<img height="1" width="1" src="https://www.facebook.com/tr?id=1835157903235293&amp;ev=PageView &amp;noscript=1">
I’ve been TTC for over 2 years, and I’m still not pregnant. What now?

I’ve been TTC for over 2 years, and I’m still not pregnant. What now?

Kindara | August 26, 2021 | trying to conceive
Share this post:

Before you start trying to conceive, there’s no way to know how long it will take you to get pregnant. This journey is different for everyone- the time it takes to get pregnant and the reasons for infertility depend on many individual factors. 

Though 80 to 90% of couples will get pregnant during the first year or 2 of trying, conception may simply take longer for others. It’s not necessarily a sign that you and your partner won’t be able to conceive on your own (1). 

Read on to learn why it may take some couples longer to conceive and what your options are after TTC for over a year or more.

Looking for scientifically backed data to help you get pregnant faster?
Download your e-book for FREE and start reading.
Download Free E-Book  "How To Not Waste Another Month Trying to Conceive"

What’s the difference between subfertility and infertility?

According to the American Society for Reproductive Medicine, infertility is defined as the inability to get pregnant after one year of having unprotected sex. If you’re 35 or older, that time drops to 6 months (2). The term “infertile” can definitely be scary, but, despite how it sounds, it doesn’t necessarily mean that you won’t be able to conceive naturally. It just means that you haven’t done so yet (3).

That’s where we get into the idea of “subfertility.” This term covers couples who are infertile according to the above definition but are still technically able to conceive. Sometimes, for reasons doctors may not always be able to pinpoint (ie: unexplained infertility). In this case, it simply may take some couples with subfertilty longer to get pregnant than others (4) and they may or may not need fertility assistance. 

In subfertile couples, there may be factors that make it harder to conceive — such as irregular ovulation or sperm abnormalities. Timing intercourse, changing lifestyle factors or medications may may lead to conception. On the other hand, truly infertile couples are unable to conceive naturally, no matter how much time they spend trying (3, 5).

As long as you or your partner haven’t been diagnosed with a condition that makes it impossible for you to conceive, there’s no reason to stop trying after 2 years (unless you want to).

What are the most common causes of infertility?

There are a number of factors that can make it more difficult (though not impossible) for couples to conceive. For females, the most common cause of infertility is ovulation disorders, meaning that ovulation either happens irregularly or doesn’t happen at all. Ovulation can be affected by many things, including polycystic ovary syndrome (PCOS), thyroid problems, aging, and lifestyle and environmental factors (6).

The primary cause of infertility in males is problems with the testicles that impact sperm health. Conditions that can affect sperm shape, count, and motility include diabetes, thyroid problems, injury to the testicles, age, and lifestyle and environmental factors (7).

Though issues with sperm or ovulation may be the main reasons some couples have trouble conceiving, they are far from the only possible explanations. There are many other potential obstacles to conception, and it’s difficult to know exactly which ones are affecting you or your partner without talking to a qualified medical professional.

For more reasons behind infertility, check out the Infertility FAQs webpage on Kindara. 

Should you see a fertility specialist?

Many couples put off seeing a fertility specialist in hopes that they’ll get pregnant on their own. If you’ve been trying for over 6 months to a year and it still hasn’t happened, it doesn’t mean you won’t eventually conceive. However, it does mean there’s a possibility that something specific is keeping you from getting pregnant. 

A fertility specialist consultation is your opportunity to learn more about the state of your fertility and determine whether there’s anything you or your partner can do to increase your chances of conceiving each cycle. Your specialist will look for any conditions that may make you unable to conceive naturally, whether that’s blockages in the fallopian tubes, a lack of healthy sperm, or another factor (6, 7)

If they discover issues that may be affecting your fertility, a specialist can recommend lifestyle changes and/or medications to increase your chances of getting pregnant. By learning more about your fertility, you can avoid wasting valuable time trying to conceive naturally if there’s something preventing you from doing so. 

