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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.

Q: How long should it take to get pregnant? Does it vary by age?

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.

Medical Contribution by: Ricardo A. Yazigi, M.D. of SGF’s Towson, MD and Bel Air, MD offices.

Editor’s Note: This post was originally published in 2015 and has been updated for accuracy and comprehensiveness as of December 2019. 

To learn more about trying to conceive or to schedule a new patient consultation, please contact our New Patient Center at 888-971-7755 or click here to complete this quick online form.

Dr. Shayne Plosker, who sees patients in SGF’s Brandon, FL office, joined ABC’s The Morning Blend to answer questions related to age and how it can impact a woman’s fertility. Watch the full clip below.

Host: This is something we talk about a lot on our show behind the scenes. My co-host, Carly, is out on maternity leave and I was in my mid-thirties when I had a child. I have friends who are in their forties now. As you get older, it seems like unless you’re there, you don’t know how hard it can be to get pregnant.
Dr. Plosker: I think a lot of folks are planning their careers, getting ahead, maybe haven’t met their partner just yet. All of a sudden, they are in their mid-thirties, late-thirties, even early forties and decide, “I would like to have my family now.”

Host: And women start realizing that getting pregnant is more difficult than they thought.
Dr. Plosker: Absolutely. It’s important to be aware or understand that there are plenty of women who get pregnant without any difficulties, even in their mid-thirties and early forties. But it’s a little bit like roulette. It’s a difficult fact of life to wrap your arms around, but as we get older, our biology starts to decline. A lot of people feel great in their mid-to-late thirties and early forties, but don’t realize that the biological clock is still ticking away.

Host: When does advanced maternal age begin and when do women have to start worrying about it?
Dr. Plosker: The clock starts around age 33 or so. If you look at the likelihood of getting pregnant at age 25 right through to age 33, probably not different. And then around that time is when things start to decline. I think that decline is much more meaningful beyond age 35 and starts to accelerate from there.

Host: If people out there are trying to get pregnant and it isn’t happening, where can they go for help?
Dr. Plosker: The type of physician is called a reproductive endocrinologist. We are physicians who are trained initially as obstetrician-gynecologists and had additional training to specialize in infertility treatments including in vitro fertilization (IVF).

Host: Is age the only factor or are there multiple other factors that contribute to infertility?
Dr. Plosker: Every woman is different, but age is the most significant factor. The number of eggs decline with age. A woman is born with as many eggs as she’s ever going to have and from birth until menopause, there’s an ongoing loss of eggs. The other issue that comes up is the quality of the eggs decline.

Interestingly enough, the rest of the reproductive system very often seems to function perfectly well. For example, a lot of women in their forties are able to get pregnant using eggs from an egg donor because the uterus and rest of the reproductive system is able to function just fine.

Host: Can complications arise from carrying a child at advanced maternal age?
Dr. Plosker: There are concerns. As women get older, there’s a higher risk of having children with genetic abnormalities. I think the common one that people are most aware of is Down syndrome. From a genetic perspective, Down syndrome is having an additional 21st chromosome. That becomes more common or a greater risk as women get older, but just to keep some perspective, if you’re 40, your chance of having a baby with Down syndrome might be 1 in 80. If you’re 25, it’s maybe 1 in 1,300. It’s higher but shouldn’t scare people from trying to have a family. It’s about a 1 percent risk, so it’s not high.

If You’re Ready to Start or Grow Your Family

Use your age to empower you to take proactive steps in your family building. Women under the age of 35 who have been trying for a year (or over 35 who have been trying for 6 months), should talk with a reproductive endocrinologist. Starting earlier will leave more treatment options available to pursue and give you the best chances of success.

Shady Grove Fertility’s team of highly renowned reproductive endocrinologists are available for consultations to review medical history and advise if you need a fertility evaluation. Talking with a fertility specialist can provide you with the answers you need and help you understand why getting pregnant is taking longer than expected.

If You’re Not Ready and Want to Pause the “Biological Clock”

The best time to have a baby is an incredibly personal decision and one that takes significant thought and consideration.

Since fertility is known to decline with age, freezing your eggs now will maintain your current level of fertility. By freezing eggs at an earlier age and before there is evidence of declining ovarian reserve (quantity of eggs) or declining ovarian function (one’s ability to produce one healthy egg each month), a woman extends her fertility potential, creating a back-up option.

Looking for more information? Watch our Egg Freezing On-Demand Webinar, available for viewing at your convenience.

During our on-demand event, hosted by Shruti Malik, M.D., from SGF’s Fair Oaks, VA and Arlington, VA offices, you’ll learn about Shady Grove Fertility’s Egg Freezing Program and hear first-hand experience from Dr. Malik herself. Dr. Malik will review SGF’s simplified program, explain how we determine who makes a good candidate for egg freezing, and discuss what to expect during the egg freezing process, the success rates associated with egg freezing, and the unique SGF financial programs.

