Is it normal to not get pregnant after 4 months of trying to conceive?

Many people are unable to get pregnant even after preparing for about 4 months. This will make them very anxious, and they are always afraid that this situation is caused by some physical reasons. If this is really the case, they need to go to the hospital for a detailed examination in time, so that they can determine the cause of their illness, which is usually caused by a systemic disease.

1. Infertility caused by ovarian factors accounts for about 15% to 25% of infertility. Ovarian infertility can be caused by a variety of factors:

① Local factors of the ovary: such as congenital absence of ovaries or immature ovaries, premature ovarian failure, polycystic ovaries, and certain ovarian tumors such as granulosa-theca cell tumors and testicular blastomas, which can affect ovarian hormone secretion and ovulation.

② Systemic diseases such as severe malnutrition or lack of certain important nutritional factors in the diet can affect ovarian function and cause infertility; chronic diseases, metabolic diseases such as hypothyroidism or hyperthyroidism, diabetes, adrenal dysfunction, etc. can also lead to infertility.

③ Central influence: endocrine imbalance between the hypothalamus, pituitary gland and ovary, pituitary tumors or scars can cause ovarian dysfunction and lead to infertility; mental factors such as mental stress or excessive anxiety can affect the hypothalamus-pituitary-ovary axis and inhibit ovulation.

2. In addition to ovarian factors that can cause female infertility, it can be roughly divided into the following categories according to its location and cause:

(1) Infertility caused by vulvar and vaginal factors: Congenital malformations such as absence of hymen, vaginal septum, and congenital absence of vagina can hinder sexual life; severe vaginal inflammation can cause a large number of white blood cells to swallow sperm, reduce sperm motility, shorten sperm survival time, and affect conception.

(2) Infertility caused by uterine factors: accounting for about 10% to 15% of infertility. A normal uterus is tilted forward and the cervix is ​​bent backward. After sexual intercourse, the cervix is ​​immersed in semen, which is conducive to conception. If the uterus is tilted backward and the cervix is ​​bent forward and upward, it may affect conception. Due to insufficient progesterone secretion from the ovaries, the endometrium secretes poorly. Uterine hypoplasia and endometrial inflammation such as tuberculous endometritis and submucosal uterine fibroids can all affect the implantation of fertilized eggs.

(3) Infertility caused by cervical factors: It is a relatively important cause of infertility, accounting for about 10% to 20% of infertility. During ovulation, the external opening of the cervix expands from 1mm in diameter after menstruation to 3mm. The cervical mucus increases during ovulation and is clear and transparent. The pH value is 7.0 to 8.2, which can neutralize the acidity of the vagina and is beneficial to the activity and passage of sperm. Due to chronic cervicitis or low estrogen levels, the cervical mucus may become viscous or contain a large number of white blood cells, which is not conducive to the activity and passage of sperm and can affect conception. In addition, cervical polyps or cervical fibroids can block the cervical canal and affect the passage of sperm. Stenosis of the cervical opening may also be the cause of infertility.

(4) Infertility caused by fallopian tube factors: Inflammation and adhesion of the fallopian tubes cause blockage of the fallopian tubes, which hinders the meeting of the egg and sperm and causes infertility. Pelvic endometriosis can also cause adhesion and distortion of the fallopian tubes, resulting in infertility.