In the last couple of months we have been receiving more questions on the basics of how to increase your chances of getting pregnant without fertility treatment, the best timing for intercourse, and when you should worry because you are not getting pregnant. We turned to Dr. Isaac Sasson, a reproductive endocrinologist with Shady Grove Fertility for some answers.
There are some very important factors to take into consideration when trying to have a baby. Before you begin temperature charting and using ovulation predictor kits, you want to go through a mental checklist. Some of the factors that affect fertility are:
- Weight, and
- The regularity of your menstrual cycle.
A woman within normal age and weight ranges, with regular periods, can usually predict when she is ovulating. However, before we discuss ovulation predictor kits, temperature charts, and new apps that are available, it is important to understand reproductive physiology as well as factors that could affect your chances to conceive.
The Basics of How Women Get Pregnant
In order for a woman to have a baby, you need a brain, a uterus, fallopian tubes, sperm, and eggs. In the ovaries there is something called a follicle. This is a fancy name for an egg sac. Each follicle has one egg in it. Each month, a woman has a whole group of follicles, with eggs inside them, available that month.
The brain makes a hormone called follicle-stimulating hormone (FSH). FSH tells the follicles in the ovary to grow and get bigger. One gets to be about 20MM and all of the others disintegrate. That big follicle makes estrogen and tells the lining of the uterus to grow and get ready for a pregnancy. The brain will now respond with a hormone called luteinizing hormone (LH)—this is what’s typically predicted by an ovulation predictor kit. LH is only present in the body for 1 day every month.
About 24 to 36 hours after LH appears, ovulation occurs. The egg is released from the follicle into your abdomen where it will be vacuumed up by the fallopian tubes. The egg will wait in the fallopian tube until sperm arrives and fertilization will occur. After 5 days, the embryo will travel down the fallopian tube into the uterus where it will attach to the uterine lining.
The best way to know if you are ovulating or not is if you are having regular cycles. If you usually know exactly when you are getting your period each month, there’s a very good chance you are releasing an egg regularly. If, on the other hand, your period comes sporadically—30 days one month, 45 or 60 days to the next one—you may need to get some help in regulating your ovulation.
Two Main Factors That Impact Fertility
While there are many factors that can affect fertility, we want to focus on two of the main factors, age and weight. The woman’s age is the biggest factor to consider when trying to get pregnant. This is true for all women: the older you get, the fewer eggs you have. Your body does not produce more eggs, nor is there any available treatment to increase the quantity or quality of your egg supply.
Even though statistical trends have shown that the age of women at the birth of their first child has steadily been on the rise since the mid-1970s, a woman’s fertility peaks in her mid-20s, begins to decline around 27, and drops off more steeply after age 35.
A woman’s fertility is measured by her ability to achieve a pregnancy on a given month. For women, the ability to conceive is tied to the quality of her eggs. As women age, hormonal changes begin to take place. There is a lot going on but of particular interest are the two main hormones controlling the development and release of the egg each month. These hormones we discussed earlier are follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
A rising FSH level is linked to a decreasing egg quality. Decreased egg quality means it becomes more difficult for the sperm to fertilize the egg naturally. There may even be chromosomal abnormalities occurring within the egg itself, which is why we recommend an amniocentesis for pregnant women over 35.
Another factor to consider is the number of eggs. As a woman ages, the number of eggs in her ovarian reserve continually declines. Women are born with their lifetime supply of eggs—generally around 1 to 2 million. By the time a woman reaches menopause, typically in her early- to mid-50s, as many as a few hundred remain, potentially even less.
To illustrate this point, the natural pregnancy rate for women older than 30 is 20 to 30 percent per month but by age 40 the likelihood of conception occurring naturally drops to less than 5 percent per month.
Get Your Ovarian Reserves Tested
You can ask your doctor to check your egg supply during a routine OB/GYN exam. Regardless of your age, you can request ovarian reserve testing, which is often covered by insurance, during a regular, annual visit to your OB/GYN. This can help women proactively plan for the future and serves as a baseline for future comparison.
Impact of Weight on Fertility
The second contributing factor to fertility we will review is weight. This can often be a sensitive topic, but it’s important to address, because it can have a significant impact on your overall health and your ability to get pregnant.
A person can determine if he or she is maintaining a healthy weight by using a (BMI) score. BMI measures the percentage of body fat based on your height and weight.
Women who are underweight may not be getting adequate nutrition and may not be ovulating on a predictable basis. Studies have shown though that in patients whose infertility is specifically due to weight, correction of the underlying condition can lead to pregnancy in up to 70 percent of women.
The good news is, a modest weight loss of 5 to 10 percent can affect a woman’s ability to resume regular ovulation if her inability to conceive is associated with weight alone.
Should You Exercise When Trying to Get Pregnant
Many patients ask how much exercise is ok when they’re trying to get pregnant. While the link between exercise and fertility is difficult to define with certainty, some facts have been well established. Intense physical activity, such as that of competitive female athletes, can disturb the menstrual cycle, but moderate activity has little effect on the cycle. Obesity is associated with decreased fertility. However, weight loss in obese women can improve their fertility.
When is the Best Time to Have Sex in Order to Get Pregnant
When couples have reviewed all of this information, and everything seems to be working appropriately, timed intercourse using temperature charting or ovulation predictor kits can be very successful! Trying is free and couples should know that, even in the best circumstances, it will still take some time to get pregnant. Timed intercourse is one of the simplest treatment options for infertility and can be a starting point for many couples trying to conceive.
There are many new apps today available that can help track your monthly cycle, your temperature, mood, and medications. One of the most favorable apps that I recommend is the Glow app. It has a fertility calendar, a daily health log, medication tracking, and discussion rooms, and can be linked with a partner.
Other Creating a Family resources you will enjoy:
- Foods and Diet That Can Increase Your Fertility
- Getting Pregnant with PCOS
- Getting Pregnant after 40 (With or Without Fertility Treatment)
- How to Treat Infertility in Women Younger than 35
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