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How to get pregnant naturally

Getting pregnant naturally is a complicated process that involves multiple steps, starting with the proper balance of reproductive hormones in both partners to produce healthy eggs in women (or those with a female reproductive system) and sperm in a man (or those with a male reproductive system).

During a menstrual cycle, the ovary releases one mature egg (ovulation) that is swept into one of the nearby fallopian tubes. The egg has to be fertilized within 12 to 24 hours. Through intercourse, the sperm enters the vagina, passing through the cervix and uterus and into one of the fallopian tubes. When the egg and sperm meet in the fallopian tube, they can attach to one another and result in fertilization and a single-cell zygote.

The zygote must then move to the uterus (womb), dividing into more and more cells and forming a ball along the way. This ball of cells is called a blastocyst, which arrives at the uterus 5-6 days after fertilization. When the blastocyst begins to implant in the uterus, a pregnancy officially starts.

Timing sex when a woman is most fertile (the fertility window)

Considering the above information on what must happen for conception to occur, the best thing a couple can do to try to get pregnant naturally is have sexual intercourse during the timeframe when a woman is most fertile. The fertility window for a woman begins five days prior to ovulation and ends after ovulation. Sperm can remain viable within a woman’s body up to five days but an egg is only viable for fertilization up to 24 hours after release.

Typically ovulation occurs about 14 days before menses, but this may vary and ovulation is not guaranteed to be on time every month. Ovulation happens when luteinizing hormone, LH, causes a woman’s body to release an egg.

No app or test will be a perfect predictor of ovulation. Over-the-counter ovulation predictor kits use a urine sample to detect the level of LH (luteinizing hormone), indicating the fertility window is open. The LH surge happens one day before ovulation, so start testing on the 11^th day of the cycle to detect the LH surge. If possible, try testing at the same time each day, ideally in the afternoon. Testing first thing in the morning may cause false positive tests. Also, testing when the urine is very dilute, or clear, can cause false negative results.

Tracking basal body temperature is another way to predict ovulation, but it requires more work and must be carefully conducted. Also, once one’s temperature has risen, ovulation has already occurred and the most fertile window has passed. Some kits test saliva and cervical secretions, but these are not as reliable as the LH kits.

We recommend exposure to sperm through intercourse every 1-3 days around the time of ovulation to maximize chances of pregnancy during one’s most fertile window. Intercourse before ovulation is more likely to result in pregnancy than intercourse after ovulation. Timed intercourse ensures that there is always sperm available to fertilize an egg.

Chance of getting pregnant naturally

The chances of getting pregnant naturally are not as high as many people think, which is one of the reasons infertility isn’t diagnosed until a relatively long period of time trying to conceive has passed. The age of the woman, or an LGBTQ+ person with a female reproductive system, plays a big role.

This is because egg quantity and quality decline with age. Along with that decline comes a reduction in the chance of the egg developing into a healthy embryo that can become a healthy fetus and reach live birth.

A woman in her 20s has a 20%-25% chance of getting pregnant each month. This is the decade when a woman is typically most fertile as her eggs are at peak quality and plentiful.

A woman in her 30s has a 15%-20% chance of conceiving each month. However, a woman’s fertility begins to rapidly decline after the age of 35. A woman in her 30s may consider ovarian reserve testing to plan for pregnancy.

A woman in her 40s has less than a 5% chance for pregnancy each month. Women between the ages of 45 and 49 have only a 1% chance. This does not mean it will be impossible to get pregnant.

How long does it take to get pregnant?

Some couples can get pregnant quickly but typically conception is challenging for many. If having sex every two to three days, most couples will get pregnant within a year of trying.

The American Society for Reproductive Medicine states that the chance of a young couple getting pregnant in the first three months ranges from 20% to 37%. There is an 80% chance a couple (if the partner with female reproductive system is under the age of 40) will get pregnant within a year and a 90% chance of conception in two years.

