In the event that you have not been able to conceive even after trying for six months you might consider the following points to understand the possible reasons for you being unable to conceive. There are some women related fertility issues that you might consider checking:

1. Periods - are you having regular, short or longer periods? Here short periods and long periods refer to less than 24 days and greater than 34 days respectively.

2. Bleeding - do you experience bleeding during your period?

3. Body Mass Index (BMI) - Is your BMI overweight or underweight? Overweight and underweight BMI is usually calculated as BMI of 25 and 18.5 respectively.

4. Cancer treatment - have you undergone any form of cancer treatment?

5. Diabetes - Do you have history of being diabetic?

It may also be possible that the male partner might as well be the reason why you are not being able to conceive. You might check the following male fertility issues:

1. Testicles operation - Have you undergone any operation on your testicles?

2. Hernia repair - Did you have any hernia repair

3. Blood during ejaculation - do you find any blood during ejaculation

4. Mumps - Have seen the formation of any mumps?

5. Injury to testicles - Have your testicles undergone any injury

6. Vasectomy - Have you had a vasectomy?

7. Overweight Body Mass Index - Are you overweight (with a body mass index greater than 25)?

8. Diabetes - Do you have diabetes?

It is normal for partners to try conceiving for over six months without any success. So, do not worry yourself unduly. Keep a check on the above issues. However, if the same continues for over a consider visiting your doctor for advice.

Source: http://theadventurouswriter.com/blogbaby/why-cant-i-get-pregnant-male-female-fertility-problems/

1. Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods. Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause

2. Blocked fallopian tubes due to pelvic inflammatory disease , endometriosis , or surgery for an ectopic pregnancy

3. Physical problems with the uterus

4. Uterine fibroids , which are non-cancerous clumps of tissue and muscle on the walls of the uterus

5. Periods - are you having regular, short or longer periods? Here short periods and long periods refer to less than 24 days and greater than 34 days respectively.

6. Bleeding - do you experience bleeding during your period?

7. Body Mass Index (BMI) - Is your BMI overweight or underweight? Overweight and underweight BMI is usually calculated as BMI of 25 and 18.5 respectively.

8. Cancer treatment - have you undergone any form of cancer treatment?

9. Diabetes - Do you have history of being diabetic?

Health flags that male partners need to check while getting conceived to reduce chances of infertility and increase probability of conception are mentioned below:

1. A problem called varicocele. This happens when the veins on a man’s testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm.

2. Other factors that cause a man to make too few sperm or none at all.

3. Movement of the sperm. This may be caused by the shape of the sperm. Sometimes injuries or other damage to the reproductive system block the sperm

4. Testicles operation - Have you undergone any operation on your testicles?

5. Hernia repair - Did you have any hernia repair?

6. Blood during ejaculation - do you find any blood during ejaculation?

7. Mumps - Have seen the formation of any mumps?

8. Injury to testicles - Have your testicles undergone any injury?

9. Vasectomy - Have you had a vasectomy?

10. Overweight Body Mass Index - Are you overweight (with a body mass index greater than 25)?

11. Diabetes - Do you have diabetes?

12. Heavy alcohol use, drugs, smoking, environmental toxins etc are also required to watch out for during conception of children.

Source: http://www.cdc.gov/reproductivehealth/Infertility/index.htm

http://theadventurouswriter.com/blogbaby/why-cant-i-get-pregnant-male-female-fertility-problems/

This is actually a good way to ensure healthy pregnancy period and a happy conjugal phase. When the partners feel they are settled emotionally, physically and financially (especially in case of working couples where the woman might have to take break from work – at times permanently) they can plan to have a baby.

It is however, advised to undergo fertility tests on both the partners to be sure that both of you have no fertility related issues.

If you and your husband have been trying for months to conceive without success, you may begin to wonder if you're doing something wrong or start asking yourself questions such as, "Is my ovulation cycle off?", "Are we having enough sex?", “Am I too stressed out?" or "Could it have something to do with that nuclear power plant in my backyard?" Although aspiring mothers seem to worry about nearly everything under the sun when it comes to making babies, one of the last things they tend to consider is diet.

Miracle Fertility Foods?

Zinc

There are countless conflicting opinions when it comes to fertility-boosting foods. Some studies point to zinc as the magic fertility bullet. This type of research claims that the consumption of at least 15 mg of zinc a day can increase semen and testosterone production in men and ovulation and fertility in women, report the editors at Fertility.com. Zinc plays a positive role in female fertility by promoting proper cell division, a process critical to the earliest stages of conception and fetal development. Similarly, in male reproduction zinc may well be necessary for adequate testosterone levels and sperm counts. Oysters, chicken, beef, crab, and turkey are all good sources of zinc.

