You may be surprised to learn that your diet, lifestyle and environment all have a profound bearing on your individual reproductive health. There are a number of things you can do to maximise your chances of conception and encourage a healthy pregnancy.
Visit our Preconception care page to learn more about the factors that play a major role when trying to conceive.
The days leading up to ovulation are the most fertile in your menstrual cycle. You have a greater chance of conceiving if you time having intercourse one to three days before ovulation or every two days around it. This means that sperm are ready and waiting for the egg when the female ovulates. If you wait until after ovulation before you have sex, you probably will have missed the opportunity for conception that month.
The days leading up to ovulation (when the egg is released from the ovary) are the most fertile ones in your menstrual cycle. This corresponds with the second week, and the beginning of the third, in a 28-day cycle with a 14-day luteal phase. During this fertile time, the egg is moving down the fallopian tube, waiting to be fertilised.
The egg can survive for 12 hours post-ovulation, while sperm are able to survive and fertilise an egg for two to three days in the fallopian tubes. To learn more, visit our Fertility window page.
It is important for couples to understand that even if they are doing everything right to conceive, it may still take a while to fall pregnant.
Conception rates for normal, healthy couples are, at best, 20% to 25% per menstrual cycle. Once a woman reaches the age of 35, her fertility begins to decline. By age 40, it is estimated that her conception rate is in the range of 8% to 10% a month and at age 43, the pregnancy rate is thought to be as low as 1% to 3% a month.
Why Does Fertility Decline With Increasing Age?
Ageing of the ovaries is the main reason why fertility declines as we grow older, and it is part of the normal changes that affect all organs and tissues as time passes.
Most women have about 300,000 eggs in their ovaries at puberty. For each egg that matures and is released (ovulated) during the menstrual cycle, at least 500 do not mature and are absorbed by the body. As the woman ages, her remaining eggs also age, making them less capable of fertilisation and their embryos less likely to implant.
Ageing also affects men, but to a much lesser degree. It impacts on sperm and coital frequency. There is no maximum age after which men are not capable of conceiving a child.
The average length of the menstrual cycle is 28 days, but it can range between 25 and 35 days. The length of the cycle is calculated from the first day of the period to the day before the next one starts.
The menstrual cycle is determined by a complex interaction of hormones, so any hormonal imbalance can make your period irregular. Although irregular cycles are not dangerous in most cases, it is important to determine the cause. Irregular periods can indicate that ovulation isn’t taking place every month.
Women with irregular cycles, suggesting a problem with ovulation, should consider evaluation and treatment as soon as possible.
Certain female conditions can hinder a couple’s attempts to conceive. These include:
The quality of the sperm (motility, morphology, count and vitality) can affect a couple’s likelihood of falling pregnant.
Many factors can affect male fertility, including:
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Your treating doctor may request a blood test to measure estrogen, luteinising hormone (LH), follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH) levels to ensure these are normal. This test is usually performed in the first week of your menstrual cycle.
A pelvic ultrasound can check for ovarian cysts and determine whether there are any physical changes, such as fibroids or polyps, that may affect your cycle.
Your treating doctor can also request the Anti-Mullerian hormone (AMH) test, also called the “egg-timer test”. This is a blood test that can be performed at any time during the menstrual cycle. It may be used with other blood tests and transvaginal scans to predict ovarian reserve. AMH is produced by small follicles that are in the ovary and contain eggs. The amount of AMH gives an indication of the number of eggs you are producing, or your ovarian reserve. However, this test cannot predict the quality of the eggs. For more information about AMH, please read our fact sheet: Anti-Mullerian hormone (AMH).
Usually, doctors request a basic physical exam and a semen analysis, and often a blood test to assess hormone levels such as FSH, LH and testosterone. Depending on the results of these tests, your treating doctor may want you to have more checks, such as sperm DNA fragmentation or a testicular biopsy. For more information about these tests, visit our Sperm test and semen analysis page.
It is important for couples to understand that general practitioners are usually reluctant to request a series of fertility tests unless a couple has been trying to conceive for a year (or six months if you are over 35).
If you have not achieved a pregnancy after a year (or six months if you are over 35) of unprotected intercourse, you should seek medical advice from your GP or a specialist.
Infertility affects men and women. It results from a male factor in about 30% of cases, a female factor in 30% and both male and female factors in 30% of instances. About 10% of infertility problems remain unexplained even after complete medical evaluations.
While infertility can be a devastating experience for you and your partner, the good news is that it can be treated.
Several medical conditions can be treated with assisted reproductive technology (ART). City Fertility provides treatment for a number of infertility conditions. For more information about fertility treatments, visit our Fertility services page.