You’ve ditched the contraception, are taking your prenatal vitamins, have been eating a healthy balanced diet and now you want to try for a baby! It is a hopeful and exciting time that can be a little daunting as well. Here is what you need to know to maximize your chances of conceiving.
If you haven’t yet, start tracking your menstrual cycle. It will be helpful to know how long your cycle lasts to help determine when you might be ovulating. A full menstrual cycle goes from first day of bleeding in one period until first day of bleeding in the next. Average cycle length is ~28 days and ovulation occurs around day 14. There is variation, but knowing your average cycle length can help gauge when you are likely to release the egg and thus when to time having intercourse.
Ways of monitoring ovulation:
- Cervical mucus: The mucous of the cervix changes over the menstrual cycle. The amount of cervical mucus increases before ovulation as estrogen levels increase. The peak is usually within two to three days of ovulation. Vaginal secretions that are slippery and clear indicate the best time for pregnancy.
- Basal body temperature (BBT): Checking daily BBT when you’re fully at rest (i.e. when you first wake in the morning) can help determine ovulation. The progesterone rise that occurs after ovulation causes a slight increase in BBT. BBT tracking is helpful to determine if you ovulated, but for women trying to get pregnant, you are most fertile in the two to three days prior to the temperature rise. It is best to look for a trend of when in the menstrual cycle you are ovulating and then you can time intercourse based on that trend.
- Ovulation predictor kits: These are commercially available kits that involve urinating on a stick over several days to detect the LH hormone surge that occurs just prior to ovulation. These tests are helpful in that when you get a positive test, you are likely to ovulate in the next day or so and can time intercourse accordingly.
The time that you are most fertile is the six days leading up to ovulation. To be even more specific, pregnancy is most likely to result when intercourse occurs within the three-day interval ending on the day of ovulation. This is because once the egg is released; it lives for only about a day. Sperm, on the other hand, can live in the female genital tract for a few days. Frequent intercourse (every one to two days) during your most fertile time yields the highest pregnancy rates. Specific time of day, position, or rest time following intercourse do not have any meaningful impact on fertility.
Unable to track your ovulation?
Don’t fret! Accurately predicting ovulation by any method can be challenging. If you have regular intercourse, this can help increase your chance of conception. As a general rule, if you have regular cycles and have regular intercourse soon after you’ve stopped menstrual bleeding and through the estimated ovulation time, then the likelihood of conception is optimized.
As far as lubrication for intercourse, be careful what you use. Some lubricants can decrease fertility based on laboratory studies. It is best to avoid water-based lubricants (such as Astroglide and K-Y Jelly) as well as olive oil and even saliva, as these can all have negative effects on sperm function. The best options to use include: canola oil, mineral oil, or hydroxyethylcellulose-based lubricants (such as Pre-Seed and ConceivEase), if needed.
Other things that can help increase your chances of getting pregnant naturally include lifestyle modifications such as limiting alcohol (< two drinks per day) and caffeine consumption (no more than two or three cups/day), smoking cessation, avoidance of recreational drugs, and an overall healthy bodyweight and lifestyle. A preconception visit with your provider is also recommended at least three months before you want to start trying. This visit is important to make sure your vaccines are up-to-date, that any medical conditions are appropriately managed, your medications are safe for pregnancy, etc.
Statistics show that approximately 80% of couples will conceive in the first six months of attempting pregnancy. However, time to conception increases with age. Fertility declines in both men and women. In women, this decline occurs after the age of 35 and is generally due to the decreased quality and/or quantity of the eggs. In men, the decline occurs in the late 40s and can be seen in changes in the semen parameters. Unfortunately, there is not a lot that can be done about this. Fertility preservation with egg, embryo, or sperm freezing is an option if you know early you aren’t ready to get pregnant. But if you are trying to conceive and not having success, a consultation with a reproductive and fertility specialist should be considered. This is best done after six months of unsuccessful attempts to conceive for women over age 35, or after one year of trying if under 35.