We hate to say, “You’re doing it wrong,” but you might be doing it wrong – at least, in terms of maximizing fertility at home. There are mountains of misinformation out there in regards to ovulation, fertility windows and timing intercourse at home.
There are many misconceptions regarding the Fertile Window, what it is, and how long it lasts. Thus, many prospective patients come to us exasperated because, “they’ve tried everything…” only to learn they were waiting too long to have intercourse – or not long enough – making it impossible for those eager sperm to meet their fated target.
The bottom line when it comes to trying to conceive without medical help is that Timing Is Everything. Yes, health is a factor (more on that later in the chapter), particularly medical conditions that contribute to your infertility diagnosis. Even so, roughly 88% of the population is able to conceive a baby without medical assistance, and it’s the result of all the players – man, woman, sperm, egg – being present at the right time.
First things first: in order to maximize your chances of getting pregnant at home, and without help from a fertility specialist, you need to have a clear understanding of the factors involved in “The Fertile Window(s).” When all factors are considered, this window is only open for a few days – and the egg is only viable for one of those days.
Your overarching Fertility Window is really comprised of three separate, small windows:
The Egg: This is the most important window because it’s the shortest one. A mature, viable egg only lives for 24-hours. The process of an egg’s maturation and release into the fallopian tubes is called “ovulation.” A woman with a healthy menstrual cycle will ovulate once every cycle (a menstrual cycle is roughly 28-days long, plus or minus several days on either end depending on the woman). Once the egg is released, it only lives for 24 hours.
Thus, the key is to have as many sperm present as possible when that egg is released. This is why we joke that getting pregnant is kind of like dating, with the male partners consistently waiting around for the female to be ready.
The Sperm: Sperm, on the other hand, can live a little longer. Healthy sperm can live for about three days in and around the fallopian tubes. Weaker sperm may die off as early as 12-hours or less after they are ejaculated, while “super sperm” have been found to live as long as seven days.
Pregnancy rates are higher when sperm are waiting in the tube for the egg to be show up, rather than risking the shorter-lived egg to wait around for the sperm to appear.
3-Day Prediction : Once you get to know your cycle (which we’ll discuss below), and with the help of a OPK, you can get pretty accurate about when your fallopian tubes will have a mature egg in place. OPKs test for luteinizing hormone (LH) in the urine, which rises rapidly right before ovulation takes place. When the OPK gives you a “positive” response, you will be fertile sometime in the next 12- to 48-hours, but sometimes ovulation will not occur until 72 hours later, which may be too large of a window for some sperm.
For this reason, you’ll want to have intercourse on the day that the OPK turns positive and for the next two days – just in case you’re on the later-end of the ovulating spectrum.
Keep in mind that the OPK may only be able to detect the LH hormone in your urine for about 24 hours, so you should be consistent and to the OPK at the same time each day. For example, it is easy to miss the positive OPK if you test Monday morning and then not again until Tuesday evening.
When you ovulate, your body temperature does a little jump, typically about 0.4 degrees Fahrenheit (note the decimal point). This increase is a result of the increased progesterone that is produced after ovulation. In some cases, this temperature shift is as slight as 0.2 degrees Fahrenheit or less.
A Basal Body Thermometer is a specialized thermometer that measures your body’s temperature at rest (right when you wake up in the morning before you start burning energy moving around) to an extra decimal point, and it only measures temperatures between 96.00 and 99.00 degrees. You can buy one in your local drug store and it is a great tool for learning more about when your body ovulates so you can get better at timing intercourse.
Here’s the kicker: since the spike happens after ovulation occurs, you are benefitting from retrospective data.
An increase in BBT is NOT a predictor of ovulation, rather, it can help you to learn two things:
Most women ovulate around Day 14 of their cycle, but since women and their fertility windows vary – it’s worth it to become more intimate with your own menstrual cycle so you can be more accurate with ovulation predictions.
Chart your BBT every single morning, at the same time, for several cycles to look for consistent patterns. This will help you identify the most typical days you ovulate in your own cycle as well as the duration of your luteal phase, the part of your cycle after ovulation – and the only phase in your cycle when you’re fertile. You can bring your charts to your doctor, who can help you make sense of them and give you more details about what your body’s fertility window looks like – and when it is most likely to be open.
The morale of the BBT story is if you are waiting for your temperature to rise to have intercourse, you are “doing it wrong.”
Sometimes, when “getting pregnant” is harder work than couples anticipated, sexual intercourse becomes more like business than pleasure. This is dangerous because, in addition to losing the pleasure, fun and intimacy that sex adds to a relationship, studies show women who have sex during the follicular phase (outside the fertile window) tend to have higher pregnancy rates than those who only have sex during the luteal phase (during the fertile window).
When you are entering the fertile window, however, sexual timing matters. We recommend that couples have sex every day, or at least every other day, for the few days before and after ovulation is predicted. If you know your partner has a low sperm count, have sex every other day to maximize the amount of sperm that will be present when the egg makes her appearance. After you have gathered a few months of data from your OPK and BBT, it is fine to take a break from record keeping and enjoy intercourse every other day around your ovulatory window.