However, while zinc is known throughout the medical community as a helpful mineral that keeps reproductive systems in good working order, no studies show that downing a dozen oysters or gobbling up a 20-pound turkey every day will transform you into a baby-making factory. As a matter of fact, taking excessive amounts of any type of vitamins or minerals can decrease fertility.

Caffeine

Then there are the coffee advocates. A couple of studies suggest that when some men drink coffee before sex, their sperm becomes more energetic. Because sluggish sperm is a primary cause of male infertility, java fans believe coffee could be the answer to their conception problems.

On the other hand, a study conducted by Yale University School of Medicine claims that the risk of reduced fertility is higher in women who consume caffeine—especially in women who drink more than three cups off coffee a day. So don't join your man when he indulges in a cup of coffee before a baby-making session—if you choose to believe this somewhat contradictory research, that is.

Iron

A number of nutritionists also believe that apricots, clams, shrimp, prunes, and tofu can enhance your fertility due to their high levels of iron. Some studies indicate that women with low iron reserves are less likely to conceive, so many people assume that consuming more iron must increase fertility. These fertility food advocates also say this rule holds true for foods containing vitamin B12, vitamin C, vitamin E, and calcium.

Take a vitamin-mineral supplement.

Although you can meet almost all of your nutritional needs through a balanced diet, many experts believe that even the healthiest eaters can use extra help. You may find it particularly hard to eat well when you're at work or parenting other children, so taking a prenatal vitamin ensures that you're getting enough folic acid and other nutrients to boost your chances of conceiving. Remember that a supplement is a safeguard, not a substitute for a sound diet. Talk with your doctor about the right prenatal supplement for you.

Get lots of folic acid — at least 400 micrograms a day.

This vitamin has been proven to reduce a baby's risk of neural-tube birth defects such as spina bifida, and it is linked to a lower incidence of heart attacks, strokes, cancer, and diabetes.

Most women of child-bearing age should get 400 micrograms (mcg) daily, the equivalent of 0.4 milligrams (mg). If you have a family history of neural-tube birth defects or take medication for seizures, your doctor may suggest that you boost your daily intake to 4,000 mcg, or 4 mg, starting at least a month before you conceive and continuing throughout your first trimester

Separating Fact from Fiction

Although there are many fertility-boosting food believers out there, many nutritionists don't buy the notion that eating certain foods ensures you'll be a mother within the next year. However, dietitians and nutritionists do recommend a balanced diet complete with all of the necessary nutrients.

Cynthia Sass, a registered dietitian, licensed nutritionist and national media spokesperson for the American Dietetic Association, doesn't believe that specific foods can increase a man or woman's fertility. On the other hand, Sass says, "An overall balanced diet can help greatly." She explains, "Studies have shown that being overweight is linked to infertility, as well as following a too restrictive diet or a diet deficient in key nutrients such as zinc. Researchers at the University of Adelaide have found that diet and exercise changes can help women struggling with infertility become pregnant."

Rather than focusing on specific types of food, Sass explains that women struggling with getting pregnant should seek out a healthier diet in general. "An optimal diet will best support the functioning of every system in the body, including the reproductive system. This means eating the right number of calories to support ideal weight, and choosing mostly nutrient-rich foods with treats in moderation."

The goal is to strive for a balanced diet full of healthy nutrients when you're trying to conceive. If this doesn't work and you've been trying to get pregnant for more than a year, you should definitely make an appointment with your doctor.

What to avoid?

If your eating habits leave something to be desired — and many people's do — you'll have to make some adjustments. Some solid advice: Cut out or only occasionally drink alcohol. (For non-alcoholic alternatives, see our list of the best virgin drinks). Stop using recreational drugs and, if you smoke, quit. All of these substances and habits can harm a developing fetus.

You may also want to cut back on caffeine. The research on whether caffeine can affect fertility is mixed. Experts generally agree that low to moderate caffeine consumption, less than 300 mg a day or about the equivalent of three cups of coffee, won't affect your fertility, but your doctor may recommend that you cut caffeine out entirely to play it safe. Learn more about caffeine and fertility.

Although fish is generally very healthy, certain types are high in mercury, which can be dangerous to your unborn baby. Because mercury can accumulate in your body and linger there for more than a year, it's best to avoid high-mercury fish such as shark, swordfish, king mackerel, and tilefish while you're trying to conceive. Instead, eat lower-mercury fish such as salmon and canned light tuna once or twice a week. Read more on eating fish while trying to conceive.

Processed meats should be consumed in small amounts, and smoked or raw meats should be avoided entirely during pregnancy. Even hot dogs or deli meats should be heated until they are steaming before you eat them if you are pregnant.

http://www.babycenter.com/0_trying-to-conceive-five-changes-to-make-to-your-diet-now_3558.bc

Source: http://www.babyzone.com/preconception/getting_pregnant/article/foods-increase-fertility

http://www.babycenter.com/0_trying-to-conceive-five-changes-to-make-to-your-diet-now_3558.bc

Other investigations are described below.

