Before you see a specialist
Trying to get pregnant is a unique and exciting project, in which the woman often begins to experience doubts about her fertility after her first few periods come without the objective of becoming pregnant being achieved. It is worth remembering that becoming pregnant is a very complex process and that the probability of managing it in any given menstrual cycle is approximately 25% (although this probability falls rapidly as a woman gets older).
For this reason, before you consider going to a reproductive specialist, we recommend that you follow some of the advice that we have provided in this section for improving your chances of getting pregnant.
You should always take into account that
Whilst spermatozoa can survive in the female reproductive system for approximately three or four days, the ovum, from the moment it is released during ovulation, has just 24 hours in which to be fertilised. As such, a couple will have the best chance of conceiving if they have sexual relations one or two days before ovulation.
The methods and advice that we provide next are designed for the most part to help you determine naturally the days during your menstrual cycle when you are the most fertile (the day of ovulation) and, as a result, which are the best days for becoming pregnant.
Some methods and advice for improving fertility
The Ovulation Test method: this consists of using an ovulation test (which you can buy in chemists) to detect the increase in the ovulation hormone LH between 24 and 36 hours before ovulation, which identifies the best two days for conceiving within a cycle. Having sexual relations during these two days offers the best chances of conceiving.
The Basal Temperature method: this method consists of determining the basal body temperature throughout the menstrual cycle. In a normal 28-day menstrual cycle, ovulation takes place, as a general rule, on day 14 of the cycle. But it is possible to have shorter or longer cycles. The mechanics are simple. Each day, when you get up, you measure your basal body temperature and mark it on a graph. You always measure your basal temperature in the same place and with the same thermometer. By doing this you can detect the peak in temperature which triggers ovulation. This peak is based on the fact that the hormone progesterone increases basal temperature by 0.2 to 0.5 degrees centigrade before ovulation. Two or three days after ovulation, basal body temperature can rise by between 1 and 1.5 degrees centigrade, and it will stay like this until the next menstrual period. If, during this stage, you become pregnant, this basal temperature will be maintained throughout the entire pregnancy. Fertile days include a few days before and a few days after ovulation. This is an effective method, although there are various factors which can upset exact measurement. In addition, it is important to remember that basal temperature curves for some women are difficult to interpret, especially during times of stress or illness.
Cervical mucus: another natural method for identifying a woman’s fertile days is determining cervical mucus. Do not make the mistake of thinking that the day when secretion of cervical mucus is at its height is the most fertile day. Around six days before ovulation, the cells in the neck of the uterus produce cervical mucus with particular characteristics: watery, elastic, similar to raw egg white, and if you put it between your thumb and index finger you will be able to stretch it out as a fine thread before it breaks. The last day on which you can feel lubrication is the most fertile day of the cycle, and that is when you have the best chances of conceiving. The feeling of lubrication can last one or two days longer, indicating that you still have a good chance of getting pregnant. After ovulation (the ovum remains viable for around 48 hours) you will experience less lubrication around the vulva, and the discharge will be dry and sticky.
Keeping an intercourse schedule: a woman normally ovulates 14 days after her period arrives. If a woman has a regular cycle of 28 days, ovulation will take place in the middle of the cycle (14 days after the first day of bleeding). If the cycle is longer, for example 34 days, ovulation happens around day 20 – not in the middle of the cycle. As a general rule, the formula will be length of menstrual cycle minus 14 days.
Regular sexual relations: knowing that spermatozoa can survive inside the woman for several days, if a couple has sexual relations on a regular basis (two to three times a week) she will increase her chances of having spermatozoa present at the moment when ovulation occurs. It is a myth that men should “abstain from sexual relations”. Long periods of abstinence (longer than 8 – 10 days) can lead to a decrease in sperm quality and increase the number of abnormal or dead sperm in the ejaculate. On the contrary, having sex too often leads to the presence of immature spermatozoa. Our advice is to have sexual relations two or three times a week, at any point of the woman’s cycle, and to try to have sex at the weekends, as during those days the couple is more relaxed and has more time. After having sex, the woman should not use a douche. Additionally vaginal creams and lubricants should not be used during sexual relations, as they can endanger the survival of the spermatozoa in the vagina.
When should we think about going to an Assisted Reproduction Clinic?
We recommend that you go to an Assisted Reproduction Clinic when:
- After a year of sexual relations without using contraception you have not managed to become pregnant, for women younger than 35.
- After six months of sexual relations without using contraception you have not managed to become pregnant, for women older than 35.