Starting a family can be a magical and amazing time in your life - but it can also be stressful. One in eight couples in the United States is affected by infertility. And while it’s a fairly common problem, many don’t know when or how to begin their infertility journey. So, we’re breaking down the steps to take if you’re concerned about your fertility.
Fertility vs. Infertility
First, let’s break down what it means to be fertile and infertile.
Fertility is the ability to produce a child. You are most likely to conceive in the first few months of unprotected intercourse. About 80% of couples conceive in the first six months of attempting to get pregnant.
Infertility is the inability to achieve a successful pregnancy. This is generally considered after 12 months or more of regular, unprotected vaginal sex. You may want to seek treatment earlier based on medical history or after six months of trying if you are age 35 and older. Your chances of getting pregnant begin to decrease significantly after age 35.
Your Fertile Window
When is sex most likely to produce a pregnancy?
Your likelihood is greatest when intercourse occurs the day before ovulation. It starts to decline on the day of ovulation.
How often should we be having sex?
A common misconception is that frequent ejaculation decreases fertility. Studies show that those with normal semen quality, sperm concentrations, and motility remain normal. You could try to have sex every day of the fertile window, but not if this causes undue stress on the couple. Aim for every other day or every third day instead.
Fertility Tracking
How do I know the days when I am most fertile?
There are many ways to track your cycle. Perhaps the simplest is a calendar. Although many apps can help, too. The period of the menstrual cycle before ovulation is known as the “follicular phase,” whereas the period after ovulation is known as the “luteal phase.” The length of a luteal phase is typically 14 days. As such, the day of ovulation can be estimated by subtracting 14 days from one’s cycle length.
For example, the day of ovulation is cycle day 14 if your cycle is 28 days. For those with a 30-day cycle, it would be day 16. The fertile window is the presumed day of ovulation and the five days prior.
Do I need to change my lifestyle?
- Weight can affect fertility, in both very thin and obese individuals. Some follow a “fertility diet” which is like the Mediterranean Diet.
- If you are trying to get pregnant, you should be taking folic acid supplements.
- Smoking has a substantial adverse effect on getting pregnant. Smoking individuals are significantly more likely to be infertile.
- Drinking alcohol and using cannabis may affect fertility as well.
- Caffeine should be consumed in moderation.
When to see a fertility specialist
If you have been having unprotected sex for 12 months without a pregnancy (six months if you are 35 and older), I recommend you see a fertility specialist. Your specialist will perform a complete evaluation to assess for any underlying causes of infertility.
Treatment options include:
- Oral medications with or without intrauterine insemination (IUI)
- Injectable medications
- In vitro fertilization (IVF)
Underlying anatomic pathology such as uterine polyps, fibroids, or uterine anomalies may be treated surgically, and abnormal semen parameters may prompt referral to a male fertility specialist with further consideration of additional targeted therapy.
Ultimately, you will work with your fertility specialist to develop a treatment plan uniquely targeted to your needs, with the ultimate goal of helping you build your family!
Disclaimer: While I am a doctor, I am not your doctor. The content in this blog is for informational and educational purposes only and should not serve as medical advice, consultation, or diagnosis. If you have a medical concern, please consult your healthcare provider, or seek immediate medical treatment.
