How can you maximise the chances of getting pregnant naturally?

By (gynecologist), (embryologist), (embryologist), (embryologist) and (biochemist).
Last Update: 09/26/2022

For a woman to become pregnant there must be sexual relations with ejaculation into the vagina. The spermatozoa then have to navigate thier way up through the female reproductive tract until they meet the ovum in the Fallopian tubes. It is here that fertilization takes place.

The fertilized egg then starts dividing and begins embryonic development, traveling to the uterus. where it must implant for gestation to begin.

In a young and healthy couple, without fertility problems, The probability of falling pregnant in each menstrual cycle is approximately 25%. After one year, 85% of couples trying to conceive  manage a sucessful pregnancy.

For this reason, it is not recommended to go to an assisted reproduction clinic until at least one year has passed with having unprotected sex on a regular basis. If the woman is over 35-38 years the recommensdation is after 6 months of trying.

Provided below is an index with the 8 points we are going to expand on in this article.

What is necessary to achieve a natural pregnancy?

The process by which a woman becomes pregnant is quite complex and many factors are involved. However, in a general way, we can mention some basic points necessary for a pregnancy to occur naturally.

First of all, the woman must have ovulatory menstrual cycles, meaning cycles in which an egg is released. This egg will be picked up by the Fallopian tubes, which must be permeable and functional (at least one of them). There cannot be a natural pregnancy with both tubes blocked, since they provide the passageway for the sperm to pass through to get to the egg and allow fertilization.

Furthermore, the male must have good seminal quality. Alterations in the concentration, mobility and/or morphology of the sperm can make it more complicated to achieve pregnancy in a natural way.

Finally, age is a very important factor to take into account when it comes to achieving pregnancy, especially in women. As the years go by, the quantity, but also the quality of the eggs decreases.

How and when can you get pregnant?

Fertilization, the encounter between egg and sperm, takes place in the fallopian tube. For this, the sperm must travel a long way from the vagina, where they are deposited in ejaculation. The egg, on the other hand, is picked up directly by the Fallopian tubes once ovulation occurs.

Subsequently, the fertilized egg (zygote) will begin embryonic development, while descending through the Fallopian tube towards the uterus. For pregnancy to occur, the embryo must implant in the uterine endometrium, thus giving rise to the beginning of gestation.

In order to achieve pregnancy, it is essential to have sexual intercourse on the woman's fertile days. These days correspond to the 3-4 days prior to ovulation, the day of ovulation and the day after. These are the days when the encounter between egg and sperm is more likely and, therefore, so is pregnancy.

The explanation is that sperm can survive up to 3-5 days in the female reproductive tract waiting for ovulation to occur and the egg to be released from the ovary. In contrast, the egg only survives 12-24 hours after ovulation, and must be fertilized within this time.

However, the couple should try not to obsess and have sex several times a day, only during these fertile days. It is best to avoid the feeling of "scheduling" intercourse and have intercourse every other day during the woman's most fertile period. In addition, greater or lesser ejaculatory abstinence may affect semen quality.

Calculating the fertiles days

In order to estimate a woman's most fertile days, it is necessary to know a little about the menstrual cycle.

A typical menstrual cycle is 28 days long, although many women have slightly shorter or longer cycles without any problem. The first day of menstruation is considered the first day of the cycle, so a woman can easily know the length of her cycles by counting the days between the start of two consecutive menses.

In this way, a woman can estimate when her next period is due and approximately 14 days before this, is roughly when ovulation will occur.

There are also fertile day calculators availble on the Internet that can help with these calculations. To use them you only need to input the first day of your last monthly period and the length of your cycle.

On the other hand, there are other methods that can also help a woman to know when her fertile days are. Among them, there is the evaluation of cervical mucus, the recording of basal body temperature or the well-known ovulation tests. In this article you can read much more information: What are the signs of fertility in women?

Advice to consider before getting pregnant

In addition to the above, there are a number of things to keep in mind when you want to start trying for a baby.

