Trying to Conceive? Here's Everything You Need to Know

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One of the most frustrating things about trying to conceive is that you don’t know how difficult or easy it’s going to be until you try. I’ve had this conversation with many friends. “I’d been on birth control since I was 18,” says Maya R. from Santa Fe, New Mexico. “When I finally went off the pill at 32, I got pretty pissed when I didn’t get pregnant instantly. Why did I waste my time with the pill if I can’t even get pregnant?!” Turns out, Maya was able to conceive after six months of trying, and then again, three years later, after only two months of trying. Another friend had a tougher road. “We tried to get pregnant for two years before seeing a reproductive endocrinologist,” says Jenny S. from Brooklyn, New York. “It was sad and lonely and long and involved. We tried everything to conceive: tests, drugs, then IUI, and finally IVF.” Two years later, Jenny gave birth to twins.

If you’re reading this, chances are you know that trying to conceive is not as easy as it sounds. At least, not for everyone. There are a lot of different factors mingled together that ultimately decide your fertility, from age and stress level, to social behaviors like smoking, drinking, and drug taking. “You shouldn’t be doing any of those things in the first trimester,” says Adelaide G. Nardone, MD, FACOG, an ob-gyn at the Ryan Women and Children’s Center in New York City. Having an unhealthy partner can also lessen your chances of getting pregnant.

So, what does it take to conceive a baby? From natural conception to In Vitro Fertilization (and everything in between), we’ve broken down how to conceive to help you through the baby making process.

How long does it take to conceive?

Most couples are able to conceive within three months after they start trying to have a baby. However, age, lifestyle factors (such as drug abuse or smoking), and infertility problems can make your conception journey longer. Here’s the breakdown:

30 percent get pregnant within the first cycle (about one month).
60 percent get pregnant within three cycles (about three months).
80 percent get pregnant within six cycles (about six months).
85 percent get pregnant within 12 cycles (about one year).
91 percent get pregnant within 36 cycles (about three years).
93 to 95 percent get pregnant within 48 cycles (about four years).

Do you need a preconception appointment?

Before you try to get pregnant, schedule a preconception visit in order to intercept problems and get them under control before conception. “Women should have a preconception counseling visit six months to a year before they’re trying to get pregnant,” advises Dr. Nardone. Big issues include getting weight under control if you are overweight or have diabetes (both of which can be passed down to kids). A healthy pre-pregnancy diet can definitely help give your fertility a boost. Dr. Nardone also suggests getting up to date on vaccinations, as well as pap smears and breast exams. Additionally, it is important to take a supplement with folic acid at least three months before you start trying to conceive. A prenatal vitamin is fine, unless you are high risk for neural tube defects such as spinal bifida (or taking seizure medication), in which case you’ll need more folic acid (1 milligram).

When should you stop taking birth control?

That depends on your birth control method, says Dr. Nardone. “If it’s a long-acting birth control with progesterone, like the Depo shot, it might take several months to get your cycle back on track, whereas birth control pills are easier to stop,” she explains. Her advice? Have one normal period before trying to conceive. “That way you’ll know your last menstrual cycle, which is important in trying to have a baby.”

What should you know about ovulation?

Ovulation is the process of a mature egg being released from one of your ovaries and pushed down the fallopian tube in order to become available for fertilization. If you are trying to conceive, it is important to understand your body and figure out your ovulation calendar. Most women have a 28-day cycle, day one being the first day of menstruation. “On average, most women ovulate 14 days after their period,” says Dr. Nardone. But that’s only if your cycle is every 28 days. If your cycle is more like every 34 days, that means you’ll be ovulating a bit later.

When is the best time to have sex if you’re TTC?

Dr. Nardone advises women to try to have sex from days 11 to 14 (leading up to, and during, ovulation). “Sperm can live up to 72 hours, so better to have sex before day 14. Frequency doesn’t really matter, but don’t get up right away, let (the sperm) sit there for a while.” There are certain sex positions that may help increase your chances of conception, too, so have fun giving those a try.

How long should you TTC naturally, before you consult your doctor?

