Whether you get pregnant quickly, or after a few months, or need fertility treatment to conceive, getting pregnant is an art.
Many factors have to line up just right with both egg and sperm – and timing! – to see those two pink lines on a pregnancy test.
If you’re just beginning your journey to parenthood and starting to think about how to optimize your chances of getting pregnant naturally, you’re probably wondering exactly how to do that. Sure, sex is involved. But when should you have sex? How often? What are the chances of success every time?
We got you.
Here’s your guide to getting pregnant naturally.
Many couples don't realize before they start trying that for fertile couples in their 30s who don't have issues with sperm, eggs, fallopian tubes or uterus, getting pregnant each month only occurs about 15-20% of the time.
That means it takes about 4-6 months to conceive the average fertile couple. Of course, it's possible to get pregnant on the first attempt, the eighth attempt, or, in the case of couples with a fertility challenge – like advanced maternal age, Polycystic Ovary Syndrome, endometriosis or sperm issues like poor motility – pregnancy can take several years, and may require the help of fertility treatment like Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), or the more natural alternative to IVF, minimal-stimulation IVF, which uses less medication and takes a gentler approach to achieve pregnancy.
When to see a fertility specialist
The rule of thumb is that if a woman is younger than 35 and has been trying to conceive for one year or longer, it's time to see a reproductive endocrinologist or fertility doctor.
If the woman is 35 or older and has been trying unsuccessfully for six months, it's time to see a fertility doctor. If you end up needing fertility help or treatment, you are not alone - infertility affects 1 in 8 couples in the U.S. Many of these couples go on to have a healthy baby thanks to fertility treatment.
Understanding the Pregnancy Process
The best place to start when trying to conceive naturally is understanding the pregnancy process.
Each month, a woman ovulates one egg from one ovary (it's possible to ovulate an egg from each ovary, but this is rare). This egg travels through the fallopian tube into the uterus in hopes of being penetrated by a single sperm, fertilizing into an embryo, and implanting inside the uterine wall, creating a pregnancy.
On the man's side, each time ejaculation occurs inside the vagina, millions of sperm begin their journey past your cervix and into your uterus in hopes of finding the egg and burrowing inside.
From there, as mentioned earlier, the fertilizing embryo implants inside the uterine wall start releasing a pregnancy hormone called HCG, and a pregnancy is established. Once you understand this process, you can begin tracking your cycle to learn your ovulation pattern.
How do I track my menstrual cycle?
To try and optimize pregnancy, you should begin tracking your menstrual cycle. The length of your cycle – the time between the start of each of your periods – varies across women, so don't assume you are on a typical 28-day cycle and you ovulate on day 14. You may not!
Cycle tracking is relatively easy, and you can learn a lot after tracking your cycle for just a few months. Day 1 of your cycle is the first day of full flow bleeding. Day 2 is the second day of bleeding, followed by day 3. From there, you continue counting upward regardless of when your period ends. At some point, maybe on days 4, 5, or 6, your period will stop, and you keep counting until it returns the following month. When it returns, you start again on day 1.
After several months, look back on your notes to see how many days were in between your periods. If you're not under a lot of stress or sick, you should see a pattern – the length of your cycles should be between 1-2 days apart each time, allowing you to pin down the exact length of your cycle. Let's say of 3 cycles you tracked, one was 24 days, the other was 2 days, and the last was 25 days. In this case, you can assume you have a 2-day cycle.
The next step is figuring out when you ovulate, and for most women, that's about 12-14 days before menstruation. That period of time between ovulation and menstruation is called the luteal phase. As mentioned above, most women have a 12-14 day luteal phase. So let's go back to our 24-day cycle example. If you have a 12-14 day luteal phase, your 'ovulation window' is anywhere between days 10-12 of your cycle. Or, let's say you have the typical 28-day cycle – your ovulation window is anywhere between days 13-15 of your cycle.
