Whether you’re just thinking about starting a family, actively trying to get pregnant, or have been struggling with infertility, getting pregnant can be an exciting yet stressful time. There are many factors that influence a couple’s ability to conceive, and the journey to parenthood may take longer than expected. Understanding your fertility, the obstacles that can make it difficult to get pregnant, and the options available for improving your chances can help put you in the best position to achieve a successful pregnancy. This comprehensive guide provides an overview of fertility basics, diagnostic tests to determine if there are any problems, and treatments ranging from lifestyle changes to advanced assisted reproductive technologies. The path to pregnancy is different for every couple, but with the right knowledge and medical support, having a baby is possible.
Introduction
Getting pregnant may seem straightforward, but for many couples it can be challenging. This comprehensive guide covers everything you need to know about fertility and trying to conceive, from the basics of how pregnancy happens to high-tech options for overcoming infertility.
The chances of getting pregnant naturally vary each month based on a woman’s age and reproductive health. For couples in their 20s and early 30s, the probability is 20-25% per cycle. By your late 30s, the odds drop to 10% per cycle and 5% or less per month in your early 40s. If after six months of timed intercourse you’re still not pregnant, it’s a good idea for both partners to get checked out. Diagnostic fertility tests like hormone level checks, ovulation tests, sperm analysis, and pelvic exams can identify potential issues preventing conception like irregular ovulation, blocked fallopian tubes, low sperm count or motility, endometriosis, PCOS, and others.
Treatment options are many and include oral or injectable fertility drugs to stimulate ovulation, intrauterine insemination (IUI) to place sperm directly into the uterus, assisted reproductive technology (ART) like in vitro fertilization (IVF) where eggs are retrieved and fertilized in a lab, and surrogacy or donor options for some diagnoses. The right course of treatment depends entirely on the underlying cause(s) of infertility for each couple.
With patience, medical guidance, and the array of options available today, most couples will ultimately get pregnant and have a healthy baby. But the journey is not always easy or short – this guide aims to prepare you for the challenges while offering hope and resources every step of the way.
Understanding Your Fertility: What Impacts Your Chances of Getting Pregnant
Getting pregnant seems like it should be easy, but for many couples it can take time. There are several factors that determine your fertility and chances of conception each cycle.
- Age: A woman’s fertility naturally decreases with age, especially after 35. While pregnancy after 40 is possible, the chances of conceiving decrease significantly each year. For men, age also impacts fertility and sperm health, though not as rapidly.
- Menstrual cycle: Knowing your cycle helps determine when you’re ovulating and most fertile. On average, ovulation occurs around day 14, but can vary from cycle to cycle. Using ovulation predictor kits or tracking your basal body temperature can help identify your most fertile days.
- Sperm health: It takes only one sperm to fertilize an egg, but if a man’s sperm count, motility (ability to swim), or morphology (shape and size) are abnormal, it may be harder to conceive. Diagnosing and treating any issues can improve your chances.
- Medical conditions: Conditions like endometriosis, PCOS, fibroids, STDs, and thyroid disease can make it difficult to get pregnant naturally. Consulting your doctor about any diagnoses and treatment options is important before trying to conceive.
- Timing of intercourse: Having sex during your fertile window, especially the 3 days leading up to and including ovulation, gives you the best chances of pregnancy each cycle. While daily sex is not required, every other day around ovulation is a good rule of thumb.
With the right knowledge and preparation, most couples can get pregnant within a year of trying. However, if it’s taking longer than expected, consulting a fertility specialist for testing and diagnosis of any issues is advised. They can help develop a treatment plan tailored to your needs and get you on the path to pregnancy and parenthood.
How Long Does It Usually Take to Get Pregnant?
On Average, It Takes Most Couples 3 to 6 Months to Conceive Naturally
According to medical experts, it typically takes most couples 3 to 6 months of having unprotected sex to become pregnant. This figure is based on the average chance of conceiving naturally within one menstrual cycle, which is between 20 to 25% for women under 35. However, a woman’s age is the single most important factor affecting her fertility and chances of conception.
- Women in their late 20s and early 30s have the highest likelihood of conceiving within the first 3 months, around 30% per cycle.
- For women 35 to 39, the chances drop to around 15% per cycle, so it may take 6 months or longer.
- Over 40, the odds of conceiving naturally within 6 months are less than 10% due to decreasing egg quality and quantity.
- Have frequent unprotected intercourse during the fertile window around ovulation for the best chances. This is usually the 5 days before ovulation and the day of ovulation itself.
- Use an ovulation predictor kit or fertility monitor to help identify your fertile days.
