Content table
There’s a mistaken belief that regular periods equal good fertility health. But that’s not always the case. It’s possible to have regular periods and still have fertility issues.
That’s because periods are only one part of the fertility puzzle. And regular periods are not proof of ovulation.
Many other factors can influence your pregnancy odds. Your reproductive health is affected by your age, lifestyle, underlying health conditions, infections, and much more.
So if you have normal periods but can’t seem to get pregnant, read on. We’ll cover 12 things that can affect your pregnancy chances, and what you can do about it.
How do periods affect your chances of getting pregnant?
Your periods help calculate your cycle length, and in turn, your fertile window. Your fertile window is the best time to get pregnant. So nailing your fertile window is a must if you’re TTC.
But your periods also offer hints about your fertility. In general, normal periods suggest your reproductive hormones are in balance. That said, periods vary widely from person to person.
So how do you know your cycles are “regular”? Here are some clues:
- Any menstrual cycle between 21 to 35 days is considered regular.
- Menstrual cycles usually last between 2 to 8 days.
- On average, women lose about 60 ml of blood during their menstrual cycle (roughly 4 tbsp.) Anything over 80 ml is considered heavy bleeding.
Irregular cycles and abnormally heavy periods may indicate erratic ovulation. This can both make it harder to get pregnant. So if you’re trying to get pregnant and your periods are outside the norm, it’s important to talk with your doctor.
Keep in mind, some women have trouble getting pregnant, even if their periods seem A-okay. Which brings up the next question…
Why am I not getting pregnant when I have regular periods?
If your period arrives like clockwork, but you’re struggling to conceive, there could be several culprits.
Here are 12 reasons you may have trouble conceiving, even if your periods are normal:
Reason #1 – Age
With age, the quantity and quality of a woman’s eggs decline. That’s why it can take longer to get pregnant as you age.
To paint a picture, a woman under 30 has an 85% chance of pregnancy within a year. But once you hit 35, your pregnancy chances drop to 66%. And by 40, those chances sink to 44%.
Reproductive hormones shift with age as well. FSH and LH increase, while estrogen and progesterone dip. And this hormonal mix doesn’t provide the ideal setup if you’re trying to get pregnant.
To learn more about how age affects pregnancy, check out this article.
What you can do: While you can’t control your age, you can control your lifestyle. So focus on that. Consume a diet with plenty of vegetables, fruits, whole grains, legumes, and healthy fats. Regular exercise, stress management, and getting good quality sleep can also help keep your hormones in balance.
If you’re over 35 and haven’t gotten pregnant after having unprotected sex for 6 months, consult a doctor. Check your ovarian reserve so you can plan the next steps.
Reason #2 – Not trying long enough
Reason #3 – Not timing sex right
Sperm can live inside a woman’s body for up to 5 days. But an egg only survives 12-24 hours once released. So to get pregnant, you’ve got to have sex at the right time.
Having intercourse during the fertile window gives you the best chance of pregnancy. Your fertile window is 6 days long. It consists of the 4 days leading up to ovulation, ovulation day, and the day after ovulation.
As you can see from the chart below, the day before ovulation offers the best chances of pregnancy:
Read More: When to Have Sex When You’re Trying to Get Pregnant?
What you can do: Pinpoint your fertile window with Inito. The Inito fertility monitor measures LH, FSH, and estrogen to give you a complete picture of your fertility window and PdG (urine metabolite of progesterone) to confirm if you’ve ovulated or not, all on a single test strip. Have unprotected sex every day, or every other day, during your fertile window.
Reason #4 – Not ovulating
As mentioned, regular periods do not confirm ovulation. It’s estimated that for a third of all menstrual cycles, an egg isn’t released. This is known as anovulation – and it’s the #1 cause of infertility.
It’s common to have an anovulatory cycle or two each year. But chronic anovulation can interfere with conception.
