Optimizing Your Chances of Pregnancy

Imagine a typical scenario- a young woman who is sexually active but needs to finish school.  And then has to get a job.  And then has to find Mr. Right.  She has spent years of her life carefully taking contraception to make sure that a pregnancy doesn't happen.  Every month brings a period and a huge sigh of relief.

Then the time comes where work is good and she is settled and ready to start a family.  She stops all contraceptives and awaits what she is certain will be an immediate pregnancy.  But the months come and go and she battles disappointment with every period that arrives.  Inevitably, she ends up in my office, asking  “why am I not getting pregnant?”

While achieving pregnancy seems like a pretty basic concept,  it is easy to become frustrated by the process.  (Alternately, there are a lot of people who get pregnant easily and unexpectedly- this article is not for you!).  There are books written on this topic, and an entire medical subspecialty devoted to the art and science of helping couples get pregnant.  Every woman’s circumstance is different, and I cannot cover the hundreds of different scenarios that exist out there.  So I will review the very basics, including what I counsel my own patients about.

First and foremost, the chances of a pregnancy occurring in a given month is about 20%.  And that is assuming that the couple is young and healthy, the timing is perfect, the woman’s cycles are regular, and the man’s sperm count is normal.  Even if all of those stars are aligned, a pregnancy will occur only 20% of the time.  It is amazing that there are any babies born at all!

Patients ask me what they can do to optimize the process, and here are a few basics:
1.  Time intercourse to the time of month that you are ovulating.  If you don’t know when you are ovulating,  you can try...

2.   ...an ovulation predictor kit.  They sell these at drugstores next to the pregnancy tests.  The kit will involve you peeing on a stick, which will show lines that become progressively darker to indicate ovulation.  For what it is worth, ovulation occurs 2 weeks before menses begins.  Do a retroactive calculation for a few months.  If your cycles are regular, chances are you will ovulate on day 14 of a 28 day cycle, or day 16 of a 30 day cycle, etc.  (Day 1 is the first day of menstrual bleeding).

3.  Have a lot of sex.  This seems basic, but we all lead busy lives and sometime couples miss each other during that fertile time of month.  Aim to have sex every other day starting at day 10 until the day after ovulation occurs.  Every other day (instead of every day) will give his sperm a chance to recoup to optimal capacity, and beginning at day 10 will ensure that sperm are around the egg when it is released.  Better yet, have sex a few times a week all month long and you’ll never miss that window of opportunity!

4.  Don’t forget your prenatal vitamin.  Taking a vitamin with folic acid can help prevent neural tube defects, and starting this pre conception is ideal.

Most couples conceive within 3 months of trying, and 70% will conceive within 6 months.  As ob/gyn’s, we don’t worry about infertility until 1 year has passed (6 months if you’re older than age 35).  Why?  Because approximately 90% of couples will conceive within the first year.  So the odds are in your favor, even if it seems things are taking a while.  It is really easy to become stressed when awaiting a pregnancy, especially when it seems that everyone around you is getting pregnant easily.  Do your best to relax and have fun with the process- chances are excellent that you will end up pregnant!

-Dr. Jahedi