- See a doctor if you are under 35 and have not conceived after 12 months of regular unprotected sex, or if you are over 35 and have not conceived after 6 months.
There are many possible issues that could make getting pregnant difficult for some couples. Diagnosing any underlying problems early on can help find solutions and increase your odds of conception. While the chances of conceiving spontaneously decrease with age, many fertility treatments are available today to assist women of all ages. The key is not to delay seeking help from a reproductive endocrinologist, especially after 35. With patience and the right medical support, most couples will ultimately be able to achieve a successful pregnancy.
Timing Intercourse and Ovulation for the Best Chance of Conception
Timing intercourse and ovulation properly is key to increasing your chances of conception. ###Knowing Your Menstrual Cycle
The first step is understanding your menstrual cycle. A typical cycle lasts 28 days, with ovulation occurring around day 14. However, cycle length varies among women and from month to month. To determine your ovulation date, track your menstrual cycle for a few months and look for changes in cervical mucus. As ovulation approaches, mucus becomes clear, slippery, and stretchy.
You can also use ovulation predictor kits to detect your LH surge, which triggers ovulation. These kits test urine and provide the most accurate prediction of ovulation.
Timing Intercourse
Have intercourse during the three days leading up to ovulation, on the day of ovulation, and the day after. Sperm can survive for up to five days inside the female reproductive tract, and this six-day window covers the lifespan of sperm and the day of ovulation. (-)Have intercourse every other day during this fertile period. (-) This frequency will ensure there are always active sperm available to fertilize the egg without depleting sperm count.
Luteal Phase
The luteal phase refers to the second half of your cycle, starting the day after ovulation and ending the day before your next period. For most women, the luteal phase lasts 12 to 16 days. If your luteal phase is shorter than 10 days, it may be difficult to get pregnant. Talk to your doctor, who may suggest treatment to induce ovulation earlier in the cycle.
Age and Fertility
A woman’s fertility and chances of conception decrease with age, especially after 35. (1.)At age 30, the chance of conceiving naturally within a year is about 20% per cycle. (2.) At age 40, the chance drops to about 5% per cycle.
Seeking medical advice can help determine if there are any issues impacting your fertility and discuss options for improving your chances of conception at any age. Diagnostic tests like hormone level tests, pelvic exams, and laparoscopies can check for problems, though some decrease fertility with age regardless of test results.
With timing, knowledge of your body’s fertility cues, and medical guidance if needed, you can optimize your chances of becoming pregnant. Best of luck!
Diagnosing Fertility Issues: An Overview of Fertility Tests
Getting pregnant can be challenging for some couples. Diagnosing any potential fertility issues is an important first step. Your doctor may order various tests to determine if there are any problems preventing pregnancy and the best course of treatment.
Blood Tests
Blood tests check hormone levels, like follicle stimulating hormone (FSH) and estradiol, to determine if you’re ovulating. Thyroid issues or polycystic ovary syndrome (PCOS) can also be detected with blood tests.
Ovulation Tests
Home ovulation predictor kits (OPKs) or fertility monitors,can detect your most fertile days by measuring luteinizing hormone (LH) levels. Ovulation tests may need to be used for a few months to accurately determine your ovulation pattern.
Imaging
Ultrasounds use sound waves to examine your reproductive organs and look for any abnormalities. They can monitor follicle growth and track ovulation. Hysterosalpingograms (HSG) use dye and X-rays to check if your fallopian tubes are open.
Other Tests
A pelvic exam allows your doctor to manually check for any issues. Semen analysis tests your partner’s sperm count, mobility, and morphology to determine if there are any male infertility factors. Genetic testing checks for genetic diseases that may affect fertility or pregnancy.
The results of these tests will help determine appropriate treatment options, such as fertility drugs, intrauterine insemination (IUI), in vitro fertilization (IVF), or surgery to correct anatomical problems. Additional testing may be ordered to confirm a diagnosis or before starting treatment.
While the road to pregnancy can be complicated, diagnosing any fertility issues is the first step towards building your family. Speaking with a reproductive endocrinologist can help determine which tests are right for your unique situation and get you one step closer to conceiving.
Fertility Treatment Option 1: Medications to Stimulate Ovulation
If you have been trying to conceive for 6-12 months without success, it may be time to explore fertility treatment options with your doctor. One of the first steps is often medication to stimulate ovulation.###
Ovulation stimulation uses drugs such as clomiphene citrate (Clomid) or gonadotropins (Follistim, Gonal-F) to stimulate the ovaries to develop mature eggs for fertilization. These medications are usually taken for about 5 days early in the menstrual cycle. They work by increasing the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to stimulate the growth and development of ovarian follicles containing eggs.
