internet rabbit hole, researching how they can keep the pregnancy safe. 

Although doing your research and getting yourself educated is great, I really want you to know that it is so much better for you to simply enjoy your victory (it’s a big deal!) and directly ask your doctor questions about how you can keep the pregnancy safe. This way, all the tips are tailored to fit your particular situation and are not based on some generalization that you find on the internet. 

To help ease your mind, let me list the top 10 things that I tell my patients and friends to do, during the first trimester. You can go over these tips with your doctor so that they can help guide you through the things you should and should not be doing. At the end of the day, we all want one thing: for you to get your dream of being a parent! 

  1. You May Not “Feel” Pregnant. This is a fear that some newly pregnant persons can experience and it unnecessarily leads to a lot of stress. Not experiencing major changes in your body or how you feel, overall, is perfectly normal! Not everyone feels a definite change in their body during the first trimester, even if you have been pregnant before. 
  1. Your Appetite. Appetite during pregnancy differs from person to person. Even though many people use the analogy of ‘eating for two’, you definitely do not need to eat more than what you are comfortable with. As a matter of fact, some pregnant persons experience a drop in their appetite, while some others experience early and very specific cravings. 
  1. Minimal Bleeding is Okay. Light to moderate vaginal bleeding is normal. For some women, this is their first sign of pregnancy. So, do not panic if you experience minimal bleeding. However, if you are pregnant and the amount of bleeding is excessive, you should notify your clinic as soon as possible. A general objective rule of thumb: we consider bleeding where you are completely soaking through two normal maxi pads per hour, for greater than 2 hours, as excessive.
  1. Avoid Raw Seafood. During pregnancy, there are some seafood that you have to avoid, even when they are cooked. Eating raw seafood can expose your baby to mercury, harmful bacteria, and parasites. If you regularly eat fish high in mercury, this heavy metal can accumulate in your bloodstream, cross the placenta into the fetus’ own circulatory system and then damage your baby’s developing brain and nervous system.
  1. Take Your Prenatal Vitamins. If you can tolerate it, I suggest you take your prenatal vitamins daily. If you cannot tolerate the vitamins, at least make sure you take folic acid. You need at least 400 micrograms of folic acid per day. However, if you are pregnant with two or more babies (i.e a multiple gestation), or if you have a history of a seizure disorder, or if you have a prior pregnancy, or had a baby that was born with signs of a folate deficiency (e.g a baby born with spina bifida or meningomyelocele), your doctor will want you to be on a higher dose of folate in subsequent pregnancies. So, check with your doctor before choosing between prenatal vitamins or starting higher doses of folic acid.
  1. Stop Herbal and Non-prenatal Supplements. There is not much data available on Herbal supplements and their impact on a pregnancy or the fetus. Therefore, we recommend discontinuing all non-essential herbs, vitamins, and supplements, including CoQ10 and DHEA, during pregnancy. If you are not sure whether your supplement is essential, contact your doctor to confirm, right away.
  1. Continue Taking Your Thyroid, Diabetes, Blood Pressure, Prolactin, or Heart Medicines. Managing these medicines is highly essential for a successful pregnancy. If you have not told your doctor about these medications before, let them know as soon as possible. Patients with poorly controlled thyroid, diabetes, blood pressure or prolactin levels are at increased risk for miscarriages, stillbirth, small (growth restricted babies), certain special birth defects and poor neurological development in the fetuses.
  1. Exercise Heartily. We suggest moderate exercise during pregnancy. However, you should always first verify what type of exercises and the level of intensity you should be doing, with your doctor. For certain underlying medical conditions in the person carrying the pregnancy, your doctor may even recommend against any exercise at all. 
  1. Continue Taking DHA or Fish Oil and Only Consume Pasteurized Milk Products. DHA (Docosahexaenoic acid) or fish oil intake can help prevent preterm labor and delivery, lower the risk of preeclampsia, and may even positively increase the birth weight of your baby. Consuming only pasteurized milk products can help protect you and your baby from harmful bacteria. 
  1. Avoid Hot Tubs or Saunas. It is advisable to avoid hot tubs and saunas because they may cause dehydration, overheating, and even fainting. Exposure to elevated internal body temperatures, like what occurs with soaking in a hot tub or sitting in a sauna for a while, during the first trimester, can also lead to some genetic changes in the developing embryo which, in turn, can result in certain congenital birth defects in your baby. In one study, special heat shock proteins are produced in the fetus as a response to exposure to stressful events such as prolonged high temperatures and these negatively affect your fetus’ development, during the critical period of organ formation and result in anatomical malformation.
  1. Avoid Alcohol and Limit Intake of Drugs like marijuana, cocaine, heroin, other opiates or other chemicals. These substances are known to cause serious malformations in different organs as well as severe mental disability in babies who were exposed to these drugs while they were in the womb.

All these tips that I have listed above are meant to help you keep your pregnancy safe. However, you should still go over them with your doctor so that they can help safely guide you through your pregnancy. It is also important that you do not let your fears interfere with celebrating your pregnancy. Enjoy this joyous moment and make sure to follow your doctor’s instructions, throughout your journey. 

Weight and Fertility

Did you know weight can affect one’s fertility and one’s chances of getting pregnant? In terms of a woman, we’re talking about the extremes of weight; whether someone is underweight, or whether someone is overweight, and especially, if someone is in what we call the obesity range.     Women …