Generally speaking, women under age 35 can try for a year before seeing a doctor; women over 35 should consult their doctor if they’ve been TTC for six months but still aren’t pregnant. There are other reasons a couple should see a physician while TTC, including irregular periods (there may be a thyroid problem), you’ve had more than one miscarriage, or you or your partner have undergone cancer treatment, says Allison Rodgers, MD, a board certified ob-gyn and fertility expert with Fertility Centers of Illinois, in Chicago.

If you’re having trouble getting pregnant, what are your options?

Your ob-gyn or reproductive specialist will give you an in-depth explanation with recommendations of what’s right for you, but here is a quick overview of what may be in store.

1. Drugs

Infertility drugs help balance your reproductive hormones, prompting one or more eggs to release in each ovulation cycle.”These can range from pills or injections with timed intercourse,” says Dr. Rodgers. Clomid (usually the first choice, for it’s effectiveness) is given to women with irregular ovulation. It can increase your chances of pregnancy between 5 and 8 percent . There’s also Human Chorionic Gonadotropin (hCG), the hormone the that placenta secretes during pregnancy; it can be injected as a fertility treatment used to stimulate ovulation in women and/or increase sperm count in men. Just be sure to talk to your doctor about possible side effects before deciding on a treatment.

2. Surgery

In certain cases, PCOS (enlarged ovaries with small cysts), endometriosis (tissue normally lining the uterus grows outside the uterus), and fibroids (growths in the uterus) can cause scar tissue or cysts which can be removed through a surgical procedure, says Dr. Rodgers, which could help with fertility.

3. Intrauterine insemination (IUI)

This process involves transferring your partner’s sperm directly into the uterus. By increasing the number of sperm that reach the fallopian tubes, you are thereby increasing the chance of fertilization. Side effects can include minor cramping and mood swings. Most couples will try two to three IUI cycles, and then move on to IVF if they are unsuccessful, according to Dr. Rodgers.

4. In-Vitro Fertilization (IVF)

The most expensive (but arguably most effective) fertility treatment is in-vitro fertilization. “The process of in-vitro fertilization involves retrieving eggs, fertilizing them with sperm, then transferring an embryo to the uterus a few days later,” explains Dr. Rodgers. Commonly, IVF is done with ICSI (intracytoplasmic sperm injection), which enables embryologists to select individual sperm to be injected into the egg. “Prior to the embryo transfer, embryos can be genetically evaluated to select the most viable embryo for transfer.” Each round of IVF takes roughly 4 to 6 weeks, and treatment costs can range greatly based on factors like insurance coverage, practice location, treatment advised, and tests required.

5. Egg donation

“Should genetic issues be present,” says Dr. Rodgers, “donor egg or sperm can be used to create healthy embryos.” The process of egg donation is basically taking healthy eggs from one person, fertilized by sperm in a lab, and then transported to the recipient. Like many fertility methods, there is no guarantee that egg donation will work, but this method does have a high success rate and is a good option for women known to have genetic abnormalities or reproductive challenges.

6. Acupuncture

Many women have found success through ancient arts. “Eastern medicine looks at things that can’t be measured by western medicine,” says Vanessa Stretton, an acupuncturist at Acupuncture Fertility Specialists in Sacramento, California. “We look at each patient with the help of Qi and Jing (a person’s essence and life force energy). There’s no western lab equivalent that can measure it.” Along with herbal medicine, supplements, dietary and lifestyle adjustments, acupuncture can help increase pelvic blood flow and increase sperm count and egg quality for women who are trying to conceive. Acupuncture can be used as an alternative or it can compliment other fertility treatments.

7. Yoga

According to Lauren Hanna of Sacred Fertility at Sonic Yoga in New York City, yoga for fertility isn’t just about yoga poses. “With the whole practice of yoga for fertility, poses themselves are only one part of it,” she says. “By treating not just the physical body, but also the spiritual and emotional self by balancing the chakra system, meditating, managing stress, and working with mantras and visualization, fertility yoga aligns with each phase of the menstrual cycle. It can also help build energy and blood flow as well as balance hormones for women who are simultaneously going through IVF.” It relieves stress, too, which can also give your fertility a boost.

Infertility can be emotionally (and financially) grueling, and couples are often advised to go into the whole thing with reserved optimism–but there is hope. Good luck!

More for Moms Who Are TTC:

Photo: Getty