Healthy lifestyle habits

There are certain considerations, related to habits and lifestyle, that the couple should follow if they want to increase their chances of getting pregnant:

  • Avoid toxic substances such as tobacco, alcohol and drugs and reduce caffeine consumption.
  • Eat a balanced and healthy diet.
  • Exercise moderately and regularly.
  • Control weight, since a low or high body mass index (BMI) can affect fertility.
  • Avoid exposure to environmental toxins and, in the case of the male, to heat sources that can increase testicular temperature and thus affect spermatogenesis.

In general, a healthy lifestyle benefits both male and female fertility, increasing the probability of achieving pregnancy.

Preconception counseling

Before trying to get pregnant it is a good idea to have a preconception counseling session with the gynecologist. In this consultation, the specialist will perform a gynecological examination of the woman, give her certain recommendations and will probably prescribe a folic acid supplementation (or a preconception supplement containing folic acid).

It is also a good time to review the medication that the woman is taking, since some drugs need to be suspended or replaced during pregnancy (or even before) if they pose risks to the fetus.

It goes without saying that when the couple decides to start trying to conceive, they should stop using any contraceptives. However, it should be kept in mind that some methods, such as the contraceptive injection, may require several months from the time the woman stops using it until fertility is restored.

Therefore, it may be advisable to abandon certain contraceptive methods early enough and use a condom until you want to start trying. The gynecologist will certainly be able to help the woman about how and when to stop using the contraceptive, depending on the method being used.

The pregnancy test

If you are looking to get pregnant, you should know when to take a pregnancy test. Doing it too soon can lead to an erroneous result, so it is essential to wait for the right date, despite the nerves and desire to know the result.

The pregnancy test, whether done with urine or blood, should be performed at least 15 days after sexual intercourse. However, if there have been several sexual relations, it may be difficult to determine the exact date. Therefore, another alternative is to wait to do the pregnancy test once there is already a delay in menstruation.

If you would like to read more about this subject, please visit the following article: When should you take a pregnancy test for it to be reliable?

FAQs from users

Do I need IVF after 10 months of trying for a natural pregnancy without success?

By Guillermo Quea Campos M.D. (gynecologist).

Sterility is defined as the inability of a couple to achieve pregnancy after 12 months of active sexual life without the use of contraceptive methods. However, this definition decreases as the woman's age advances and is reduced to 6 months after the age of 35.
Read more

How many sperm cells does it take to fertilize an egg?

By Sara Salgado B.Sc., M.Sc. (embryologist).

Although only a single sperm enters the egg and gives rise to the embryo, many more are needed in the ejaculate, because they have to go through an obstacle course and get trained until they reach the egg: vagina, cervix, uterus, fallopian tube, and ampulla, which is the part of the tube where fertilization takes place.

Optimally, of the millions of sperm that are ejaculated, a few hundred thousand arrive at the correct Fallopian tube, and once close to the egg, they have to break the envelopes that surround it, thanks to a mini-pump that they have in their head called the acrosome, which pierces the layers around the egg.

Many spermatozoa are necessary to erode the layers of the ovum and they will not fertilize it until one arrives, which is not the fastest but the most opportune, which finds a freeway and connects with the internal membrane of the ovum and it is this one that enters inside the cell and fertilizes the ovum.

When are my fertile days?

By Sara Salgado B.Sc., M.Sc. (embryologist).

The day after ovulation, the day of ovulation itself and the 3 days prior to ovulation are the fertile days of the woman, i.e., days 11-15 of the cycle approximately.

Sperm can live in the female genital tract for about 3-4 days, so if they arrive before ovulation occurs, they can wait to meet the egg.

If your periods are regular, count 14 days before you expect your next period and that is approximately the day you will ovulate. Ovulation tests measure the peak of the ovulatory hormone, LH or luteinizing hormone, which rises in levels just before ovulation, so they are a more effective way to calculate your fertile days.

In the case of irregular periods, or months without menstruation, it is advisable to consult a gynecologist if you are looking for pregnancy, because if the egg is not in the fallopian tubes waiting for the sperm, a natural pregnancy will not occur.