It makes sense that babies do best when they grow in a healthy environment. Thus, your body is pretty smart about when it allows fertility and when it blocks it. The healthier you are, and the healthier your lifestyle is, the better it is for your fertility and your future baby.
Some women have had irregular menstrual cycles for so long, they consider it “normal.” However, irregular periods and/or absent periods is not normal and it means you aren’t ovulating regularly. If your periods are always irregular, schedule an appointment with your OB/GYN to determine the cause and help you decide on the best method of treatment, or the next best step for getting pregnant. In other words, women with irregular or absent periods should not try to conceive for an entire year before seeking help.
If we had to sum up the lifestyle required for optimal fertility in a single phrase it would be, “everything in moderation.” That is the rule of the game when it comes to food, caffeine and alcohol intake. Drugs and smoking cigarettes, however, are 100% out of the question as far as fertility is concerned.
Being underweight and overweight can both have a negative impact on fertility. The body considers eating too few calories and/or burning too many calories to be a sign that it’s not a good time to bring a baby into the world.
Thus, women who are underweight (collegiate athletes, marathon runners, extreme sport enthusiasts, etc.) often have irregular periods or their periods stop altogether. This means they aren’t ovulating. The same is true for anorexics or bulimics. Overeating that leads to obesity also has its fair share of problems, resulting in insulin resistance and hormone imbalances in both women and men. Obese men often have low sperm counts.
Try to keep your body mass index (BMI) between 19 and 25 to maximize fertility. A healthy diet that is high in lean proteins, colorful vegetables and fruits and plenty of water is the ideal. Try to minimize fatty meats, processed foods and sugars. The more you can focus on pesticide-, herbicide-, and hormone-free foods and dairy products the better as each of these have been associated with compromised fertility.
Men with low sperm motility (slow sperm) often benefit from a supplement called L-carnitine (900 mg per day). Men with poor sperm shape/morphology may see improvement with Vitamin E (150 IUs per day) and zinc (15 mg per day). Both Vitamin E and zinc are powerful antioxidants. Search them online and look for foods that are high in these nutrients and other antioxidants so you can incorporate them into your diet.
There is also a correlation between low Vitamin D levels and female infertility. Women who live in areas with less annual sun exposure, like the Pacific Northwest, are more apt to have low Vitamin D levels. Have your blood tested and take a Vitamin D3 supplement if your levels are below normal (30 ng/mL) to be on the healthy side.
Note: Always check with a doctor before adding any new vitamin or mineral supplement to your routine, especially if you are taking any prescription medicine.
Regular exercise is good for the body and the soul. It will help you achieve and maintain your target BMI and it also helps to stave off heart disease, diabetes and other health conditions known to have adverse effects on fertility. Exercise is also a good stress reliever.
Again, keep in mind that too much exercise can be a bad thing. If you are a female athlete or have a more extreme workout regimen, it might be time to tone the exercise routine down a bit and get your body back in balance.
There is no doubt anymore that stress and infertility are related. Just as starvation – a form of physical stress – can cause irregular or absent cycles, emotional and psychological stress can have a similar effect. The hard thing is that these latter forms of stress are more difficult to quantify and measure. What is highly stressful to one person may not even phase another.
What we do know is that when the body is under stress, prolactin, adrenaline and cortisol levels go up. These are all “stress hormones” that are primarily designed to express themselves for the (ideally) occasional “fight or flight” scenario. If you are stressed out, your body lives in a perpetual state of “fight or flight,” and this throws your hormone levels out of whack, which directly impacts fertility.
It’s up to you to take responsibility for your stress levels. Managing stress is a way of telling your body, “it’s safe to grow a baby here.”
Things that can help you remain calm and return to a less stressful balance include:
There are conflicting messages out there when it comes to consuming alcohol and/or caffeine and fertility. Here is what we know from the most current studies:
Caffeine is associated with higher heart rates, anxiety and nervousness – which can also be associated with “stress”. Women who are trying to conceive should consider weaning themselves down to a single caffeinated beverage per day to err on the safe side.
Smoking is bad for you, your body and everything related to it. Women who smoke have decreased fertility rates, increased miscarriage rates, and they also go through menopause earlier than nonsmokers. Plus, smoking negatively affects egg quality and puts babies at risk for health complications.
As if that weren’t enough, smoking causes poor sperm quality and second-hand smoke is equally as harmful. If you want to get pregnant and increase your chances of having a healthy baby, you and/or your partner should quit smoking. Make an appointment to talk to a doctor about smoking cessation support programs.
Maximizing fertility at home is all about timing, but it is also about being as healthy as you can be. Knowing your cycle and timing sexual intercourse accordingly is best paired with a sound diet, moderate exercise routine and a healthy lifestyle.