The NHS estimates that 1 in every 7 couples have problems conceiving.

The average couple has around a 25% chance of getting pregnant in each cycle. And most couples (84%) will conceive naturally within a year of trying.

The first reason for not falling pregnant could be that you’re just not having sex often enough. Try for at least two or three times a week. Once you’ve ruled that out, have a look at these common reasons for infertility -

1. Time

The chances of sperm connecting within an egg happens just once a month. It’s especially important to have lots of sex around ovulation. It's a short window of opportunity, around 12 to 24 hours, but the chances of conceiving are much higher than normal.

How do you know when you’re ovulating?

Your basal body temperature falls slightly, then rises again.

You’ll notice a change in cervical mucus. It becomes clearer, thinner, and more slippery - a bit like egg whites. Why is this? Well, it’s all related to oestrogen levels. During a monthly cycle women produce four different types of mucus. Each has a different structure depending on its job. This stretchy fertile mucus has long pathways to allow sperm to move quickly.
Your cervix softens and opens up.
You may feel a slight twinge of pain or mild cramps in your lower abdomen.
Your sex drive may increase.
You may notice some light spotting.
Making a note of these changes can help you to work out when you ovulate. You can also buy ovulation testing equipment

2. PCOS

Your ovaries usually release just one egg a month at ovulation. In Polycystic Ovary Syndrome (PCOS) the egg is often retained in follicles that haven’t properly matured. These follicles look like small cysts on the ovaries giving Poly Cystic Ovary Syndrome its name.

It’s thought one in ten women in the U.K. suffer from PCOS and it’s one of the most common reasons for infertility or subfertility.

There are common signs you might be suffering from PCOS. Menstrual cycles are long or irregular, and ovulation is infrequent. There can be external signs, such as acne or more body hair than usual, caused by hormonal issues. And women with PCOS often, but not always, put on some extra weight due to insulin resistance. This can start a vicious cycle; testosterone is released which creates weight gain. The excess weight leads to greater insulin resistance. And so it goes on.

5. Endometriosis

It’s not always clear why endometriosis cause problems with fertility. But here are some possible reasons:

Adhesions in the pelvis, so could stop the egg moving down the fallopian tubes. So could chemicals produced by the endometriosis

Inflammation in the pelvis stimulates production of cells that kill sperm

The eggs can be of poor quality or fail to release from the ovaries each month.

Could you have endometriosis? Common symptoms include pain -

before/during/after menstruation
during ovulation
in the bowel during menstruation
when passing urine
during or after sexual intercourse
in the lower back region

You may also have

diarrhoea or constipation (in particular in connection with menstruation)
abdominal bloating (in particular in connection with menstruation)
heavy or irregular bleeding
fatigue

7. Thyroid disorder

Menstruation and pregnancy depend upon a cocktail of hormones. The thyroid gland is a small butterfly shaped structure at the front of the neck. It produces hormones essential for growth and development. Women produce more of these hormones during the fertile years of their lives. It's thought having too little (hypothyroidism) can hinder fertility. Signs include feeling tired and cold, and putting on weight. Talk to your GP about a thyroid test if you suspect a thyroid imbalance.

9. Irregular periods.

Periods that are all over the place can make it harder to track when you’re ovulating.

At worst, they could mean you're not ovulating at all, which mean you aren’t able to get pregnant. Weight loss, hormonal imbalances, or thyroid disorders can play havoc with your periods. To get them back on track, start by seeing your doctor to figure out the possible underlying cause.

How acupuncture can help

Acupuncture could help you by

Giving you a regular, smooth flowing, menstrual cycle. A regular menstrual cycle can increase your chances of pregnancy.
Improving the flow of blood to the uterus. This allows it to thicken ready for implantation, and can help reduce uterine spasms so the egg can implant.
Improving the flow of blood to the ovaries, helping them to function well
Relieving stress
Increasing sperm count, quality, and motility

And you may find your quality of life improves too if you’ve suffered with common menstrual problems.

3. Diminished ovarian reserve

You are born with all the eggs you will ever have. This stash of eggs is called the ovarian reserve.

The number of eggs and their quality dwindles over time. This is a completely normal part of aging. But sometimes it occurs sooner than it should. This is called premature ovarian failure or premature ovarian insufficiency.

4. Male Infertility

In my time treating infertility I have seen many women but only two men. Yet male infertility is estimated to contribute to around a third to a half of all cased of infertility.

Pinpointing the root cause usually starts with a semen analysis or a sperm count. Volume, Count, Morphology, motility. Or, to put it another way …….

Is there enough semen? how many sperm are in it?

are they the right shape? and how fast do they move?

It’s also worth checking if anatomical problems, infections, or uncontrolled chronic diseases like diabetes, to infections. Lifestyle factors like obesity, smoking and alcohol use can come into play.

Both men who came to clinic had issues with their sperm. And tests by the fertility clinic showed both moved into the normal range after a course of acupuncture.

6. Uterine fibroids

Fibroids are non-cancerous growths in or around the uterus. They can cause heavy or painful periods, abdominal pain, lower back pain. You could also suffer from constipation, a need to go to the loo often, or difficulties with sex. Fibroids could cause fertility issues by blocking a fallopian tube or stopping a fertilised egg attaching itself in the womb.

8. Pelvic Inflammatory Disease

Bacterial infections of the womb, fallopian tubes, and ovaries are commonplace. Signs include

Pelvic or lower abdominal pain
Heavy and/or painful periods
Bleeding between periods and after sex
Unusual discharges – yellow or greenish colours can show an infection
Pain when you go for a wee

If you’re experiencing these, contact your GP. A course of antibiotics could solve the problem. If left untreated PID can cause long term damage to the fallopian tubes

1 0. Stress

You’ve probably heard of “fight or flight” and “rest and digest” Both are responses of the nervous system. In fight or flight mode non-essential functions are shut down.

No one worries about digestion or procreation if they are running for their life.

This probably explains why the effects of stress on either partner could affect fertility. Stress has been associated with both ovulation irregularities and abnormal sperm development. (JL p 422),. Natural conception and IVF are both more successful with lower levels of stress, according to some studies.

If your life is stressful, it’s worth looking at reducing that stress. Age old techniques, such as meditation, can help. So can breathing practices, walks in nature, and socialising with friends.

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