Getting Pregnant: Frequently Asked Questions about Fertility

Since the road to pregnancy is different for every woman, trying to get pregnant can be a confusing time. Whether you’re just starting to try to conceive or been trying for some time and wonder how to boost your odds, you likely have many questions about fertility. To help calm the overwhelm and make sense of all the information available about fertility and getting pregnant, here are some frequently asked questions (and the answers) about fertility.

What is fertility?

Fertility is the ability to conceive and produce children. Fertility can be statistically measured by a fertility rate that reflects the number of children per population. Fecundity, the physiological potential for reproduction or how many children a single woman can give birth to, depends on health, age and willingness to reproduce.

Pregnancy results when:

• An egg is released from an ovary (ovulation) at the right time
• The egg travels through the fallopian tube and gets to the uterus (womb)
• A man’s sperm fertilizes the egg
• The fertilized age implants to the inside of the uterus

If there are any hiccups with these steps, infertility can result.

How common is infertility?

About 15-20% of couples will have some sort of infertility issue. Infertility is not just an issue with women’s reproductive systems - 40% of cases are diagnosed as an issue with the male’s body and 15% of the time there are factors with both individuals. 

What causes infertility?

Infertility is when a pregnancy hasn’t resulted after one year of trying (6 months for women 35 years or older) or a woman can get pregnant but is unable to stay pregnant. There are several issues that can make it challenging to conceive and sustain a pregnancy. Infertility for women and men can be caused by issues related to hormones; the environment; genetic or anatomical factors; chemicals including medicines, alcohol and cannabis; current or previous medical conditions such as scarring of fallopian tubes, endometriosis, trauma; as well as age. While the specific cause of infertility might never be known for every individual, medical professionals will look to these areas to try to determine what might be the cause in order to help couples overcome infertility.

Can someone be too old to get pregnant?

Age can certainly play a significant factor in a woman’s ability to conceive without intervention. Women are born with all the eggs they will ever possess. Due to the normal aging process eggs can be impacted by unfavorable cellular and chromosomal changes. Menopause, when women stop menstruating, is typically considered the end of women’s fertility. While a small percentage of women have early or late menopause, the average age for women to enter menopause is 51 years old; however, periods tend to become more irregular and less frequent several years before menopause. Female fertility is at the highest level when women are in their late teens to their late twenties and fertility starts to decline during the thirties. As a woman ages, the following are more likely to occur:

• Ovaries might be less able to release eggs
• Other health conditions might cause fertility problems
• Miscarriages

Is there a test for fertility?

There’s not one test a medical professional can order to determine fertility, but they will record your medical history, do a physical exam, check blood work to determine hormone levels such as progesterone, thyroid and prolactin, and do an ultrasound to check the reproductive system. 

There are at-home ovulation prediction tests that identify the luteinizing hormone (LH) in urine. A surge of LH triggers ovulation, so it’s best to have intercourse with 48 hours of this surge for the best odds to get pregnant. Anytime you use these at-home tests, it’s important to follow the directions perfectly otherwise the results of the tests might be compromised. 

What are things to do to boost fertility?

While there are things you cannot control when trying to get pregnant, the following lifestyle changes are known to boost odds of getting pregnant

• Eat a low glycemic diet that’s protein-rich and low in carbs and sugar.
• Avoid alcohol, caffeine, tobacco. Smoking and alcohol are also known to be bad for sperm.
• Body mass index (BMI) should be between 20 and 25; being overweight or underweight can affect hormone levels.
• Get at least 30 minutes of aerobic exercise five times per week.
• Take prenatal vitamins even as you are still trying to become pregnant.
• Track your cycle (there are many apps available for this) to better understand when you ovulate and help see any abnormalities with your cycle. While the average menstrual cycle lasts 28 days, the normal range is between 24 and 35 days. Even with this variance, ovulation occurs 14 days before your period starts. For planning purposes, the first day of your cycle is the first day you have a regular flow.  
• Practice meditation, mindfulness and breathing techniques to reduce stress.

Learn more: Why Dad's Nutrition and Lifestyle is Just as Important to Family Planning as Mum's

When is it time to see the doctor?

Women should ask questions of their doctor well before they are ready to get pregnant to understand any concerns that might impact fertility in the future and so they have information to best prepare their bodies for pregnancy. Information is powerful and will allow women to make informed decisions about when to begin their own journey to pregnancy, how their anatomy works in order to boost odds of getting pregnant and how to prepare for any potential issues in the future.

Women who are under 35 years and have been trying to conceive for a year should seek the counsel of an infertility specialist; those who are 35 years and older should talk to a medical professional after 6 months of trying. At that time, a woman’s specific circumstances can be assessed and options for next steps can be discussed.