Common causes of anovulation include:
- Chronic stress
- Being overweight or underweight
- Excessive exercise
- Polycystic ovary syndrome (PCOS)
- Stopping birth control recently
- Certain medications (including steroid medications and some antidepressants)
What you can do: If you suspect you’re not ovulating, check your progesterone or PdG levels. Progesterone rises after an egg is released. Progesterone’s rise in the luteal phase confirms ovulation. Inito measures your PdG (a urine metabolite of progesterone) to confirm you’re ovulating.
Read More: Anovulation: Everything you need to know about the #1 cause of infertility
Reason #5 – PCOS
Polycystic ovary syndrome (PCOS) is a hormonal imbalance that can cause ovulation problems. Women with PCOS often have excessive levels of androgens (male hormones). This can disrupt menstrual cycles and interfere with ovulation. Instead of follicles being released, they stay in the ovaries and form cysts.
One of the hallmarks of PCOS is irregular cycles. Yet some women with PCOS still get regular periods. However, that doesn’t mean they’re ovulating.
Regular periods may be accompanied by other symptoms of hyperandrogenism. This includes acne, weight gain, and hirsutism, which is excessive hair growth on the face or body.
That said, not all women have obvious signs of PCOS like weight gain, acne, or facial hair. If your PCOS symptoms are mild, this can lead to a missed diagnosis.
Learn More: PCOS and Pregnancy: All You Need to Know
What you can do: If you have PCOS symptoms like facial hair, acne, or weight gain, visit your healthcare provider. They can do blood work to determine if you have PCOS. And consider using Inito to confirm you’re ovulating.
Reason #6 – Implantation failure
Sometimes the egg gets fertilized but doesn’t implant properly into the endometrium. This is known as implantation failure.
- Implantation failure may be due to:
- Chromosomal abnormalities
- Endometrial receptivity
- Uterine infections
- Hormonal or metabolic disorders
- Thrombophilia
What you can do: Check your progesterone levels. Your body needs adequate progesterone for successful implantation. Visit your doctor to be tested for any underlying medical conditions that can hinder implantation.
Read More: How to Make Implantation Successful: What You Need to Know
Reason #7 – Blocked fallopian tubes
Your fallopian tubes are the pathway connecting your ovaries and uterus. They’re also the meeting point for an egg and sperm. So if this pathway gets blocked, so does fertilization.
Blocked fallopian tubes may be due to:
- Endometriosis
- Pelvic inflammatory disease (PID)
- Damage or scarring from previous surgeries
- Sexually transmitted infections (STIs)
Some women with a blocked fallopian tube may feel pelvic pain. Others may experience no symptoms other than infertility.
What you can do: If you’re TTC and all your blood work seems okay, your doctor may suspect blocked fallopian tubes. In this case, they will recommend a hysterosalpingogram (HSP). This is a type of X-ray that can determine whether your fallopian tubes are open or not.
Reason #8 – Vaginal infections & STIs
Untreated vaginal infections can cause inflammation in the genital tract. This may lead to infertility. Inflammation could be due to endometriosis, bacterial vaginosis, or pelvic inflammatory disease.
STIs like chlamydia or gonorrhea can create scar tissue in the pelvic organs. This can block the fallopian tubes and interfere with fertilization.
Yeast infections can thicken your cervical mucus and make it harder for sperm to swim. They can also alter your vaginal pH and hinder sperm viability.
What you can do: If you suspect you have an STI, see your doctor. They can test and give you the appropriate medication. Consider taking probiotics if you have bacterial vaginosis or a yeast infection.
Reason #9 – Male infertility
It takes two to conceive. And between 40-50% of infertility stems from the male partner.
This could be due to low sperm count or poor sperm motility, meaning sperm have trouble swimming properly. Some sperm may also have head or tail defects that affect their ability to reach and penetrate an egg.
What you can do: Get infertility testing to assess your partner’s sperm.
Reason #10 – Lifestyle factors
Your lifestyle can also throw off your pregnancy odds. If you’re chronically stressed or have insomnia, you’re more likely to face infertility issues.
Stress increases cortisol levels. And cortisol and progesterone are made from the same precursor, pregnenolone. This means the more stressed you are, the more pregnenolone is redirected to produce cortisol, instead of progesterone. But it’s not just stress to watch out for.