When to see a fertility specialist

If the partner with female reproductive organs is younger than 35, we recommend seeing a fertility specialist if unsuccessful after a year of trying to conceive. That timeframe is reduced to after six months if the woman is 35 or older and immediately if 40 or above. We provide fertility testing and treatment options for all individuals and couples no matter their sexual orientation or gender identification.

People with health histories that may hinder getting pregnant naturally should see a fertility specialist sooner rather than later. Some health factors include:

• Infrequent or no menstrual periods.
• Prior or current sexual transmitted infections (STIs).
• Past abdominal or pelvic surgery.
• History of infertility.
• Previous problems with testicles or genitals.
• Ejaculation problems.
• Opening of urethra not in the end of the penis, called hypospadias.

Learn more about fertility evaluations

How to Get Pregnant Naturally

Getting pregnant naturally

Many couples and individuals experiencing difficulty getting pregnant may take steps to improve the chances of becoming pregnant naturally before seeing a fertility specialist. According to the American Society for Reproductive Medicine (ASRM), couples have the highest chance of getting pregnant in the first three months of trying, at between 20-37 percent. After those first months, the longer a fertile couple tries to get pregnant, the greater their chance of success as the months of trying add up. ASRM says the likelihood that a couple not experiencing infertility will conceive in one year of trying is 80 percent, and 90 percent in two years of trying.

The following practices, from how and when to have sex to lifestyle habits, can help maximize the chances of pregnancy. Because issues affecting fertility occur just about equally in men and women, both partners should heed the advice below.

Getting pregnant naturally at a glance

• Natural pregnancy occurs from sexual intercourse in which the man’s sperm is ejaculated into the vagina, traveling to and fertilizing her egg to create an embryo that implants in the womb.
• Couples trying to conceive naturally enhance their chances by engaging in ovulation monitoring and timing sexual intercourse to coincide with the presence of an egg.
• There is no evidence that sexual position affects fertility rates, however, couples should avoid certain lubricants that can negatively impact sperm health.
• Lifestyle changes by men and women, such as maintaining a healthy weight and avoiding habits that harm fertility, can improve the chances of getting pregnant naturally.

Smart sexual intercourse can improve natural fertility

The most important thing a couple or individual can do to increase chances of natural pregnancy is to monitor ovulation (the release of a mature egg for fertilization), and time intercourse to that (see below). After doing everything they can in that regard, men and women should primarily focus on the health of their reproductive systems (more below).

Many myths and misconceptions surround conception, particularly how to have sex in order to get pregnant. There is no evidence that the likelihood of pregnancy is increased by certain sexual positions, prolonged rest by the woman after intercourse or by the woman lying in a certain position after sex. Normally, sperm ejaculated into the vagina reach the fallopian tubes where egg fertilization occurs within minutes, no matter what position is taken during intercourse.

However, many commonly used vaginal lubricants can negatively affect sperm survival and motility (sufficient movement to get to the egg). When trying to get pregnant, avoid using most commercial lubricants, saliva or olive oil during intercourse.

ASRM recommends canola oil, mineral oil, or hydroxyethylcellulose-based lubricants (Astroglide Natural, Kama Sutra Premium), as necessary.

How often should couples have intercourse?

While there is no standard number of times a couple should have sex, studies have shown that those who have sex at least twice per week increase the probability of pregnancy. There is also research showing that long periods of abstaining from sex can decrease a man’s sperm quality.

Previously, there was a belief that there should be a waiting period before trying to get pregnant for women who have been taking birth control. This is no longer the accepted thinking. Now it is believed that there is no reason to delay attempting to conceive.

The timing of intercourse is more likely to impact the chances of pregnancy rather than how often intercourse takes place. Intercourse prior to ovulation is more likely to result in pregnancy.

Ovulation and timing intercourse

Ovulation, or the woman’s release of an egg during her menstrual cycle, is a crucial component of getting pregnant. After being released from the ovary, an egg only lives approximately 12 to 24 hours. Because of this, it is essential a couple have sex on or prior to the day of ovulation. The most effective way of doing this is to monitor ovulation, as described below.