Once ovulation has been triggered through these medications, intercourse or intrauterine insemination (IUI) is timed to increase the chances of conception. The odds of pregnancy success with ovulation stimulation and timed intercourse are around 10-20% per cycle for women under 35, and 5-10% for women over 40. For IUI, the rates are slightly higher at around 15-25% per cycle for under 35 and 10% for over 40.
A major benefit of ovulation stimulation is that it is a less invasive and lower cost option compared to IVF. It also allows for pregnancy to occur through normal means of intercourse or IUI. However, there are risks of multiple pregnancy (twins or more) if too many follicles develop, and a risk of ovarian hyperstimulation syndrome (OHSS) which can cause painful, swollen ovaries, nausea, and fluid retention.
If you have irregular ovulation or menstruation, polycystic ovary syndrome (PCOS), or unexplained infertility, ovulation stimulation is often tried first before moving on to more advanced treatments like IVF. The chances of success will depend on factors like age, ovarian reserve, cause of women infertility, and whether there are any male factor issues as well. Working closely with your reproductive endocrinologist will help determine if ovulation stimulation is right for you and maximize your chances of pregnancy.
Fertility Treatment Option 2: Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is a fertility treatment option for couples in which sperm are placed directly into a woman’s uterus around the time of ovulation.### IUI can be used to treat infertility caused by problems with the male partner’s sperm, the female partner’s cervix, or unexplained infertility.
The IUI procedure is relatively simple and noninvasive. First, ovulation is monitored using ultrasounds and ovulation predictor kits to determine the optimal timing for insemination. Once ovulation has occurred or is about to occur, a semen sample is collected from the male partner and washed to separate the sperm cells from the seminal fluid. The sperm are then inserted into the uterus using a thin, flexible catheter. This places the sperm closer to the egg, increasing the chances of conception.
IUI offers some benefits over natural intercourse or in vitro fertilization (IVF). It is less expensive and invasive than IVF, and it allows for controlled timing of insemination around ovulation. However, IUI also has lower success rates than IVF, especially for women over 35 or couples with severe male factor infertility. After 3-4 failed IUI cycles, the chances of success diminish significantly, and IVF is usually recommended.
The success rates of IUI depend on several factors, including the woman’s age, the cause of infertility, and the use of fertility drugs. On average, the success rate per IUI cycle is:
- 10-20% for women under 35
- 5-10% for women 35-39
- 2-5% for women 40 and over
To optimize your chances of success, you should:
-Track ovulation to time IUI properly. Insemination should occur within 6-12 hours of ovulation for the highest pregnancy rates.
-Use fertility drugs to stimulate the ovaries and produce multiple eggs, if needed. This increases the odds that at least one egg will be fertilized.
-Have an initial fertility workup to check for any issues that could impact IUI success before proceeding with treatment.
-Consider lifestyle changes like diet, exercise, and limiting alcohol or caffeine intake.
-Be patient through the process. Conceiving through IUI can take several cycles.
With the right diagnosis and treatment plan, IUI can be an effective way for many couples to achieve pregnancy. However, you should go into IUI with realistic expectations about the number of cycles it may take and the possibility of needing to progress to IVF. By understanding the factors that influence your chances of success, you can work with your doctor to optimize your treatment and support your journey to parenthood.
Fertility Treatment Option 3: In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is a complex series of procedures used to treat fertility and assist with the conception of a child. IVF involves fertilizing an egg with sperm in a laboratory and then transferring the resulting embryo into the uterus. IVF is the most effective form of assisted reproductive technology and has a relatively good success rate compared to other fertility treatments.
The IVF procedure starts with stimulating the ovaries to produce multiple eggs using fertility drugs. The eggs are then removed and fertilized in a lab. Once fertilized, the embryos grow for 3 to 5 days before the best embryos are selected for transfer into the uterus. Any remaining high-quality embryos can be frozen for future use.
The steps involved in a standard IVF cycle are:
- Ovarian stimulation using fertility drugs.
- Egg retrieval procedure to collect the eggs.
- Insemination of eggs with sperm in a lab.
- Fertilization and embryo development.
- Embryo transfer of the best quality embryos into the uterus.
- Remaining embryos can be frozen for future transfers.
IVF has a higher success rate than other treatments since it allows for the selection and transfer of high quality embryos. According to recent statistics, the live birth rate for IVF cycles in women younger than 35 is around 45% per cycle. For women ages 35 to 37, the success rate is around 35% per cycle. The success rate does decrease with increasing age.