How many days does ovulation last?

By Sara Salgado B.Sc., M.Sc. (embryologist).

The ovulatory phase, that is, the period when the egg is released and ready to be fertilized, lasts about 24 hours. Ovulation occurs in the middle of the menstrual cycle, on approximately day 14. Once released, the egg has a life span of only 24 hours, so that if it is not fertilized within this time it will die and be expelled through menstruation.

Can I become pregnant while on my period?

By Sara Salgado B.Sc., M.Sc. (embryologist).

Although theoretically ovulation occurs 14 days before the period, sometimes, when the cycles are irregular or short, ovulation occurs at the same time as the previous period, so, although it is rare, there are pregnancies that occur during menstruation.

Most women's menstrual cycles last 28 days, but others have shorter cycles and therefore may ovulate before the end of menstruation. The shorter the cycle, the closer ovulation and menstruation are, and therefore, pregnancy could occur. If we add to this the fact that the sperm remain in the female reproductive tract for 3 to 4 days, fertilization can occur.

The same can happen with those women who have irregular cycles, since it is difficult to predict the moment of ovulation. There are also women who ovulate early, on the 10th day of the cycle instead of the 15th, always counting on 28-day cycles. Thus, it is possible that they can become pregnant if they have unprotected sex during their period. In addition, the chances increase if the period lasts a week or more.

If you want more information about the possibility of pregnancy with menstruation access this article: Can I get pregnant while on my period?

If I have my period, is it possible to have become pregnant before?

By Sara Salgado B.Sc., M.Sc. (embryologist).

The period is the detachment of the endometrium from the previous cycle and occurs when there has been no implantation of an embryo, therefore, in general, if you have a period there is no pregnancy.

If I had three normal periods and the fourth is delayed, could I have fallen pregnant before the first one?

By Laura Garrido B.Sc., M.Sc. (embryologist).

Absolutely not. Every menstruation means a cycle without embryo; therefore, if you had unsafe sexual intercourse before a series of regular periods, pregnancy is unlikely the reason for the delay.

Can I get pregnant without penetration?

By Laura Garrido B.Sc., M.Sc. (embryologist).

No. Neither through masturbation, neither through anal penetration, nor through vaginal frictions. Vaginal penetration is necessary for a pregnancy to take place. "And without ejaculation?" There are different opinions about the presence of sperm into the pre-seminal fluid, still the famous "pull-out method" is responsible for several unwanted pregnancies. Thus, if penetration takes place, there's no contraceptive efficacy.

Is there a chance of pregnancy without ejaculation? Can I get pregnant with pre-seminal fluid?

By Sara Salgado B.Sc., M.Sc. (embryologist).

There are different opinions regarding the presence of spermatozoa in the pre-seminal fluid, but the famous "withdrawal method" is responsible for numerous unwanted pregnancies, so if there is penetration, there is no contraceptive security.

If you would like to know more abou the possibility of falling pregnant from preseminal fluid, please visit the following link: Spermatazoa in pre-seminal fluid: Is there a chance of pregnancy?

After how long can I tell if I am pregnant?

By Sara Salgado B.Sc., M.Sc. (embryologist).

Approximately 15 days after intercourse a woman can take a pregnancy test to find out if she is pregnant. It is always recommended to wait until a delay in menstruation occurs to do the test.

If you are trying to get pregnant you may be interested in learning about pregnancy symptoms. If so, we recommend reading the following article: What are the symptoms of pregnancy throughout the nine months?

Alternatively, if you have been ttc with your partner for over a year (6 months if you are over 35), and have not been successful, it is a good time to attend a fertility clinic, in order to carry out a fertility study. In the following link you can get some advice about how to choose your fertility clinic:Things to consider when choosing a fertility clinic.

