Here’s what doctors want you to know about fertility timelines and conceiving.
Deciding to have kids can be a thrilling time in your life, but it can also be unexpectedly stressful ― especially if you embark on the process and it doesn’t happen right away.
How long will it actually take to get pregnant once you start trying? The answer depends on a number of factors. But there are some general timelines you can use to help you along the way.
Many people end up pregnant within just six months of trying through sex, according to Alan B. Copperman, director of reproductive endocrinology and infertility in the department of obstetrics, gynecology and reproductive science at Mount Sinai Health System.
“If a woman is in her 20s, most of the eggs are healthy, and conceiving is often easy,” Copperman said.
However, it may take longer or pregnancy may get more complicated the older you get, he added. This is hardly uncommon ― research shows that more and more women are choosing to have children later in life. And many go on to have healthy pregnancies.
Estimates suggest fertility problems affect roughly 12.1% of women ages 15 to 44, according to statistics from the U.S. Centers for Disease Control and Prevention. Roughly 7.3 million women in that age range have sought treatment.
But before you get too concerned, wait a year. One year is a good benchmark for most couples trying to conceive through sex, explained Shweta Patel, an OB-GYN with Orlando Health Physician Associates. For those older than 35, you may want to consider seeing a doctor sooner than a year since women tend to have fewer viable eggs the older they get.
“I usually say that on average, 1 in 10 couples will be successful the first month and each month after that,” she said. “That’s referring to a healthy couple who’s simply trying without any other means of tracking or fertility planning.”
While this advice mostly focuses on conceiving through sex, some of the same rules apply for other methods. If you’re considering IVF as a way to get pregnant, it will take about one to two weeks of ovarian stimulation ― which involves injecting medicine to help your ovaries produce multiple eggs ― before doctors can retrieve the eggs.
Then, after the retrieval and the fertilization, the embryo is transferred into the uterus. About 12 to 14 days later, you should know if the procedure worked and if you’re pregnant. Several IVF cycles may be required to get pregnant (but, of course, it’s different for everyone and isn’t guaranteed to work). IVF is also costly ― something you should definitely prepare for in advance.
How To Up Your Odds Of Getting Pregnant Sooner
If you want to improve your odds of conceiving during that first year through sex, you can use a combination of strategies to set yourself up for success.
First, both Patel and Copperman suggested getting into the best overall health you can before trying for a baby. You may want to visit your doctor before you begin the process to make sure your body is in its best condition for pregnancy. It’s also important for IVF; for instance, research has shown a link between low vitamin D deficiency and decreased odds of conceiving via IVF.
“Focusing on health and wellness and reproductive awareness [is] important,” Copperman said, adding that your doctor can perform standard genetic or disease testing that may give you some important insight.
If you have an infection, for example, you’ll want to treat it before trying to get pregnant. If you have a genetic abnormality that might hinder pregnancy, you’ll want to know about it.
Beyond that, Patel said you’ll want to have a check-up to identify health conditions you might be able to improve. “For instance, if you have diabetes or uncontrolled high blood pressure, you’ll want to get your numbers into normal range,” she said.
Patel said obesity may increase the odds of developing issues like gestational diabetes and raise your risk of complications like miscarriage or stillbirth.Untreated thyroid issues may also up your chances of stillbirth, premature birth or miscarriage. Your OB-GYN can let you know what other health issues should be treated.
If you’re trying to get pregnant through sex, Patel said a combination of tools can help you narrow down the window in which you might be fertile each month. Apps, of course, are popular right now.
“I always tell patients that most apps are algorithm-based and not scientifically associated with your body,” Patel said. “That said, they are useful to narrow down the week you’ll be ovulating.”
Natural Cycles is an app that tracks fertility using the basal body temperature method, which relies on taking your temperature each day to predict when you’re ovulating. It’s one of the only contraception apps that has been cleared by the U.S. Food and Drug Administration, with many people using it to help aid in pregnancy (or for birth control).
Patel also suggested checking your cervical mucus for an “egg white-like consistency” if you want to gauge by sight. As estrogen rises and you approach ovulation, this thicker mucus helps sperm travel through the cervix toward the egg to increase your odds of conceiving. You should see a “transparent, like raw egg white,” “slippery,” or “stretchy/elastic” mucus, a few days before ovulation, as well as when you’re ovulating ― which is peak fertility time for you.
“Once you’re in the right week by monitoring the signs, you can use ovulation predictor kits to get the day right,” Patel said. “Start having sex the day your ovulation test is positive, and then a few days after.”
The best way to get as accurate as possible? Use all three methods. “It’s best to use apps in conjunction with basal body temperature and cervical mucus consistency,” Patel said.
What If It’s Been More Than A Year?
If it’s been a year ― or sometimes less, depending on your age ― it might be time to see your doctor to create a more thorough plan.
“It is never too early to get a reproductive check-up,” Copperman said, adding that it’s recommended for patients under 35 to get checked after trying for one year, and for patients to get checked after six months of trying if they’re over 35. But no matter how old you are, if you want to go in before that, “you should be empowered to ask questions and get answers sooner rather than later,” he said.
In other words, if you’re concerned, there’s nothing wrong with getting checked out no matter where you are in the process of trying to conceive. Or, if you’re just getting started, try setting an appointment with your doctor a year from now just so you don’t have to stress about it.
When you do go get checked out, you can start with your OB-GYN. Some may refer you to a fertility specialist who will check for infections, problems with sperm production or delivery, structural damage, ovulation disorders and more.
“There is a lot we can learn by taking a thorough history,” Copperman said. “In an initial consultation, a trained fertility specialist can usually narrow down whether the cause of infertility is related to eggs, sperm, uterus or tubes.”
In one-third of cases, there’s a problem relating to the man; in one-third of cases, there’s a problem relating to the woman; and in one-third of cases, there are issues affecting the fertility of both or there is no known cause, Patel said.
“Men will get a semen analysis, but with women, it’s more complex,” she said. “We’ll make sure there’s no miscommunication going on between the brain and the ovaries involving the hormones that help prime and release the eggs. We’ll check to see if there’s any reason she’s not ovulating. We’ll make sure the plumbing is OK, which we can look at using radiologic studies. We’ll check to see if there’s a genetic abnormality.”
If you’re not pregnant after the first cycle of IVF (most people aren’t ― the odds are just over 21%), your doctor may suggest some changes to your medications or routines to improve your chances the next round.
Treatments vary based on the cause of your problem and how you’re trying to get pregnant, whether it’s through sex or through medical interventions.
“Treatment options can often be low-tech, and be as simple as having a couple better time intercourse to ovulation,” Copperman said. “In other cases, intrauterine insemination (IUI), fertility drugs like clomiphene citrate, and even surgery like laparoscopy or hysteroscopy might be helpful.”
For couples trying to get pregnant through sex, if there’s no blockage or structural abnormality, Patel said she often tries clomiphene citrate (clomid) for six months. The daily pill is usually taken for five days beginning on day five of a woman’s cycle.
“Each month, eggs are sort of competing for which will be released by a single ovary,” Patel said. “In simple terms, we remove the mechanism that keeps all the eggs from spilling out at once, and actually allow a woman to ovulate more than one egg per cycle.”
If clomid does not work, Patel often opts for letrozole ― a stronger drug aiming for similar effects. If six cycles of this are ineffective, couples will often be counseled on IVF.
All of these treatments increasingly up your odds of successfully conceiving biological children. So, just know: If you want to have kids, there are tons of options to try. And just because you don’t get pregnant after a month, or even a year, doesn’t mean you won’t. Take it step by step.