IVF can be an effective solution for issues like low sperm count or motility, blocked fallopian tubes, endometriosis, or unexplained infertility. The IVF procedure does come with risks like ovarian hyperstimulation syndrome and multiple pregnancies. The high cost and emotional toll are also significant factors to consider before pursuing IVF treatment. For the best chance of success, you should choose an experienced clinic and physician.
Fertility Treatment Option 4: Third-Party Reproduction (Using Donor Eggs or Sperm)
Third-party reproduction, or fertility treatment using donor eggs or sperm, may be an option if you have problems with ovulation or sperm production, or certain genetic diseases. It can allow you to have a biological child when conceiving with your own eggs or sperm is not possible.
Donor Eggs
Using donated eggs, or ovum donation, involves fertilizing another woman’s eggs with your partner’s sperm and then transferring the resulting embryos into your uterus. This allows you to experience pregnancy and childbirth. Donor eggs are often used when the female partner has problems with ovulation or egg quality, or has a genetic disease she does not wish to pass on.
Donor Sperm
Donor insemination using donor sperm allows a woman to become pregnant when male factor infertility is present. It involves placing donor sperm into the uterus during the fertile period of a woman’s cycle. Using donor sperm allows single women and same-sex couples to have a child as well. Donor sperm is tested for infectious diseases before use.
Choosing a Donor
Some donors are open to being contacted by any offspring once they turn 18, while others prefer to remain anonymous. You can choose donors based on ethnicity, physical attributes, education level, and other traits. However, there is no guarantee of outcomes.
Legal Considerations
Using third-party reproduction creates additional legal issues to consider regarding parental rights and responsibilities. It is important to consult with a lawyer to understand all legal obligations and draw up proper contracts before proceeding.
Success Rates
Success rates vary and depend on factors like maternal age, egg/sperm quality, and embryo quality. Using donor eggs or sperm does not guarantee pregnancy, but pregnancy rates are often higher than using your own eggs or sperm in certain situations. Multiple cycles may be needed to achieve pregnancy.
In summary, third-party reproduction can help many couples and individuals build their families when natural conception is not possible. However, it is a complex process that requires medical, legal and emotional support. Speaking with a fertility specialist is the first step to explore your options and find the best solution for your unique situation.
Fertility Treatment FAQs: Common Questions About Diagnosis and Treatment Options
Many people have questions about fertility treatments and what options are available to help diagnose and treat infertility. Here are some of the most frequently asked questions and answers about fertility treatments:
What are the most common fertility treatments?
The most well-known fertility treatments are:
- Intrauterine insemination (IUI): Inseminating sperm into the uterus during ovulation. Used for mild male factor infertility or unexplained infertility.
- In vitro fertilization (IVF): Stimulating the ovaries to produce multiple eggs, retrieving the eggs, fertilizing the eggs in a lab, and transferring the resulting embryos into the uterus. Used for blocked tubes, male factor infertility, endometriosis, and unexplained infertility.
- Fertility drugs: Medications used to stimulate the ovaries to produce multiple eggs in one cycle. Often used in combination with IUI or IVF. Used for ovulatory disorders or unexplained infertility.
How successful are the different fertility treatments?
- IUI success rates are 10-20% per cycle for women under 35, and 5-10% for women over 35.
- IVF success rates are 40-50% per cycle for women under 35, 25-30% for women 35-37, and 10-15% for women over 40. Success rates decrease with each year of age, especially after 37.
- Fertility drug success rates depend on the specific medication used and factors like age and diagnosis. Higher doses of gonadotropins tend to have higher success rates for ovulatory disorders, around 15-20% per cycle.
What diagnostic tests may be required before treatment?
Common fertility tests include blood tests to check hormone levels, pelvic ultrasounds, sperm analysis, and hysterosalpingogram (HSG) to check if fallopian tubes are open. These tests help determine potential barriers to pregnancy so the most appropriate treatment can be selected based on your unique situation. Additional testing may be needed for some conditions before proceeding to more advanced treatments.
With the variety of options available today, most infertility cases can be effectively diagnosed and treated. Speaking with a reproductive endocrinologist is the best way to get answers to your specific questions and explore which options may be right for you based on factors like age, diagnosis, and personal preferences. The key is to not lose hope – infertility is a medical issue and help is out there.
Conclusion
In summary, understanding fertility and planning for pregnancy can feel overwhelming. However, by arming yourself with knowledge about ovulation, timing intercourse, fertility testing options, and treatment alternatives, you can maximize your chances of success. While age, health issues, and other factors outside of your control do play a role, there are many steps you can take to support your fertility journey. Staying informed, asking questions, and working closely with your doctor are the best ways to navigate challenges and find the path to parenthood that is right for you. With patience and perseverance, you can achieve your goal of starting or growing your family.
Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.