Smoking cigarettes and drinking alcohol can also reduce fertility. Marijuana has an effect on both male and female fertility too. Marijuana is linked with a lower sperm count and decreased sperm motility in men. For women, marijuana can lower luteinizing hormone (LH), which may affect ovulation.
Your weight also affects fertility. Being overweight or underweight can create hormone imbalances like estrogen dominance, which can lead to ovulatory issues. Generally, BMIs between 18.5 and 24.9 are the sweet spot for conception.
What you can do: Lead a healthy lifestyle. Exercise, eat a nutritious diet, and get 7-8 hours of sleep every night. Keep stress at bay with relaxation techniques like yoga, meditation, or breathwork. Steer clear of alcohol, tobacco, or other drugs.
And if you could use some additional support on your conception journey, consider joining our Facebook community.
Read More: Diet & Fertility: Eat Your Way to Better Baby Odds!
Reason #11 – Autoimmune conditions
Research shows there’s a connection between autoimmunity and infertility. Autoimmune diseases like Hashimoto’s thyroiditis, lupus, and celiac disease make the immune system overactive.
The body produces antibodies and may attack the reproductive organs by mistake. This can affect your hormones, as well as ovulation and implantation.
What you can do: Talk with your doctor if you suspect you may have an autoimmune condition. And if you do, know that it’s possible to get pregnant with the right diagnosis and treatment.
Reason #12 – Unexplained infertility
Roughly 15 to 30% of couples face unexplained infertility. This is an inability to get pregnant without any clear cause. Meaning, you go through fertility testing, and everyone comes out normal.
Not getting answers can be extremely frustrating. But while you may not pinpoint a cause for unexplained infertility, you can still treat it.
What you can do: Keep trying to conceive for one year if you’re under 35, or 6 months if you’re over 35. After that time, if you still haven’t gotten pregnant, talk to our doctor and consider fertility treatments or artificial reproductive technology (ART).
Summing it up
Here’s the TL; DR version of what we’ve just covered:
When should I see a doctor?
As said earlier, if you’re under 35 and have been having difficulty conceiving for a year, visit your OBG-YN. If you’re over 35 and haven’t conceived after six months, see your doctor. And if you’re over the age of 40 and trying to conceive, talk with your doctor right away.
They can help identify any factors that could be interfering with your fertility – or refer you to a fertility specialist if needed.
Takeaways
If you’re struggling to get pregnant, despite having regular periods, know there is hope.
Simple things like cleaning up your diet, managing stress, and tracking ovulation can often have a huge impact on conception. Other times, you may need to consult with your doctor to dig deeper.
To quickly recap, here are the culprits to watch out for that can make it harder to get pregnant:
- Age
- Not trying long enough
- Not timing sex right
- Ovulation problems
- PCOS
- Implantation failure
- Blocked fallopian tubes
- Vaginal infections and STIs
- Male infertility
- Lifestyle factors
- Autoimmune conditions
- Unexplained fertility
If you suspect any of these could be interfering with your fertility, talk with your doctor.
Was this article helpful?
- The Normal Menstrual Cycle and the Control of Ovulation – Endotext – NCBI Bookshelf
- Heavy periods: Overview – InformedHealth.org – NCBI Bookshelf
- Knowledge about the impact of age on fertility: a brief review – PMC
- ABC of subfertility: Extent of the problem – PMC
- Findings from a mobile application–based cohort are consistent with established knowledge of the menstrual cycle, fertile window, and conception
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4546331/
- Do hyperandrogenic women with normal menses have polycystic ovary syndrome? – Fertility and Sterility
- Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease
- Trends of male factor infertility, an important cause of infertility: A review of literature – PMC
- Full article: The relationship between stress and infertility
- Infertility in women and moderate alcohol use. – PMC
- Associations between smoking status and infertility: a cross-sectional analysis among USA women aged 18-45 years – PMC
- Effects of marijuana on reproductive health: preconception and gestational effects – PMC
- Diagnosis and Treatment of Unexplained Infertility – PMC
