May 30, 2025, 4:04 pm | Read time: 3 minutes
Month after month, hoping. Test after test, facing disappointment. One day, you find yourself not just quietly wondering in your head, but asking out loud in the shower, talking with your best friend, or scrolling through forums: Why am I not getting pregnant? The pressure builds–and nerves are frayed. But before you blame yourself or lose hope, remember there are many medical reasons why it might not happen right away–and even more ways to investigate the cause.
The desire is there–but the positive pregnancy test remains elusive. Month after month, the same disappointment. If you’re asking yourself, “Why am I not getting pregnant?” you’re not alone. But before panic sets in or Google becomes your oracle, there are many possible reasons why it might not be working–and even more medical answers. Gynecologist and reproductive medicine specialist Dr. Heidi Gößlinghoff explains what matters now.
Overview
First Step: Blood Test
A very simple first step: a blood test. Twice in the cycle, once at the beginning and once towards the end. Why? “This allows us to assess hormone levels–such as estrogen, progesterone, or luteinizing hormone,” says Dr. Gößlinghoff. Another crucial aspect: “We also look at vitamin levels, especially vitamin D and folic acid.” Yes, even a vitamin deficiency can stand in the way of having a child.
Make Use of Ultrasound
If you think an ultrasound is just for a sweet look at the baby–think again. Even without an embryo in the picture, it can reveal a lot. For example:
- Are there cysts in the ovaries?
- Are the fallopian tubes possibly swollen or filled with fluid (indicating a blockage)?
- Are there fibroids or polyps in the uterus that could prevent implantation?
- Is there a so-called septum, a thin membrane in the uterus that could disrupt implantation?
“We can identify all of this excellently via ultrasound,” explains the gynecologist. “But: What we can’t see are the eggs themselves–they are a tiny two micrometers in size.”
Check the Patency of the Fallopian Tubes
If you’ve been wondering for a while, “Why am I not getting pregnant?” the patency of the fallopian tubes is often checked. If they are blocked, the egg can’t travel–and pregnancy doesn’t occur.
There are two methods for this:
- No surgery, no anesthesia, no drama. “We introduce a gel-foam mixture through the uterus and observe via ultrasound whether it flows through the fallopian tubes,” says Dr. Gößlinghoff. “Since it contains a lot of air, it reflects wonderfully–we see a white echo and immediately know if everything is clear.”
- A bit more involved, but necessary if adhesions or endometriosis are suspected, is the surgical method with laparoscopy. Here, a blue liquid is used, and a camera checks whether it exits on both sides. “That’s a clear sign: The fallopian tubes are open,” explains the expert.
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Not every woman needs to undergo all examinations immediately–but if the desire for a child remains unfulfilled for months, a targeted look is worthwhile. Ultrasound, blood values, fallopian tube check–this is not magic, but modern medicine. Dr. Gößlinghoff sums it up: “We can clarify many causes with a few examinations–and often small measures already help.”
So: Don’t despair, get checked. And maybe soon, the wish for a child will come true. Until then, remember: Don’t put too much pressure on yourself. That’s also medicine–just without a prescription.