The 10 Most Common Reasons for Infertility I see in my Practice

Whether you’re preparing for pregnancy naturally or planning for IUI or IVF, your body deserves to be in the best possible state to support new life. While assisted reproductive technologies have their place (IUI has a 10–20% success rate, IVF up to 55% under age 35), those numbers drop with age—and you have far more power over the outcome than you might think. 

This blog breaks down key areas I explore with clients to maximize fertility success—whether you’re at the beginning of your journey or navigating a more complex path. I wish even fertility clinics prioritized the exploration of these points below, but unfortunately many, if not most, do not. Every woman and couple is unique, but these are common themes I see often in practice. 

1. Nutritional Deficiencies

Nutrition is the foundation of fertility—full stop. Your mitochondria (aka your cellular energy powerhouses) play a huge role in egg and sperm health, fertilization, and embryo development. And guess what fuels mitochondria? Nutrients.

Many women (and men) are unintentionally under-eating or relying on refined carbs to get through the day. Add stress and burnout to the mix, and your nutrient stores get drained quickly. Supporting fertility means nourishing your body deeply and consistently—not just with calories, but with minerals, vitamins, and blood sugar-stabilizing meals that support your hormonal rhythm.

2. Living on Stress Hormones

Your body will always prioritize survival over reproduction. You cannot be in a chronic state of fight-or-flight and expect your sex hormones to flourish.

And yes, stressing about trying to conceive is stress. So is constantly comparing yourself to others or pushing timelines that don’t match your body’s natural rhythm. Your nervous system needs to feel safe for your reproductive system to function optimally.

3. Underlying Infections

Infections like H. pylori, gut bacterial overgrowths, candida, parasites, and viruses (looking at you, Epstein-Barr) can all drain your system, deplete nutrient stores, and create chronic inflammation. When your body is busy fighting invisible invaders, it’s not prioritizing conception—it’s in defense mode.

And let’s be honest—many of these infections are overlooked or missed in conventional testing. A “negative” doesn’t always mean you’re in the clear.

4. Toxin Exposure

You don’t have to be living in an obviously moldy basement to be exposed to environmental toxins—many of them are invisible and everywhere.
Some common offenders:

• Mold (even in new homes)
  
• Non-stick cookware (Teflon)
  
• Synthetic fragrances (candles, perfumes, lotions, air fresheners)
  
• Plastics, BPA, phthalates
  
• Pesticides and herbicides
  

These toxins act as endocrine disruptors—they interfere with your hormones and fertility in powerful ways. Reducing your toxic load is a huge piece of preconception prep.

5. Anovulatory Cycles

Yes—you can still have a period and not be ovulating. This is more common than people realize, and it’s a major issue when trying to conceive.

Ovulation is what triggers progesterone production, the hormone that stabilizes the uterine lining and supports early pregnancy. No ovulation = no progesterone = increased risk of miscarriage or implantation issues.

6. Improper Cycle Tracking

If you’re only using a period-tracking app that predicts ovulation based on your bleed dates… you’re missing the big picture.
Ovulation can shift month to month based on:

• Stress
  
• Illness
  
• Poor sleep
  
• Nutrient status
  
• Environmental changes
  
• Emotional trauma
  

Real cycle tracking involves learning to read your body: BBT (basal body temperature), cervical mucus, and cervical position. Tools like the Fertility Awareness Method (FAM) and wearable devices can help—but they should be personalized, not automated.

7. Over-Exercising

Let’s say it again for the people in the back: your body cannot run on stress hormones and expect to ovulate.

Excessive workouts, especially when not fueled properly, keep the body in survival mode. Dr. Stacy Sims said it best: “Women are not small men.” Over-training can worsen hormone imbalances, increase inflammation, and hinder conception.

Ask yourself:

• Is exercise a way to numb or avoid deeper emotions?
  
• Are you chasing control over your body instead of supporting it?
  
• Does your movement match the phase of your cycle?

8. Metabolic Dysfunction

Blood sugar regulation is everything. If your body’s blood sugar is all over the place, it’s not thinking about babies—it’s trying to keep you alive.

Sadly, many women only have fasted glucose or hemoglobin A1C tested. These markers are limited. I always recommend adding insulin and C-peptide to get a true picture of your metabolic health.

Dysregulated blood sugar also impacts egg quality, thyroid function, inflammation, and even the labor and delivery process. It’s not just about fertility—it’s about a healthy pregnancy and baby, too.

9. Hormonal Imbalances

Yes—hormones matter. But they’re often a symptom, not the root cause.

Progesterone, in particular, is key to sustaining a pregnancy, especially in the first trimester. Low progesterone can lead to difficulty conceiving or maintaining pregnancy—but it doesn’t usually start there. It’s often the result of:

• Chronic stress (and Type A personalities…I said what I said, and I’m a recovering Type A personality myself)
  
• Under-eating
  
• Over-exercising
  
• Poor sleep
  
• Toxin exposure
  
• Digestive dysfunction

Hormones are often the first to dysregulate and the last to recalibrate. When a client says, “I think it’s just my hormones,” I lovingly say—“Let’s look at everything else first.”

10. Poor Sperm Health

Let’s not forget the other half of the equation: sperm quality matters. A lot.

Erections ≠ healthy sperm.
Men are 50% of this equation—and their nutrient status, stress levels, lifestyle, and toxin exposure all play a huge role in conception and baby’s health.

If you’re preparing your body, your partner should be too. Period.
Sperm takes about 90 days to regenerate—so the work he does now matters for your pregnancy later. Choose a partner who values his health as much as you value yours.

Every case is so different, some more simple, some way more complex. Working with someone to help you explore all of the above (and more) into greater depth, will not only leave you feeling amazing overall, but also your chances of conceiving.

With love,
Ashley