Trying to get pregnant: ovulation, timing and healthy habits

Planning a pregnancy raises many practical questions. This article explains how long conception usually takes, how ovulation affects timing, which health steps are advised before pregnancy and when to ask for help, based on the NHS and MedlinePlus.

1. Introduction

Conception time varies from person to person. The NHS says age, general health, any fertility issue, how often a couple has sex and the method used (sex or artificial insemination such as IUI) all affect the chance of pregnancy ^[1]. For people aged 39 or under who have sex without contraception every 2 to 3 days, the NHS says pregnancy is likely within a year ^[1]. Its infertility page adds that when the woman is under 40, more than 8 in 10 couples conceive naturally within a year, and that about 1 in 7 couples may have difficulty conceiving ^[2]. Some people conceive quickly and others take longer ^[2].

2. Ovulation and the fertile time

Ovulation is the release of an egg from an ovary. You are most likely to conceive around ovulation. The NHS says this usually happens about 14 days before your next period, but the exact timing depends on the length of your cycle ^[1]. For example, someone whose cycles are longer will ovulate later in the cycle than someone with shorter cycles.

Ovulation problems are a common cause of fertility difficulty. The NHS says ovulation problems are the most common cause of infertility in women, and lists conditions behind them, including polycystic ovary syndrome, thyroid conditions and premature ovarian failure ^[3]. Very irregular or missing periods are a good reason to talk to a doctor early. MedlinePlus advises seeking care if you have irregular periods ^[4].

3. How often to have sex

The NHS timing figures above assume sex every 2 to 3 days without contraception ^[1], and the page does not give a stricter schedule. The NHS notes that stress can strain relationships and reduce desire for sex ^[2].

Some couples use artificial insemination instead of sex. The NHS says that for people aged 39 or under using intrauterine insemination (IUI), it may take 6 to 12 rounds of treatment to become pregnant ^[1]. This shows that even with medical help, conception can take time, and patience and support from your partner, family and doctor matter. If waiting is affecting your mood or your relationship, mention it to your doctor, because MedlinePlus says counselling and support groups can help ^[4].

4. Steps to take before pregnancy

The NHS suggests these steps while planning a pregnancy ^[1]:

• Vaccines and screening. Have the MMR vaccine if you have not already, check whether cervical screening is due, and get tested for sexually transmitted infections if there is a risk.
• Supplements. The NHS advises taking vitamins and supplements, including folic acid and vitamin D. Your doctor or pharmacist can tell you what is right for you.
• Smoking, alcohol and drugs. Stop smoking, avoid alcohol and avoid illegal drugs. A GP can help if you need support.
• Diet and weight. Eat a healthy diet. Being too underweight or overweight can make it harder to conceive. Excess weight in pregnancy raises the risk of high blood pressure, pre-eclampsia, gestational diabetes and blood clots.
• Medicines. Do not stop prescribed medicine without speaking to your GP or specialist first.

If you have had cancer treatment or have a health condition, the NHS advises talking to your GP about planning a pregnancy ^[1]. The NHS infertility page gives similar guidance for both partners. Smoking, including passive smoking, lowers the chance of conceiving and can reduce semen quality. A body mass index of 30 or more reduces fertility. Heavy drinking can affect sperm quality, and the safest approach while trying to conceive is to avoid alcohol ^[2]. Sexually transmitted infections such as chlamydia can also affect fertility ^[2].

5. Age

Fertility declines with age ^[2]. The NHS timing figures apply to people aged 39 or under, and the page gives no figures for older age groups ^[1]. MedlinePlus and the NICHD use a shorter timeframe of 6 months before calling it infertility when a woman is over 35 ^{[4, 5]}. The NHS advises seeing a GP sooner if the woman is 36 or over ^[2].

6. When to see a doctor

The NHS says to speak to a GP before you start trying if you have a health condition such as epilepsy, diabetes, sickle cell disease or HIV, take any medicines or herbal remedies, have a known fertility issue, find sex difficult, or need help with smoking, alcohol or drugs. See a GP if you have been trying for a year or more. The NHS advises going sooner if the woman is 36 or over or you already know you may have a fertility problem ^[2]. If tests find a fertility problem, the NHS says treatment may include medicine, surgery, IVF or IUI, depending on the cause ^[1]. The NHS also says stress can affect fertility, so it can help to be open with your partner and your doctor about how you are coping ^[2].

In an emergency, call your local emergency number (112 in India, 911 in the United States).

7. Conclusion

When the woman is under 40, more than 8 in 10 couples conceive naturally within a year of regular unprotected sex. Having sex every 2 to 3 days, stopping smoking, avoiding alcohol, keeping a healthy weight and reviewing medicines and vaccines before pregnancy are practical steps. If pregnancy does not happen, early advice from a doctor helps. The doctor decides which tests and care are right for you.