Maximising your chances of conception

One of the most effective ways of enhancing your chances of becoming pregnant is getting to know your menstrual cycle. It can be helpful to keep track of your cycle in diary or with an app on your phone. Understanding your cycle and being able to identify your fertile period helps increase your chances of conceiving naturally. It is really important to be aware of your fertile period because once ovulation occurs, the egg only survives for 12- 24 hours. Sperm can survive for up to 5 days, so you should aim to have intercourse in the days leading up to ovulation.

Menstrual Cycle

A woman’s menstrual cycle can range from 24 to 35 days. A cycle is divided into two phases, occurring either side of ovulation; the follicular phase and the luteal phase.

The follicular phase is of variable length and is measured from the first day of the period until ovulation. It is during this time that, under the guidance of follicle-stimulation hormone (FSH), a dominant follicle (a fluid filled sac containing an egg) develops in the ovary in preparation for ovulation. The follicles in the ovary produce oestrogen that increases to a peak prior to ovulation.

A surge of luteinising hormone (LH) is then released and approximately 24-36 hours later the egg is released (ovulation). This usually occurs 14 days before the next period. The next phase is known as the luteal phase and is fairly regular in length, usually 10-16 days. The dominant follicle remaining after the egg is released forms the corpus luteum which produces progesterone. Progesterone causes the lining of the womb (endometrium) to thicken up in anticipation of a pregnancy. If fertilisation does not occur, the corpus luteum breaks down, progesterone levels drop and the endometrium is shed as a period (day 1 of the next cycle).

Cervical Mucus

During the menstrual cycle there is variation in the type and amount of cervical secretions. By understanding these changes and correlating them with your menstrual cycle you should be able to identify your most fertile period in order to maximise your chances of conceiving.

The start of the follicular phase is the woman’s period (usually 2-6 days in length). Following the period, the amount of cervical mucus is minimal for a few days and there is a dry vaginal sensation.

The amount of secretions then increases slightly, so a woman may notice a sticky white/pale yellow discharge on her underwear followed by a creamy white/yellow discharge that indicates possible increased fertility.

As the fertile period begins, the secretions become more watery and slippery with a very wet vaginal sensation. The most fertile cervical mucus resembles raw egg white and is clear and stretchy (it may be stretched several centimetres between your fingers). This mucus has similar qualities to semen, allowing the sperm to survive and pass through the cervix in order to be available at the time the egg is released.

Following ovulation, the levels of oestrogen drop quickly (as progesterone rises) and the cervical fluid changes abruptly, leaving a dry feeling for most of the remainder of the cycle.

How often to have sexual intercourse?

There is no right or wrong answer to this question. The more frequently you have unprotected sex, the better your chances of becoming pregnant. It is recommended to have sex every 2 – 3 days throughout the month. However, there are certain days during the month when you are at your most fertile, and therefore having sex around this time point will improve your chances of pregnancy.

It is recommended to have intercourse around the time of ovulation. On a 28 day cycle, ovulation usually occurs around day 14. On a 30 day cycle, ovulation is around day 16. You are recommended to have intercourse in the 5 days leading up to ovulation and the day of ovulation itself.

It is important not to become too focused on having intercourse to become pregnant. This takes the fun out of it and can cause strain in a relationship and can become a chore that needs to be done rather than an enjoyable act between two people who love each other.

Ovulation Prediction Kits

Ovulation predictor kits tests can be helpful if you are unsure that you are ovulating each month, or if you are unsure what day ovulation occurs in your cycle. These kits can indicate when ovulation occurs by detecting the “LH surge”. Ovulation usually occurs in the 24 – 48 hours after this increase in hormone level. Therefore these tests indicate when you are at your most fertile. Many different types of ovulation tests are available in your local pharmacy.

Ovulation tests work like pregnancy tests in that they detect hormone levels in your urine. Follow the test instructions carefully to ensure accurate results. The morning is the best time to test as hormone levels are more concentrated first thing in the morning, rather than the evening. If you cannot test the sample straight away, store the urine in a fridge and bring to room temperature before testing.

If you have just stopped using contraceptives such as the pill, it is recommended to allow two normal menstrual cycles (two ‘periods’) before using an ovulation test. Otherwise your menstrual cycle may not have returned to normal and an LH surge will not be picked up. You may also get a negative result if you have used the test too late into your cycle. If you have a history of polycystic ovarian syndrome or you are taking medications to improve your fertility, you may get a false positive result as women with PCOS have higher levels of LH throughout the cycle.

Regular use of ovulation tests can be expensive. If you wish to use these tests, we suggest using them for one or two months to see if you are ovulating and to get to know your cycle. If you are ovulating each month, and you have an awareness of the length of your menstrual cycle, then it is probably no longer necessary to use the tests.

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