Why can't I get pregnant after one year of intercourse?

It is a very happy thing for a couple to conceive a healthy baby. Although pregnancy is a relatively natural thing, it is often not so easy for many couples. Many couples have had sex for a year and still have no signs of pregnancy, which makes people particularly worried and anxious. In fact, in order to successfully conceive a baby, you must also grasp the correct time when having sex, and the couple should do a good pre-pregnancy check-up. Let’s find out why you don’t get pregnant after one year of having sex?

Why can't I get pregnant after one year of intercourse?

Infertility refers to the inability of a couple to become pregnant after living together for more than one year without taking any contraceptive measures after marriage. Pregnancy is a matter for both men and women, and infertility diagnosis must be based on both male and female factors. Women’s ovulation disorders may be caused by factors related to the uterus, cervix, fallopian tube, and some immune factors. Male factors mainly include sperm abnormalities. Oligospermia, abnormal sperm count, abnormal sperm motility, abnormal morphology, azoospermia, and some sexual dysfunctions lead to infertility.

Infertility may be caused by the woman, the man, or both. About 60% is due to female factors, about 30% is due to male factors, and about 10% is due to factors of both parties.

1. Female infertility factors

(1) Vulvovaginal factors:

① Abnormal development of the vulva and vagina: Hermaphroditism includes true hermaphroditism and pseudohermaphroditism, the latter of which includes testicular feminization, congenital adrenal hyperplasia, ovarian masculinization, etc.

Abnormal development of the hymen: occluded hymen, hard hymen, etc.

Vaginal malformations: congenital complete or partial vaginal atresia, double vagina or vaginal septum.

② Scar stenosis: Adhesion scar stenosis is formed after vaginal injury, which affects the entry of sperm into the cervix and affects fertilization.

③ Vaginitis: mainly Trichomonas vaginitis and fungal vaginitis. In mild cases, it will not affect conception. In severe cases, a large number of white blood cells consume the energy substances in semen, reduce sperm activity, shorten survival time, and even phagocytize sperm and affect fertilization.

(2) Cervical factors: The cervix is ​​the pathway for sperm to enter the uterine cavity. The amount and properties of cervical mucus will affect whether sperm can enter the uterine cavity.

① Abnormal cervical development: congenital cervical stenosis or occlusion. In mild cases, it may cause poor menstrual discharge, reduced menstrual volume, dysmenorrhea, and may be complicated by endometriosis. The cervical canal is underdeveloped and elongated, which affects the passage of sperm; if the cervical canal mucosa is underdeveloped, the glandular secretion is insufficient.

② Cervical inflammation: In severe cases, the amount of purulent leucorrhea in the cervical canal increases and becomes thicker, affecting sperm penetration.

③ Cervical neoplasms: Cervical polyps, cervical fibroids, etc. block the cervical canal and affect fertilization.

(3) Uterine factors:

① Congenital malformations of the uterus: Abnormal development of the uterus, such as congenital absence of the uterus, rudimentary horn uterus, bicornuate uterus, septate uterus, etc., all affect conception.

② Endometrial abnormalities: endometritis, endometrial tuberculosis, endometrial polyps, endometrial adhesions or poor endometrial secretory response may affect the implantation of the fertilized egg.

③ Uterine tumors: Endometrial cancer causes infertility, most patients with atypical endometrial hyperplasia are infertile, uterine fibroids can affect conception, and submucosal fibroids can cause infertility or miscarriage after pregnancy.

(4) Fallopian tube factors: The fallopian tube has the function of transporting sperm, picking up eggs and transporting fertilized eggs to the uterine cavity. Fallopian tube disease is the most common factor in infertility, and any factor that affects fallopian tube function will affect fertilization.

① Incomplete development of the fallopian tube: Poor development of the fallopian tube affects peristalsis, is not conducive to the transportation of sperm, eggs and fertilized eggs, and is prone to fallopian tube pregnancy; congenitally excessively slender and twisted fallopian tubes affect the movement of sperm or eggs.

② Inflammation of fallopian tubes: Inflammation of fallopian tubes can cause adhesion of the fimbria or obstruction of the lumen. Adhesion of the fallopian tubes to the surrounding tissues affects peristalsis and causes infertility. Tubal tuberculosis causes tubal stiffness, fistulas, etc.

③ Lesions around the fallopian tube: endometriosis is the most common disease, in which the ectopic endometrium forms nodules in the fallopian tube or the ectopic endometrium outside the pelvic cavity causes fallopian tube adhesions.

(5) Ovarian factors:

① Abnormal ovarian development: polycystic ovary, ovarian agenesis and ovarian hypoplasia.

② Endometriosis: The traditional view is that endometriosis is the external growth of the endometrium beyond the uterine cavity (excluding the myometrium). When endometrial tissue grows in areas other than the lining of the uterine cavity, it is called endometriosis. The relationship between endometriosis and infertility. According to reports from Tianjin and Shanghai, primary infertility in patients with endometriosis accounts for 41.5% to 43.3%, and secondary infertility accounts for 46.6% to 47.3%, while the infertility rate in the normal population is 15%. Severe endometriosis causes adhesions, affects ovarian function, and hinders the maturation and release of egg cells.

③ Luteinized unruptured follicle syndrome (LUFS): Brosen speculated that LUFS is one of the pathogenic factors of endometriosis. The basis is that in LUFS, since the follicles are not ruptured, the 17-β estradiol and progesterone in the ascites are less than normal, and the inhibitory effect on ectopic endometrial cells is lost, and the patient's ovaries do not ovulate.

④ Luteal insufficiency: Insufficient luteal secretion in patients with ectopic pregnancy affects conception.

⑤Ovarian tumor.

(6) Ovulation disorders: Factors that cause ovarian dysfunction and anovulation can lead to infertility.

① Central influence: Disorders in the hypothalamus-pituitary-ovarian axis cause menstrual disorders, such as anovulatory menstruation and amenorrhea; pituitary tumors cause ovarian dysfunction and lead to infertility; mental factors such as excessive tension and anxiety can affect the hypothalamus-pituitary-ovarian axis and inhibit ovulation.

② Systemic diseases: severe malnutrition, excessive obesity or lack of certain vitamins in the diet, especially E, A and B, can affect ovarian function; endocrine and metabolic diseases such as hyperthyroidism or hypothyroidism, hyperthyroidism or hypoadrenal cortex function, severe diabetes, etc. can also affect ovarian function and lead to infertility.

③ Local factors of ovary: congenital ovarian dysplasia,

The above is an introduction to what happens when you don’t get pregnant one year after having sex. After understanding it, we know that there are many reasons for this phenomenon, such as wrong time or physical problems, which can easily lead to this situation. Therefore, in order to be able to conceive a healthy baby more smoothly, couples must go to the hospital for infertility examination when they have not gotten pregnant for a long time.