A woman who has a regular cycle, between 25 and 35 days, is likely ovulating regularly. This typically occurs two weeks before the woman’s menstrual period. For a normal 28-day cycle, ovulation should be expected on days 13 to 15.

For women with irregular cycles, or absent menstruation, further evaluation should be done to determine if ovulation is occurring. Treatment options may be considered if it is not.

Monitoring ovulation

Monitoring a woman’s ovulation can be done with ovulation kits, apps, or calendar tracking. Following are some methods of ovulation monitoring.

• Luteinizing hormone (LH) level monitoring: These over-the-counter urine analysis kits monitor changes in LH levels. When these levels surge, ovulation usually happens within 12 to 36 hours.
• Cervical mucus: This method is an inexpensive option for tracking ovulation. However, it can be difficult to interpret and has limited accuracy.
• Smartphone apps: These apps monitor cycle length and calculate the anticipated day of ovulation.
• Basal body temperature chart: This method of ovulation tracking is one of the less practical options because it detects ovulation after it has occurred. This tool tracks a woman’s body temperature, which may rise 0.5 degrees after ovulation.

How to get pregnant through lifestyle improvements

Both men and women wishing to achieve pregnancy can do things to help give them the best chance for success. These include practices men can follow to ensure the health and vitality of their sperm and things women can do to increase their reproductive functioning.

Maintaining a normal body mass index (BMI) between 19 and 25 is essential for women trying to conceive. According to the American Pregnancy Association, being either underweight or overweight can affect fertility and the health of a pregnancy. Being obese or overweight can harm a man’s sperm health.

Exercise can also help women maintain optimum health, which can have an impact on the chances of pregnancy. Moderate aerobic exercise can improve lung capacity and blood circulation. Weight lifting can help women lose weight and increase muscle strength.

A healthy, balanced diet can improve both men’s and women’s overall health. While there is little evidence that a specific type of diet can increase the chances of fertility, a diet of lean meats, fruits, vegetables, and whole grains is beneficial for everyone. Additionally, the U.S. Department of Health and Human Services recommends a supplement of 400 micrograms of folic acid each day for women trying to get pregnant.

Incorporating healthy choices into a lifestyle also involves removing those things that can negatively affect a person’s health. Here are some habits to limit or stop:

• Smoking: Smoking has a known negative impact on estrogen levels and can impair ovulation. Men who smoke can have a decrease in their sperm quality. According to ASRM, both male and female smokers are about twice as likely to struggle with infertility than nonsmokers.
• Caffeine: A study in the American Journal of Obstetrics & Gynecology indicated that there was a link between caffeine intake of more than 1 cup a day and a higher risk of miscarriages.
• Alcohol: ASRM recommends women who are trying to conceive have no more than two drinks per day. Heavy alcohol consumption is linked to higher estrogen levels, which can impair egg growth. It has been linked to lower testosterone levels for men and can cause erectile dysfunction.
• Drug use: Drug use contributes to poor overall health and can also decrease the quality and number of a man’s sperm. Recreational drugs, such as cocaine and marijuana, can harm sperm production. Additionally, steroids can cause male fertility issues.
• High temperature: Because sperm mature in the testicles, which are a few degrees below normal body temperature, regularly engaging in activities that increase the scrotal temperature can decrease sperm production. Holding a laptop directly on the lap, excessive time in hot tubs, and wearing tight underwear are discouraged, as they can raise the temperature of the testicles.
• Sexually transmitted diseases (STD): Chlamydia, gonorrhea, and other STDs can cause damage and scarring of the fallopian tubes. This damage can cause tubal factor infertility. STDs are also linked to pelvic inflammatory disease (PID), which can increase the risk of infertility.

Fomin's clinic — a network of multidisciplinary clinics

If pregnancy does not occur within six months of active sexual life, then this is one of the signs of infertility. But don't panic. This does not mean at all that you have infertility, perhaps it is enough for you, for example, to adjust your diet. Second, infertility is treated. Well, you should not immediately cheat yourself on the subject of IVF. Remember, infertility is not the same as IVF.

