Struggling to conceive can be emotionally draining and confusing. If you’ve been trying for months or even years without success, it’s natural to wonder what might be going wrong.

While some fertility factors are beyond your control—like genetics, age, or certain medical conditions such as polycystic ovary syndrome (PCOS) or endometriosis—many other aspects of fertility are linked to lifestyle and timing.

Here are six common reasons you might not be getting pregnant, along with practical steps to improve your chances of conception.

1. You Might Be Having Too Little Sex

It may sound obvious, but timing and frequency of sex play a crucial role in getting pregnant. To conceive, intercourse must occur during your fertile window—the days leading up to and including ovulation, when the egg is released.

If you’re only having sex sporadically or relying solely on ovulation calculators, you might be missing this window. Ovulation can vary each month, especially if your cycles are irregular.

Tips to increase your chances:

  • Aim for sex every 2–3 days throughout your cycle, not just during expected ovulation.

  • Track fertility signs such as cervical mucus changes, basal body temperature, or use ovulation predictor kits.

  • Remember, sperm can survive up to five days in the female reproductive tract, so consistent intimacy gives you more opportunities for conception.

2. Experiencing Stress Without Coping Skills

Stress is a part of life, and trying to conceive can make it even worse. But high levels of unmanaged stress can interfere with hormonal balance, affecting ovulation and sperm production.

As Dr. Diana Bitner, OB-GYN at Spectrum Health Medical Group, explains: “Stress is a given—it’s all about how you cope with it.”

Healthy coping strategies include:

  • Breaking problems into manageable steps

  • Practicing mindfulness or meditation

  • Going for daily walks or yoga sessions

  • Reading or journaling

  • Talking to a therapist

  • Exercising moderately

You don’t have to eliminate stress completely—just focus on building healthy routines that help your body stay hormonally balanced.

3. Having a Weight That’s Too High or Too Low

Your weight can directly influence your hormones and fertility. Both high and low body weight can disrupt ovulation and sperm quality.

A major review found that:

  • Infertility risk increases by 27% in women with overweight and 78% in women with obesity.3

  • Couples in which both partners had obesity took up to 59% longer to conceive than those with healthy BMIs.4

For people assigned female at birth:

  • Being underweight can cause low estrogen, leading to irregular or missed periods and preventing ovulation.5

For people assigned male at birth:

  • A low BMI can reduce sperm count and volume, while obesity can impair testosterone levels and sperm motility.6

The takeaway:
Aim for a balanced, sustainable weight through healthy eating and regular physical activity—not crash dieting or overexercising.

4. Intense Exercise Routines

Exercise is beneficial for overall health, but too much high-intensity activity can sometimes backfire when trying to conceive.

Rigorous exercise—like marathon training, long-distance cycling, or heavy daily workouts—can disrupt the body’s hormonal balance, leading to irregular ovulation or implantation issues.

Research shows:

  • Very intense exercise combined with low calorie intake may suppress fertility hormones and menstrual cycles.9

  • Moderate activity (such as brisk walking, light jogging, or yoga) supports reproductive health.

Recommendations:

  • Aim for 75–150 minutes per week of moderate to vigorous exercise.11

  • Include rest days to prevent hormonal stress.

  • Focus on overall fitness, not extreme performance.

5. Not Eating Well

Nutrition plays a major role in reproductive health. A diet high in processed foods, saturated fats, and added sugars can harm fertility, while nutrient-rich diets can support hormonal function and egg/sperm quality.

Foods linked to better fertility:

  • Fruits and vegetables rich in antioxidants

  • Whole grains for stable energy and hormonal balance

  • Unsaturated fats (like olive oil and nuts)

  • Fish high in omega-3s, which improve sperm motility and egg health

Foods to limit:

  • Trans fats (fried or processed foods)

  • Refined carbs and sugary drinks

  • Excess caffeine or alcohol

Small dietary changes—like eating more whole, plant-based foods—can make a noticeable difference over time.

6. Smoking

Smoking is one of the most harmful lifestyle habits for fertility—both for men and women.

It can:

  • Damage sperm DNA

  • Reduce egg quality and ovarian reserve

  • Disrupt hormone production

  • Increase the risk of miscarriage and infertility

Quitting smoking improves fertility outcomes within months. Start by setting a quit date, informing loved ones, and seeking professional support if needed.

If you or your partner smoke, quitting together can significantly improve your chances of conception.

Other Factors To Consider

In addition to the main causes above, several environmental and lifestyle factors can influence fertility:

  • Shift work: Irregular schedules or night shifts can disrupt your body’s circadian rhythm, which regulates hormones.15

  • Chronic illnesses: Conditions like thyroid disorders, diabetes, or autoimmune diseases can interfere with reproductive hormones.

  • Caffeine and alcohol: Excessive consumption can slightly lower fertility over time.

  • Age: Fertility naturally declines after 35 for women and 40 for men.

Dr. Bitner emphasizes that maintaining good sleep, nutrition, and exercise habits is key—especially for those with demanding or irregular jobs like nurses and physicians.

When To See a Doctor

If you’ve been trying to conceive for over 12 months (or 6 months if over 35) without success, it’s time to talk to a healthcare provider.

A fertility specialist can help assess:

  • Ovulation patterns

  • Hormone levels

  • Egg and sperm quality

  • Uterine or tubal health

Early evaluation can identify treatable causes and help you explore options such as fertility medications, intrauterine insemination (IUI), or IVF.

A Quick Review

Fertility challenges can arise from a mix of biological and lifestyle factors. Common reasons you might not be getting pregnant include infrequent sex, unmanaged stress, weight imbalance, excessive exercise, poor diet, or smoking.

While some causes like age or medical conditions aren’t within your control, adopting healthier habits and seeking medical advice early can greatly improve your chances of success.

If you’re struggling, remember—you’re not alone, and help is available.