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Trying to conceive but nothing’s happening — even though your tests are all ‘normal’?
You’re not alone. Around 1 in 7 couples in the UK experience fertility problems. And for many, the most frustrating part is being told that everything looks fine. You’ve had your bloods done. Maybe an ultrasound. Your partner’s semen analysis was okay too. So why aren’t you pregnant yet?
The truth is: normal doesn’t always mean optimal. And sometimes, the standard tests just aren’t looking deep enough.
Let’s explore why you might still be struggling — and what can actually help you move forward.
The Limitations of Standard Fertility Tests
Most women start their fertility journey with their GP. This often includes basic blood tests and perhaps a referral for an ultrasound scan (assuming you get that far in the first place!)
While this is a good starting point, these tests can miss important pieces of the puzzle.
For example:
- Progesterone is often used to check if you’ve ovulated — but only works if done at the right time. If you have a textbook 28-day cycle and ovulate on day 14, then a day 21 progesterone should be accurate. If your cycle is longer or more variable, this test can be meaningless if done on the wrong day.
- Thyroid function tests may be described as “normal” but in fact, even a subtle shift can be enough to impact fertility.
- Ultrasound scans may pick up large cysts or fibroids but won’t always show whether your endometrial lining is healthy enough for implantation or if your tubes are blocked. Most scans also don’t check your antral follicle count.
- Semen analysis might be normal, but sperm DNA quality and infections can be missed
Put simply: these tests are designed to screen for major red flags, not to optimise your chances of conception.
Commonly Missed Causes of Subfertility
You might be told your tests are ‘fine’ — but there are several underlying issues that often get overlooked:
PCOS and Irregular Ovulation
Polycystic Ovary Syndrome (PCOS) can show up in subtle ways. You might not have classic symptoms, but irregular or poor-quality ovulation can still be present — and not detected by basic scans or hormone panels.
Thyroid Imbalance
Thyroid issues — even ‘subclinical’ ones — can affect ovulation, egg quality, and implantation. Ideally, your TSH should be below 2.5 if you’re trying to conceive, even if the lab says your result is ‘normal’.
High Stress or Cortisol Levels
Stress affects your hormones, particularly the delicate balance between oestrogen, progesterone, and cortisol. It can delay ovulation or stop it altogether. Yet stress is almost never assessed in routine fertility checks.
Weight and Metabolic Health
Being underweight or overweight can both reduce fertility. But it’s not just about the number on the scale — metabolic health, insulin resistance, and inflammation can all impact ovulation and egg quality, even in women with a ‘normal’ BMI.
Male Factor Issues
Many people assume fertility is mostly a female issue, but male factors contribute to up to 50% of cases. A basic semen analysis might say “normal” — but more advanced testing could show problems with sperm DNA fragmentation or morphology.
So… Could Something Be Holding You Back?
If you’re here reading this, chances are you’re already wondering if something’s being missed. That’s exactly why we created the “What is stopping me getting pregnant” checklist — a simple, free quiz to help you spot potential gaps in your current fertility picture.
Whether it’s a hormone imbalance, a lifestyle factor, or a missing test result, this checklist helps you join the dots and feel more in control of your next steps.
👉 [Take the free quiz now] and take the first step to uncovering what’s really going on.
What You Can Do Next
If you feel like you’re not being heard, or you’re tired of waiting for answers — you don’t have to go through it alone. At The Female Health Doctor, we offer a Fertility MOT designed to go beyond the basics.
We offer:
- Detailed hormone panels timed to your cycle
- Thyroid and nutritional assessments
- Pelvic ultrasound scans to check your ovarian reserve
- Vaginal swabs and infection screening
- One-to-one doctor-led consultations that focus on you, not a protocol
Together, we can map out a clear, evidence-based plan to optimise your fertility and give you back a sense of direction.
Final Thoughts
Not being pregnant yet doesn’t mean it’s not going to happen. It just means it’s time to look deeper.
You deserve more than “everything looks fine”. You deserve real answers for why you’re not getting pregnant, and a team that’s committed to helping you find them.
Take the quiz, or get in touch to start your personalised fertility journey and join our supportive facebook community to connect with others on a similar journey and get your questions answered.
Until next time,
Dr Nikki