We can do this math with longer cycles too – for women with a 31-day cycle, the ovulation window will occur between days 17-19.
But when precisely in my ovulation window do I ovulate?
This is answered most easily with two tests: cervical mucus and Ovulation Predictor Kits (OPKs).
Ovulation can also be determined by taking basal body temperature and a self-cervical exam. The two most popular ways to check for impending ovulation (it's nearly impossible to know *exactly* when it occurs even for those women who can feel ovulatory pain) are checking your cervical mucus, also known as vaginal discharge, and taking an OPK that tells you if you're about to ovulate.
While some women rely on OPKs alone, pairing them with insights about your cervical mucus increases the likelihood that you have correctly identified your ovulation window.
What does ovulatory cervical mucus look like?
Two words: egg whites. You may have heard this before, and it's true – right around ovulation, the look and feel of cervical mucus changes so drastically (for most women) that it's pretty hard to miss.
Ovulatory cervical mucus (that begins several days before ovulation and mostly disappears) is clear and stretchy, just like egg whites. If you look up images online of the mucus (type egg white cervical mucus), you'll see many accurate representations of what this looks like. Watch for discharge at the beginning of your ovulation window and a few days before, as the mucus can start a little early for some women.
Once you see the mucus, you know you're approaching ovulation. Ideally, you should start checking your OPKs a few days before the mucous change – the typical recommendation is to start testing on cycle day 10.
How do I use OPKs?
OPKs are sticks you can purchase online or in a drug store that indicate whether you're approaching ovulation. They are the most scientifically accurate form of ovulation prediction available over the counter and are quite reliable. Countless women swear by them during their pregnancy journeys.
They work like pregnancy tests – you urinate on a stick, and several minutes later, the presence of two lines will let you know you are approaching ovulation. If you see only one line, you are not yet approaching ovulation and should continue daily testing until you see two lines.
While one line is a control, the second line indicates that you have Luteinizing Hormone (LH) present in your urine. This hormone is produced in small quantities at all times during your cycle, and production ramps up exponentially as you near ovulation. The presence in large amounts of this hormone is what tells your ovary to release an egg. This means that your LH will peak and show two lines on an OPK, making a positive OPK when you are about 12-36 hours away from ovulation.
Some OPKs will give you an indication that the LH rise is starting before the actual peak. On the digital OPKs, this usually looks like a flashing smiley face, whereas the solid smiley face indicates you’re at the peak.
You can check out the article from The Bump for their 5 Best OPKs.
When should I have sex to get pregnant fast?
The simple answer – start having sex, daily or every other day, starting 5 days before you ovulate.
For most women, that is between cycle days 9 and 11. If you want to do the math, sperm can live for up to five days in the female reproductive tract, ovulation happens 12-48 hours after a positive OPK, and an ovulated egg lives from 12-24 hours; so in theory, you should have sex the day you see an LH rise (or positive OPK) and every day for three days after that.
Still, experts recommend not waiting quite that long to start. Just start having sex 5 days prior to your expected ovulation. Keep in mind that if you wait to start having sex until your OPK shows a peak, you might be starting too late!
Pro Tip: Once you’ve tracked your ovulation with an OPK for 2-3 months, it is no longer necessary to keep testing unless your cycle length changes! Give yourself a break!
What happens after I time sex with ovulation?
The hard part: the wait, also known as the 'two-week wait.' In other words, this is your luteal phase wait. You wait until you get your period, indicating no pregnancy, or you don't get it, indicating pregnancy!
The bottom line
Natural fertility tracking is an invaluable skill to learn to know your cycle and attempt to conceive naturally. But if it's not working after many months and you think there might be something else going on, there very well may be.
There is absolutely no shame in seeking help from an infertility specialist who will take blood work to see your baseline hormone levels and how many eggs you have in your ovaries. For some women, a little bit of medication is all it takes to conceive naturally, while others need more advanced treatment.
Regardless of your path, know you are not alone, and your family-building goals are likely within reach.