• About AFA
  • About Us
  • Board
  • Staff
  • Sponsors
  • Contact
• Library
• Donate
• Online Community
  • Create an All Access Pass
  • Find Support
  • Ask the Experts
  • Blog
  • Blog Archives
  • Online Educational Module (OEM)
  • Calendar
  • Online Webinars
  • Get Our eNewsletter and Updates
• Press & News
  • AFA in the News
  • Press Releases
  • News Archive
  • AFA Position Statements
• Join
  • For Public
  • Create an All-Access Pass
  • For Professionals
  •     » The AFA Physician Network Form
  •     » The AFA Therapist Network Form
  •     » The AFA Professional Practices Network Form
  •     » The AFA LGBT Professional Network Form
• Resources
  • Find a Professional
  •     » The AFA Physician Network
  •     » The AFA Therapist Network
  •     » The AFA Professional Practices Network
  •     » The AFA LGBT Professional Network
  • Links
•  

One of the hallmarks of the current generation is that women are choosing to have children later in life and it is likely that this trend will continue. On average, women today are having two children with approximately four years time between the first and second births. Between 1985 and 1994 the proportion of births to women in their 20s decreased from 62 percent to 53 percent, while the proportion of births to women 30 - 44 years of age increased from 25 percent to 34 percent. Since the mid 1970s there has been a four-fold increase in the percent of first births to women 30 years and older. Because fertility declines with age, having children later in life means that many couples will experience infertility in their quest to build a family.

Advances in the treatment of infertility have improved a woman’s chances of conception as she ages, and more couples than ever before are taking advantage of these new treatments. However, many couples still don’t know all they need to know about the first and most important step in the pregnancy process: ovulation.

Ovulation is the term used to define the release of an egg (usually one, though sometimes more) from a woman’s ovary. Conception occurs when a sperm fertilizes the egg. While sperm can survive for several days inside a woman’s reproductive tract, an egg can only survive for up to 24 hours after ovulation. This puts a limitation on the time when conception is most likely to occur. According to a recent survey conducted at the World Congress on Fertility and Sterility, 20 percent of the problems in conceiving are due to a couple’s failure to time intercourse correctly during the woman’s fertile time period.

The Opinion Research Corporation International (ORC) found that most women don’t know when they can become pregnant. Nearly all women (98 percent) of reproductive age are unclear about how many days each month it is possible to get pregnant, and more than half (52 percent) of women aren’t sure when those fertile days occur during their cycle. Most parents do not know the day(s) on which their children were conceived.

To increase chances of becoming pregnant, women should monitor their body’s fertile time period - the time that sperm can survive within a woman’s reproductive tract until ovulation and fertilization can occur. A woman’s most fertile period is typically several days (usually no more than 5-6) ending on the day after ovulation. Because menstrual cycles vary from one woman to another and even from one cycle to the next in the same woman, identifying a woman’s fertile time period can be challenging. However there are several methods a woman can use to determine when she is most likely to conceive:

• Calendar - A woman can chart her menstrual cycle on a calendar to determine the days she is most likely to ovulate.
• Basal Body Temperature (BBT) - The BBT is a woman’s temperature first thing in the morning, before getting up or doing any activity. In a normal menstrual cycle, a woman’s BBT rises almost one degree from just after ovulation through the beginning of her next cycle.
• Cervical Mucus - Most of the time the cervix produces a mucus that protects the body from sperm, bacteria and other organisms. For several days each month, the consistency of the mucus changes to allow sperm to enter the fallopian tubes. By monitoring these changes, a woman can determine her fertile time period.
• Symptothermal - Charting a combination of fertility indicators like cervical secretions and BBT can often help to indicate a woman’s fertile time period.

The above charting methods require women to record the secondary signs of fertility caused by changes in hormones. Because these conditions can be affected by factors such as infections or medications, they require careful monitoring and analysis, and they are never 100% reliable. An alternative to these methods is measuring changes in hormone levels. An increase in the level of estrogen marks the beginning of most women’s fertile phase, while an increase in the luteinizing hormone (LH) level signals that ovulation will occur soon - usually within approximately 24 to 36 hours.

The fertility monitor is a relatively new approach designed to provide daily information about a woman’s fertile time period. The monitor records a woman’s daily fertility level (low, high, peak) based on results from urine tests that detect increases in levels of estrogen and LH. Another in-home test that can provide useful information is an ovulation predictor kit. These products measure the level of LH, helping women identify the days they have the optimal chances of conceiving.

The chances of becoming pregnant in any one month decrease from 20 percent in women over 30 years of age to five percent in women over 40. Among healthy women trying to conceive, nearly all pregnancies can be attributed to intercourse during the six days leading up to, and ending on, the day of ovulation. Being able to identify a woman’s fertility peaks and timing intercourse accordingly can increase a couple’s chances of pregnancy and also decrease unnecessary anxiety about the process.

Couples should also recognize that other factors may contribute to a woman’s inability to become pregnant, even when she is ovulating. These include:

• previous tubal surgery
• history of pelvic inflammation or infection
• scar tissue from previous surgery
• irregular or infrequent cycles
• male partner’s infertility

A woman who is under 35 and trying to become pregnant should use timing methods for no longer than one year. If she is still not pregnant, she should consult a physician to try to determine the cause of her inability to conceive. A woman over 35 should only use timing methods for up to six months before seeking further medical attention.

For more information about timing conception and reliable methods for monitoring your fertile time period, please contact The American Fertility Association at 888-917-3777 or explore our Web site at http://www.americaninfertility.org.

Edited by:
Ellyn Modell, M.D.
Reproductive Endocrinologist
Assistant Professor of Obstetrics & Gynecology
New York University School of Medicine

Frederick Licciardi, M.D.
Reproductive Endocrinologist
Assistant Professor of Obstetrics & Gynecology
New York University School of Medicine