Do you have regular, predictable cycles? Have you ever used an ovulation prediction kit? Do you ever have mild cramping or low back pain about the middle of your cycle? These are suggestions that you ovulate. The only thing that guarantees that you ovulate is pregnancy. But there are many things that may be preventing ovulation such as: scarring of the ovary from previous surgery, endometriosis or infection; abnormalities of one or more of your hormones; or maybe you are nearing the menopause, either normally or prematurely. If an ovulation problem is preventing you from becoming pregnant, there are medications available, that may allow you to overcome this obstacle.

Fertilization

Is your husband's functional sperm count adequate to allow sufficient opportunity for sperm to reach an egg? Is his sperm capable of fertilizing an egg and is your egg capable of allowing penetration by a sperm? These are the questions that must be answered to rule out a fertilization problem. If fertilization is the problem, you will need to resort to ART (Advanced Reproductive Technologies) also known as in vitro fertilization, to become pregnant.

Tubal Transport

Have you ever had a hysterosalpinogram? This a test to determine whether your tubes are open to allow passage of the sperm to the egg and transport of the fertilized embryo to the womb. Fertilization takes place in the farthest section of tube from the uterus and the tube must then transport the embryo to the uterus. This occurs over several days. If your tubes do not support this passage, surgery may correct the problem, or in vitro fertilization may be your best option to achieve pregnancy.

Implantation

About 4% of women who seek care for infertility are diagnosed with an implantation defect. The lining of the uterus has two specific features that are necessary for implantation. These can be thought of as "velcro" and "super-glue." If either of these components is missing, the embryo doesn't "stick" to the lining of the womb and you don't become pregnant. If you have not been pregnant, and all the other infertility causes have been ruled out, you may need to check into the possibility that your lining is missing one of these vital components. If, in fact, you are one of the 4% of infertility patients who is missing either the mucin (super-glue) or the integrins (velcro), testing and treatment are available to correct this problem.

Additional maladies that can cause an implantation failure are uterine fibroids or polyps, a septum, or some other entity within the cavity of the uterus that causes uterine deformation. A hysterosonogram or hysterosalpingogram will aid in detecting these abnormalities. These can be surgically corrected, making your uterine cavity more accommodating to implantation.

The Number One Predictor of Success

There is no single factor which is totally predictive of success. However, if one had to choose the factor exerting the greatest influence, it would be female age.