Infertility is a diagnosis that 10% of women all over the world have to live with: according to statistics, every fourth married couple is infertile. In this article we will talk about what female infertility is, how to live with it and whether it can be overcome.

Female infertility is a diagnosis made after a year of unsuccessful attempts to have children, subject to regular sex with a partner without contraception. If a woman is older than 35 years, the diagnosis is made faster - after 6 months. After 35 years, the ability to conceive gradually decreases, so older women should not delay treatment.

However, one should not rush to sad conclusions either. According to statistics, even completely healthy couples under the age of 30 manage to conceive a child in the first three months only in 20-37% of cases. At the same time, after six months, pregnancy occurs already in 80% of couples. Until a year has passed from the first attempt, there is no need to worry, be examined, and even more so, to be treated.

Pregnancy depends on many reasons - in order for the "stars to align" and all the factors to coincide, sometimes it takes some time.

For example, it is known that the easiest way to get pregnant is to make love 3-4 times a week. But a break of more than 5 days can adversely affect the quality of spermatozoa.

In addition, much depends on the lifestyle of parents - stress and heavy workload reduce fertility in both men and women. It's no surprise that many successful pregnancies have started during family vacations.

If less than 6-12 months have passed since the first attempt, you can try several "life hacks":

Choose the best time to conceive. According to some reports, the day of ovulation and 2-3 days before it are best suited for conception. To find out when ovulation occurs, a urinary express test for luteinizing hormone will help - a day or two before ovulation it will become positive. However, calculating the optimal time is not always the best option.

I always oppose the calculation of the optimal time for conception, because because of this, sex begins on a schedule in a couple's life, and this is one continuous stress. It seems to me that it is more reasonable to have sex 2-3 times a week during the entire cycle.

Kosolapova Inna Vladimirovna, gynecologist-reproductologist of the Fomina Clinic, chief physician

Do not use lubricants. Water-based, oil-based and silicone-based lubricants reduce sperm survival. But lubricants based on hydroxyethylcellulose have less effect on sperm survival - so if there is a lack of lubrication, you can continue to use them.

Stop dieting. Good nutrition is the key to a successful pregnancy. But don't overeat either. There is evidence that a body mass index (BMI) of 19 is ideal for pregnancy.-thirty. In women who have a BMI greater or less, the time to conception increases.

You can calculate your BMI manually by dividing your weight by your height squared. Alternatively, you can use the built-in calculator on the website of the medical organization, or download a special application.

Quit smoking and alcohol. Smoking increases the risk of infertility by 1. 6 times. It is also better not to abuse alcohol - eat more than 20 grams of ethanol per day, the risks of "earning" infertility increase by 60%.

On the other hand, the position of the body during sex, based on the available data, does not affect the result in any way. The "missionary" position is suitable for conception just like any other.

If more than a year has passed and nothing helps, it's time to see a doctor. The diagnosis of "infertility" has the right to make only an obstetrician-gynecologist (reproductologist).

It is important to understand that infertility is not only a woman's problem. According to statistics, in the absence of children in a third of cases, the mother is “to blame”, in a third - the father, and in another third of cases the cause of infertility cannot be established. This means that with the diagnosis of "infertility" it is necessary to examine both partners.

Male infertility is diagnosed by a urologist/andrologist. But if you go to a family planning center, a reproductologist can make a diagnosis.

Most often, female infertility is associated with problems in the reproductive system: in the ovaries, fallopian (or fallopian) tubes, through which the egg passes from the ovaries to the uterus, and in the uterus itself. To figure out what exactly “broke down” in the female reproductive system, the doctor will collect an anamnesis, carefully examine the patient and prescribe tests. We talk more about this in the article "Diagnostics of female infertility".

Infertility is treated, and quite successfully — according to statistics, after diagnosis and therapy, children appear in 50% of women (without the use of assisted reproductive technologies: IVF, etc.). On the other hand, success depends on many factors, from the age and history of previous pregnancies to problems with the partner's sperm. Many factors influence the possibility of getting pregnant, so it can be difficult to predict the result.