Register today to participate in this informative, free, on-demand webinar and watch now or at your own convenience.

Egg Freezing Patient Stories

Read Meredith’s Egg Freezing Story
Read Rachel’s Egg Freezing Story

It is a cruel experience waiting month after month for a positive pregnancy test only to be met with disappointment and frustration. While infertility is defined as the inability to conceive after having regular, unprotected intercourse for 1 year, it is considered “normal” for an average woman under 35 years of age to try to conceive for 1 year before a pregnancy may occur. But for those individuals who are older than 35, that timeframe for conception becomes shorter. So what happens if I have not conceived during this timeframe based on my age? Why am I not getting pregnant?

US News turned to fertility expert, board certified reproductive endocrinologist, Dr. Eric Levens of SGF’s Fairfax, Virginia office to discuss some of the causes of infertility.

1). Maternal Age
Maternal age is the greatest predictor of a woman’s chances of achieving a pregnancy. Starting in a woman’s late 20s, the probability of pregnancy begins to decline. This decline accelerates as a woman reaches ages 35-40 years of age. The principle reasons why fertility declines so sharply during this time are due to a decline in the number of available eggs and the increasing rates of genetic abnormalities that occur as eggs mature. The net result is a decline in the overall pregnancy chances and an increase in the rate of miscarriage. Remarkably, the ability to successfully carry a pregnancy does not change much over the course of a woman’s life.

2). Smoking
Most people know that smoking can have a negative effect on their health including the development of emphysema and lung cancer. But many do not realize this includes a detrimental impact on their reproductive potential. Compared to non-smokers, smokers on average experience a longer time to conception and higher risk of infertility due to a direct impact of smoking on the quantity and quality of eggs. Moreover there is a dose dependency as the greater the daily quantity of cigarettes smoked, the greater the impact on one’s fertility. Smoking also increases the rate of follicular depletion resulting in an earlier average age of menopause.

3). Body Weight
A woman’s body mass index (BMI) is strongly connected to her fertility potential. While not every woman who has a BMI that is too high or too low will have difficulty conceiving, there are many who do. Women who are both overweight and underweight have a greater risk of ovulatory dysfunction represented by irregular menstrual cycles. As BMI increases, there is an increasing risk of insulin resistance that disrupts follicle development and elevates levels of testosterone, making ovulation and conception difficult.

While being overweight has an impact on fertility, an appropriate amount of body weight is actually necessary for proper reproductive function. “When one’s BMI is too low, the body sees this as stress and tends to preserve oneself at the expense of one’s fertility,” says Dr. Levens. “Long distance runners, ballet dancers, and women with eating disorders are among those who may need to increase their body weight before trying to get pregnant,” Dr. Levens adds. If you aren’t having regular menstrual cycles, this is an indication to seek help quickly, well before the 6-12 month timeframe discussed above.

4). Medical Conditions
Accounting for nearly one-third of all infertility diagnoses in women, polycystic ovary syndrome, or PCOS, is the most common ovulatory disorder in women of reproductive age. Polycystic ovary syndrome (PCOS) is caused by hormonal dysfunction that limits or prevents ovulation. Endometriosis is also a common cause of infertility in which endometrial tissue (tissue that lines the inside of the uterus) grows outside the uterus. This type of infertility can often go undiagnosed as many women don’t have noticeable symptoms.

5). It’s Not You
While infertility is generally perceived as a female issue, the reality is 40 to 50 percent of infertility is attributable to male factors. “There’s a fairly equal distribution between male and female factors,” Dr. Levens says. Erectile dysfunction, ejaculatory issues, and sperm production problems are some of the common (and often treatable) culprits of male infertility. Because basic testing for these problems, a semen analysis, is relatively simple and inexpensive, it should be performed as part of a couple’s routine testing to determine the underlying cause(s) of the infertility.

6). Unexplained
There are three simple initial tests for fertility: semen analysis, bloodwork and ultrasound, and a hysterosalpingogram (HSG) that checks if your Fallopian tubes are open and functioning properly. If all of the testing comes back normal, you may have a diagnosis of unexplained infertility. This can be a very frustrating diagnosis as there is not an obvious “reason” for the infertility. “In the setting of unexplained infertility, there is often a knowable cause of infertility, it just cannot be seen. Sperm and eggs unite in the Fallopian tube and many times the explanation for unexplained infertility involves poor fertilization or poor embryo development. The problem is that these events occur within a women’s body. Often unexplained infertility is explained when these events are witnessed using tools like in vitro fertilization (IVF),” Dr. Levens says.

If you have been trying to conceive and are having no luck, seek counsel early with a fertility specialist. When it comes to fertility, time is of the essence. Don’t wait any longer to seek the help you need. Treatments exist to help nearly everyone conceive.

If you’ve been wondering why you are not getting pregnant and would like to learn more, please call our New Patient Center at 1-877-971-7755 or click here to schedule an appointment.