Why is it difficult to conceive despite normal test reports?

Question

Hello Doctor,

I am a 30-year-old female. I had a pregnancy termination through dilation and curettage (D&C), commonly referred to as an evacuation. I have been trying to conceive for the past three years without success, even though my menstrual periods are regular.I consulted a general physician (not a fertility specialist), who recommended a hysterosalpingography (HSG) test and an abdominal ultrasound scan. Both tests came back normal, and the doctor informed me that there were no visible issues.

Please help.

Answer 1

Hello,

Welcome to iCliniq.com.

I understand your concern.

A 30-year-old woman with regular periods has been trying to conceive for three years without success. A normal hysterosalpingography (HSG) and abdominal scan, and a prior abortion via dilation and curettage (D and C), but has not yet consulted a fertility specialist. Even when basic tests appear normal, infertility can result from less obvious factors such as poor ovulation quality (example, anovulatory cycles), declining egg quality or low ovarian reserve male factor infertility (which accounts for 40 to 50 percent of cases and requires semen analysis), or undetected uterine or tubal issues such as endometriosis, pelvic adhesions, or Asherman’s syndrome. Mild polycystic ovary syndrome (PCOS) or endometriosis may also be involved, even if imaging is clear. The next best step is to see a reproductive endocrinologist for comprehensive testing, including a full hormonal panel, ovulation tracking, semen analysis, and possibly advanced imaging. Lifestyle factors such as body mass index (BMI), nutrition, sleep, and stress management also impact fertility and should be considered as part of a holistic approach.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.