If the problem is overweight or underweight, it is often enough to normalize the weight for a successful pregnancy. True, much more often the problem is associated with sex hormones - in this situation, the doctor will select the appropriate medication. And if the problem is in the obstruction of the fallopian tubes or in the uterus itself, surgery may be required.

In vitro fertilization (IVF) is available for patients for whom these treatments are not suitable or have not worked.

The essence of IVF is that the patient's ovaries are stimulated with the help of hormones, then the egg is taken and fertilized with the husband's sperm, then the embryo is "grown" for some time in a special incubator and transplanted into the mother's uterus. A baby is born in the same way as other children conceived "naturally".

In Russia, the IVF procedure can be done free of charge under the CHI policy. However, it is important to understand that this is a complex treatment method that requires serious preparation and gives the best result until the age of 40-45. It is difficult to predict how successful IVF will be. According to statistics, the procedure ends with the birth of a live and healthy baby in about 27% of cases.

At the same time, IVF success rates vary greatly not only in different countries, but also in different clinics in the same city. There are clinics in which in 30-40% of cases it is possible to achieve a positive result on the first try.

Very often, mothers are concerned about possible health problems that may occur in children conceived through IVF. But in recent times there has been much less cause for concern than 20 years ago.

When the method was first created, all viable embryos that were obtained after fertilization were placed into the uterus of mothers “just in case”. If everyone took root, the mother often gave birth to twins or triplets, and sometimes “quadruples”. It is much harder to bear several children than one - and after all, mothers already had problems with pregnancy, otherwise IVF would simply not have been required.

Today, the goal of the procedure is the birth of one healthy baby, so mothers transfer only one, maximum two of the best embryos. As a result, most children born after IVF do not differ much from their peers.

• Female infertility is as common as male infertility. If you can’t get pregnant within a year, you need to be examined, and sometimes treated together with your spouse.

• Infertility is a complex diagnosis that can have many causes. However, after treatment, about half of women successfully become pregnant and give birth to healthy babies (without IVF).

• IVF is a fairly effective way to give birth to a healthy baby. However, this method (like any other) has pros and cons, so you need to make a decision after consulting with an obstetrician-gynecologist or reproductologist.

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How to become parents: alternatives to natural conception

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• How to become parents: alternatives to natural conception

One of the most painful problems of our time is infertility. Many couples have been desperately trying to conceive a child for many years, for some of them these efforts are crowned with success, while others continue to fight for their happiness. But there are cases when, due to any medical indications, pregnancy in a natural way is impossible. Then the search for alternative ways begins that will help make the family truly complete.

Today it can be in vitro fertilization, and surrogate motherhood, and adoption, guardianship, guardianship or foster family.

In vitro fertilization - IVF (2015)

IVF is a rather expensive procedure. Starting from 2013, there is a free IVF program for CHI. 2015 showed that this program is a real salvation for families with a modest budget who dream of a child. The essence of the program is that the compulsory health insurance fund allocates budgetary funds that cover the costs of IVF under compulsory medical insurance.

Thus, couples, for whom IVF seemed absolutely inaccessible before this law, got the opportunity to realize their dream.

IVF under the compulsory medical insurance policy is indicated for women suffering from the following pathologies that prevent pregnancy:

• tubal infertility;
• uterine infertility;
• cervical infertility;
• infertility due to endometriosis;
• polycystic ovarian syndrome;
• primary ovarian failure;
• ovarian dysfunction caused by medical interventions;
• uterine leukemia.

Also, IVF according to compulsory medical insurance is carried out if there is a male factor of infertility in the family.

In vitro fertilization under the CHI policy does not provide for the use of donor eggs, ICSI, pre-implantation diagnostics and surrogacy.

The IVF program under the MHI policy of 2015 does not differ from the programs of previous years and consists of the stages standard for this method: hyperovulation stimulation, ovarian puncture with egg retrieval, embryo cultivation and embryo implantation in the uterus. Women participating in the CHI program are given the opportunity to undergo only one procedure, in case of ineffectiveness of which they will need to obtain a new permit for repeated free IVF. Along with the IVF quota under CHI, there is a federal (or regional) quota program (2015), which differs in that funding is allocated from the state or regional budget, as well as the validity period of the quota. The IVF quota for CHI is valid for three months, while the federal quota is up to one year.

