For anyone who learned the ‘birds and the bees’ in their youth, the act of trying to conceive (TTC) probably seems like a very straightforward concept. However, our fertility specialists have learned that many of their patients have a different definition of what trying to conceive really means in comparison to the clinical definition. Ricardo A. Yazigi, M.D., of Shady Grove Fertility’s Towson, MD and Bel Air, MD offices provides an in-depth explanation of trying to conceive below and answers other pertinent questions about how long it takes the average fertile couple to conceive, age guidelines for conception, and more:
Q: How long does it take the average fertile couple to conceive?
A: On average, out of 100 fertile couples, about half will have conceived after 6 to 7 months of regular sexual activity. The remainder will conceive within 1 year’s time.
A: To understand this better, it is useful to review the definition of infertility: the inability to conceive after 1 year of unprotected intercourse when the woman is 35 years old or younger. For women older than 35 years old, the time is reduced to 6 months, and for women close to the age of 40, it is 3 months.
At first glance, the definition is counter-intuitive, as it seems to indicate that older women should conceive in a shorter amount of time. The fact is, however, that the opposite is true and the definition is really a guideline – there to advise women over 35 to not try for years on their own prior to seeing a specialist. A fertility specialist will initiate testing earlier in women over 35 due to the impact that age has on the quality and quantity of their eggs.
Q: What does ‘trying to conceive’ really mean? I’ve heard it’s however long you’ve been having unprotected sex. Is that true?
A: In my practice, I often hear that patients have been trying to conceive recently–say within the past year–but with further questions come to realize that they have actually been having unprotected sex for several years. It is important to realize that the definition of trying to conceive does not mention frequency or timing of intercourse, the use of ovulation predictor kits or temperature charts, checking the mucus, or any other methods other than having unprotected intercourse. Therefore, a woman having regular, unprotected intercourse is effectively “trying to conceive” whether she realizes it or not.
What is even more important is that a couple who has unprotected intercourse for 1 year or more—depending on the female partner’s age—has infertility if pregnancy doesn’t occur. The reason being is that in that period of time, the couple should have conceived even if they weren’t taking extra preventative measures or were “not trying.”
Q: If I am trying to conceive on my own, what can I do to help things along?
A: Knowing when you ovulate is the key to understanding when you are most likely to conceive. The chances of pregnancy are highest during:
- the 24 hours when ovulation is occurring;
- almost the same in the 24 hours prior to ovulation;
- and somewhat smaller as intercourse occurs in the days leading up to ovulation.
The chances decrease abruptly the day after ovulation. Therefore, intercourse the exact day of ovulation is not an absolute requisite for pregnancy. Both sperm and egg survive within the body for a period of time. In other words, the egg “waits” for the sperm and the sperm “waits” for the egg.
Women who have regular menstrual cycles—that is, roughly at the same time each month—tend to ovulate 12 to 14 days before menstruation. Generally, intercourse about once or twice a week is likely to produce a pregnancy within 6 to 7 months. For couples who have intercourse less frequently, it is better to concentrate intercourse every other day for three to four times around ovulation. Daily intercourse around ovulation or very frequent intercourse during the entire month is not necessary and may become taxing on the body and sometimes on the relationship.
For women who have irregular periods—that is, starting at different times every month—one can safely assume that ovulation is not taking place. In this case, therefore, the definition of infertility does apply, and the couple should seek help right away rather than waiting.
Q: If I was on birth control for a long time, how long should I expect it to take for my cycles to normalize?
A: As a rule, a woman should expect a menstrual period after discontinuing oral contraceptives or other hormonal contraceptives. Fertility returns soon after. Because it is an exception rather than the rule, a woman whose menstruation does not resume following the discontinuation of contraceptives should consult her doctor rather than wait, in order to investigate the reason.
Q: I’ve heard stories of people who get pregnant after adopting a baby. Does fertility improve when you stop trying?
A: There is no physiological reason to explain this phenomenon. Many women with previously diagnosed unexplained infertility may be able to conceive spontaneously, albeit at a far slower rate than fertile women. It is entirely possible for an infertile woman to have an unexpected—although welcomed—pregnancy at any time, including after the adoption of a child.
Q: How will I know if I need to see a fertility specialist?
A: Frequently couples wonder when they should see a specialist. The answer is simple. They should discuss fertility with their OB/GYN any time they have a concern. In terms of seeing a fertility specialist, they should follow the appropriate age guidelines. However, if a woman is experiencing irregular periods (or none at all) or experienced two or more miscarriages, she should not wait to consult a fertility specialist, regardless of how long she and her partner have been trying to conceive.
Editor’s Note: This post was originally published in December 2017 and has been updated for accuracy and comprehensiveness as of November 2018.
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