Tests to predict ovulation

Ovulation raises the body temperature slightly, so for many years women were advised to take their temperature every morning to find out when they were ovulating. It is also possible to test a sample of urine for LH (luteinizing hormone) and ovulation predictor kits can be purchased from most chemists. The advantage of testing urine, rather than taking the temperature, is that the sample reveals LH before actual ovulation takes place. Since examination of urine samples is expensive, the temperature method can still be used as a supplement.

Semen analysis

This will give information about the number of sperm per millilitre, the percentage of sperm swimming normally (motility), and the percentage of abnormal sperm. There can be considerable variation in the results between different samples, which is why a reduced semen analysis will always be checked with one or two repeat tests.

Hormone measurements

Hysterosalpingography (HSG)

This is an X-ray examination of the womb and Fallopian tubes and involves injecting a dye through the cervix into the womb. It does not usually require a general anaesthetic, but there may be associated discomfort.

Laparoscopy and dye examination

This involves admission to hospital and is performed under a general anaesthetic. A small incision is made in the abdomen and a needle inserted. Gas is passed through the needle to distend the abdomen then a telescope called a laparoscope is inserted into the abdomen. The womb, tubes and ovaries are then inspected. Dye is passed through the cervix into the womb and the tubes can be observed directly to see whether they are damaged or not.

Source: http://www.netdoctor.co.uk/health_advice/facts/assistedconception.htm

The different types of assisted reproductive technology (ART) are as follows:

Common methods of ART include —

1. 1. In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART. It is often used when a woman's fallopian tubes are blocked or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once mature, the eggs are removed from the woman. They are put in a dish in the lab along with the man's sperm for fertilization. After 3 to 5 days, healthy embryos are implanted in the woman's uterus.

2. 2. Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer is similar to IVF. Fertilization occurs in the laboratory. Then the very young embryo is transferred to the fallopian tube instead of the uterus.

3. 3. Gamete intrafallopian transfer (GIFT) involves transferring eggs and sperm into the woman's fallopian tube. So fertilization occurs in the woman's body. Few practices offer GIFT as an option.

4. 4. Intracytoplasmic sperm injection (ICSI) is often used for couples in which there are serious problems with the sperm. Sometimes it is also used for older couples or for those with failed IVF attempts. In ICSI, a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or fallopian tube.

ART procedures sometimes involve the use of donor eggs (eggs from another woman), donor sperm, or previously frozen embryos. Donor eggs are sometimes used for women who can not produce eggs. Also, donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby. An infertile woman or couple may also use donor embryos. These are embryos that were either created by couples in infertility treatment or were created from donor sperm and donor eggs. The donated embryo is transferred to the uterus. The child will not be genetically related to either parent.

Surrogacy

Women with no eggs or unhealthy eggs might also want to consider surrogacy. A surrogate is a woman who agrees to become pregnant using the man's sperm and her own egg. The child will be genetically related to the surrogate and the male partner. After birth, the surrogate will give up the baby for adoption by the parents.

Gestational Carrier

Women with ovaries but no uterus may be able to use a gestational carrier. This may also be an option for women who shouldn't become pregnant because of a serious health problem. In this case, a woman uses her own egg. It is fertilized by the man's sperm and the embryo is placed inside the carrier's uterus. The carrier will not be related to the baby and gives him or her to the parents at birth.

Source: http://www.cdc.gov/reproductivehealth/Infertility/index.htm

• Age of the partners

• Reason for infertility

• Clinic

• Type of ART

• If the egg is fresh or frozen

• If the embryo is fresh or frozen

• Your fertility decreases with age which means that the success of assisted-conception treatments also reduce as you get older. IVF is most successful when a woman is aged between 25 and 39

• The best chances of conceiving are within the first three cycles of assisted-conception treatments.

• If you have had a previously successful pregnancy, either naturally or through assisted-conception techniques, you will have a higher chance becoming pregnant from assisted conception.

• If you or your partner smoke, drink more than one unit of alcohol per day or drink excessive amounts of caffeine, you will lower your chances of successful assisted conception.

• If you're very overweight (with a Body Mass Index greater than 30) you will also reduce your chances of successful treatment.

There are several factors that affect how successful assisted-conception treatments will be. The single most important factor is the age of the female partner. Other factors include the number of eggs in the ovaries, how long you have had fertility problems for, how many cycles of treatment you have tried previously and if you have had a successful pregnancy before.

Source: http://www.cdc.gov/reproductivehealth/Infertility/index.htm

http://www.bupa.co.uk/individuals/health-information/directory/f/assisted-conception?tab=Common%20questions#textBlock201236