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References

Caut C, Schoenaker D, McIntyre E, Vilcins D, Gavine A, Steel A. Relationships between Women's and Men's Modifiable Preconception Risks and Health Behaviors and Maternal and Offspring Health Outcomes: An Umbrella Review. Semin Reprod Med. 2022 Jul;40(3-04):170-183. (View)

Dennis CL, Brennenstuhl S, Brown HK, Bell RC, Marini F, Birken CS. High-risk health behaviours of pregnancy-planning women and men: Is there a need for preconception care? Midwifery. 2022 Mar;106:103244. (View)

Johnson S, Marriott L, Zinaman M. Can apps and calendar methods predict ovulation with accuracy? Curr Med Res Opin. 2018 Sep;34(9):1587-1594. (View)

Partap U, Chowdhury R, Taneja S, Bhandari N, De Costa A, Bahl R, Fawzi W. Preconception and periconception interventions to prevent low birth weight, small for gestational age and preterm birth: a systematic review and meta-analysis. BMJ Glob Health. 2022 Aug;7(8):e007537. (View)

Perez Capotosto M, Jurgens CY. Exploring Fertility Awareness Practices Among Women Seeking Pregnancy. Nurs Womens Health. 2020 Dec;24(6):413-420. (View)

Wilcox AJ, Weinberg CR, Baird DD. Timing of sexual intercourse in relation to ovulation. Effects on the probability of conception, survival of the pregnancy, and sex of the baby. N Engl J Med. 1995 Dec 7;333(23):1517-21. (View)

Zaçe D, LA Gatta E, Orfino A, Viteritti AM, DI Pietro ML. Knowledge, attitudes, and health status of childbearing age young women regarding preconception health - an Italian survey. J Prev Med Hyg. 2022 Jul 31;63(2):E270-E281. (View)

FAQs from users: 'Do I need IVF after 10 months of trying for a natural pregnancy without success?', 'How many sperm cells does it take to fertilize an egg?', 'Is it possible for a woman to be pregnant and still have periods?', 'When are my fertile days?', 'How many days does ovulation last?', 'Can I become pregnant while on my period?', 'If I have my period, is it possible to have become pregnant before?', 'If I had three normal periods and the fourth is delayed, could I have fallen pregnant before the first one?', 'Can I get pregnant without penetration?', 'Is there a chance of pregnancy without ejaculation? Can I get pregnant with pre-seminal fluid?' and 'After how long can I tell if I am pregnant?'.

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Authors and contributors

 Guillermo Quea Campos
Guillermo Quea Campos
M.D.
Gynecologist
Guillermo Quea, MD has a degree in Medicine and Surgery from the University of San Martin de Porres. He also has a Master's Degree in Human Reproduction from the Universidad Rey Juan Carlos and another in Public Health and Preventive Medicine from the Universidad del País Vasco. More information about Guillermo Quea Campos
Member number: 282860962
 Laura Garrido
Laura Garrido
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Pablo de Olavide University (UPO) of Seville, Spain. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI). Experience at IVF, andrology, and general analysis laboratories. Embryologist specialized in Assisted Reproduction. More information about Laura Garrido
 Sara Salgado
Sara Salgado
B.Sc., M.Sc.
Embryologist
Degree in Biochemistry and Molecular Biology from the University of the Basque Country (UPV/EHU). Master's Degree in Human Assisted Reproduction from the Complutense University of Madrid (UCM). Certificate of University Expert in Genetic Diagnosis Techniques from the University of Valencia (UV). More information about Sara Salgado
 Silvia Azaña Gutiérrez
Silvia Azaña Gutiérrez
B.Sc., M.Sc.
Embryologist
Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics. More information about Silvia Azaña Gutiérrez
License: 3435-CV
Adapted into english by:
 Michelle Lorraine Embleton
Michelle Lorraine Embleton
B.Sc. Ph.D.
Biochemist
PhD in Biochemistry, University of Bristol, UK, specialising in DNA : protein intereactions. BSc honours degree in Molecular Biology, Univerisity of Bristol. Translation and editing of scientific and medical literature.
More information about Michelle Lorraine Embleton

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