On the other hand, if you and your partner are simply subfertile, you may choose to continue trying to get pregnant on your own. Either way, you can use the information to help you decide how to continue your TTC journey.

When should you consider assisted reproductive technology (ART)?

Visiting a fertility specialist doesn’t mean automatically turning to assisted reproductive technology, such as in vitro fertilization (IVF), to help you conceive. However, depending on the state of your fertility and where you are in your TTC journey, you may find yourself considering this option. 

How long should you try to conceive before doing IVF? The answer is different for every couple. It will depend on your treatment options, chances of getting pregnant naturally, age, health insurance and budget, and personal preferences. You may also choose to try other treatments first, such as using clomiphene or letrozole to stimulate ovulation. Then, you can either continue TTC at home, or you can undergo intrauterine insemination (IUI) at the fertility clinic (8). 

IVF is an emotionally and financially intense process. In some cases, it may make sense to wait before trying this option. One study that looked at 7,280 women who were TTC found that over 40% of women who described themselves as infertile were able to go on and conceive naturally. This is only slightly less than the 53% of women who conceived after undergoing IVF (3).

Younger couples with unexplained infertility may benefit from waiting to try IVF, as it may not necessarily increase their chances of conceiving (4). If you’re struggling to make this decision, don’t be shy about asking questions, seeking second opinions, and talking to other couples about their experiences. This choice is completely personal, and there is no single right answer. Only you and your partner can decide when (or if) it’s the right time to try IVF

To learn more about the IVF experience, read our interview with Leslie, who’s currently pregnant with her third child via IVF. 

How can you improve your chances of getting pregnant?

Whether you’re trying to conceive naturally or you’re getting treatment from a fertility specialist, there are steps you can take at home to help increase your chances of getting pregnant. Some women may benefit from following a fertility-friendly nutritious diet and making other healthy lifestyle changes, such as exercising, regulating your sleep schedule, and quitting smoking. 

One of the most impactful things you can do to increase your chances of conceiving in a given cycle is to learn how to pinpoint your fertile window. There are only 6 days each cycle that you can get pregnant — the day you ovulate and the 5 days before it (9). Charting your fertility signs can help you figure out when these days happen and plan to have sex when you’re most likely to conceive.

Click here to read our primer on charting your body’s signs to optimize fertility.

If you’re having trouble charting your fertility signs, the Priya Fertility Monitor may help you maximize your chances of getting pregnant by letting you know exactly when you’re fertile. Here’s how Kathryn R. used Priya to get pregnant on her first IUI:

“My doctor… predicted that I should ovulate around day 11-12 of my cycle. All my OPK tests and body aches were suggesting that as well, but I never quite hit high enough LH levels to be ovulating… After those days came and went, I turned to Priya to see when it predicted my ovulation. And it was spot on! 

I tracked using OPKs only in the morning until my predicted fertile window, when I started tracking 3 times a day. Turns out, I got my LH surge in the middle of the day! If it weren't for Priya, I would've gotten the timing wrong and missed my window for the IUI! Thanks to Priya, we're pregnant!”

Looking for a new way to identify your fertile window? Check out the Priya Personal Fertility System!

When you’re struggling to get pregnant, you learn to live with a lot of unanswered questions about your fertility. The longer you try to conceive, the more space those questions can take up in your mind. Charting your fertility signs can help. So can talking about your reproductive health with a trusted medical professional. The more you know, the better equipped you’ll be to decide what steps on the TTC journey make the most sense for you and your partner.

About the author:

Chanel Dubofsky's writing on gender, reproductive health, popular culture, and religion, can be found in New York MagazineLilith, RewireModern Fertility, Cosmopolitan, and others. She lives in Brooklyn, New York. Follow her on Instagram at cdubofsky.

How Not to Waste Another Month When Trying to Conceive
Download Your Free eBook