Steps to obtain a federal IVF quota:

• receipt of an extract from a doctor from the clinic indicating the type of infertility and the appointment of IVF as the only method of treatment;
• collection of a package of necessary documents;
• consideration of documents by the medical commission (within 3 working days) and sending them to the Ministry of Health in case of a positive decision, or passing an additional examination with an extract from the protocol of the medical commission indicating the reason for the refusal or referral for an additional examination;
• referring the patient to the center of reproductive technologies and issuing a coupon for IVF.

State assistance is provided for infertility treatment by the following methods: ICSI, IVF, embryonic reduction.

Theoretically, everything is simple and clear, but in practice, women may encounter some unforeseen circumstances for which they need to be mentally prepared: the reproduction center where the patient was sent has the right to schedule an examination, additional tests, which can take a long period of time. In addition, the official document does not specify the exact time for IVF, and sometimes you have to wait a very long time. The duration of the wait may depend on the availability of space in the center and other unforeseen circumstances.

If, when trying to get a quota, a woman was refused, she has the right to appeal this decision to higher authorities. The complaint is filed within the established time limits, it is accompanied by copies of documents substantiating her right to receive free assistance for IVF, the complaint is considered within 30 days.

Where can IVF be carried out under the CHI policy

You can undergo IVF both in the region where the woman lives, and in any other region where there are free places. For example, the IVF Center in Lipetsk is a participant in a program that provides state-funded infertility treatment and conducts IVF under a compulsory medical insurance policy. The Fund pays for the main stages of the procedure, in addition, the clinic itself provides the opportunity for free hatching, cryopreservation and cryopreservation. On her own, the patient pays only for the procedures that precede the initial stage of IVF and the costs that are required after the embryo is transferred into the uterus. The choice of this clinic by a woman is justified by its high efficiency, which is almost twice as high as the official statistics of the Russian IVF registry. The only obstacle may be the lack of free places, since this center is very popular, both in Lipetsk and beyond.

Surrogacy

Surrogate motherhood is used by couples who have absolute contraindications to conception and pregnancy. In this case, the embryo grown from the mother's egg and the partner's sperm is transferred to the uterine cavity of the surrogate mother, who bears the pregnancy and gives birth to a child who does not have a genetic relationship with her, and then transfers it to the hands of the natural parents. In some cases, donor oocytes are used. Donation (2015) can also apply to sperm if infertility is a consequence of male problems.

Adoption of a child: 2015

In cases where the quota is denied, it is possible to adopt a child. In this case, the child will bear the surname of the adopter and the patronymic of the father who adopted him. If necessary, the date of birth of the child also changes. He is entitled to an inheritance. In 2015, there were no changes in the adoption procedure. For registration of adoption, which takes place in court, it is necessary to provide documents relating to the income of the adopter, his living space and moral character. Unfortunately, the phenomenon of secondary social orphanhood is known, when adoptive parents abandon an adopted orphan. 2015 was no exception, the growth of this phenomenon is progressing. Not all potential parents can objectively assess their capabilities and are often not ready for the difficulties of raising a child who is not their own.

Guardianship, guardianship: 2015

No changes were made to the process of registration of guardianship (guardianship) in 2015, it remained the same. Guardianship is appointed for a fixed period, or may be indefinite. Registration takes place in an administrative manner. The procedure for registration of guardianship (guardianship) is easier than adoption, there are no special requirements for the guardian. However, the child remains with his last name, he is given the right to communicate with former relatives. In the event of the appearance of people who wish to adopt a child, the priority right remains with them. The upbringing process is controlled by the guardianship authorities and financed by the state in the form of a monthly allowance. Guardianship is issued if the child is under 14 years old, guardianship is issued for older children.

Foster family

Having concluded an agreement with the guardianship authority, parents raise children at home.

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