Getting Started on Getting Pregnant

Medically Reviewed by Zilpah Sheikh, MD on October 05, 2023
8 min read

If you're considering having a baby, you probably have wondered how long it will take to get pregnant, when to have sex, and how often. Find the answers to your questions here.

It's a common question: What are the chances that I'll get pregnant this month? For most people who are trying, the odds you'll become pregnant are 15%-25% in any particular month.

But some things can affect your chances:

Age. After age 30, your chances of getting pregnant in any given month fall. And they keep falling, dropping steeply in your 40s.

Irregular periods. This can make it hard to know when you're ovulating and when's the best time to have sex.

How often you have sex. The less often, the less likely you'll get pregnant.

How long you've been trying to conceive. If you haven't gotten pregnant after 1 year of trying, your chances of becoming pregnant may be lower. Talk to your doctor about fertility tests for you and your partner.

Illnesses or medical conditions. Some of these can affect pregnancy.

Knowing more about your menstrual cycle may help.

It's the process your body goes through to prepare for a possible pregnancy. As your ovaries get ready to release an egg, the lining of your uterus gets thicker. That makes it easier for a fertilized egg to attach itself to the wall of your uterus. If the egg doesn't get fertilized, the extra lining breaks down and gets shed through your vagina.

Your cycle begins on the first day you notice bright red blood—not just spotting—and it ends on the day before the next cycle begins. A cycle can take 21-35 days or more.

If your cycle is different by a few days from 1 month to the next, that's considered irregular. It's common, and it doesn't necessarily mean anything is wrong.

Getting pregnant timeline

With a typical 28-day cycle, your ovary releases an egg on day 14. It lives 24 hours or less. If it gets fertilized, it takes another 5-6 days to travel through your fallopian tube and implant itself in your uterus. You're officially pregnant on about day 21.

Predicting ovulation

With just 1 day to get that egg fertilized, it's important to know when it's going to be released. But if everyone's cycle is different, how can you be sure when you're ovulating?

  • Calendar tracking. You can mark the start of your period for a few months. You'll usually ovulate 14 days before your period, regardless of how long your cycle is.       There are apps that can help you keep track and send you an alert when you're most fertile. But calendar tracking isn't much help if your cycle isn't regular.
  • Cervical mucus. One sign that you're ovulating is a change in the discharge that comes from your cervix, the opening to your uterus. When your ovaries are getting ready to release an egg, the mucus may be white, yellow, cloudy, or sticky. Right before you ovulate, the mucus becomes clear and slippery and looks like egg whites. When the egg is gone, the mucus usually dries up.
  • Basal body temperature. Another sign you're ovulating is a slight rise in your body temperature first thing in the morning. It goes up the day an egg is released and stays up until your period. You need a special thermometer to catch the difference, which you can get at a drug or grocery store.
  • Ovulation test kits. These work like pregnancy tests to check your pee for hormones that increase when you're about to ovulate. They work best if you test every day for 5-10 days in the middle of your cycle. You can get them over the counter.
  • Fertility monitor. You can also buy all kinds of electronic devices that help track your temperature or hormone levels.

Can you get pregnant right before your period?

It's not the best time to try, but it's not impossible. If an egg is released in the middle of your cycle, it's gone well before the start of your next period. But if you ovulate later than you think you will, an egg could still be there when you're expecting to get your period.

Here's another common question from couples trying to conceive: How often should we have sex? In short, the answer is often.

The window of opportunity for a sperm to fertilize an egg is pretty small. Once they're inside the uterus, sperm can live for about 5 days. An egg lives about a day after it's released. You're most likely to get pregnant if sperm are waiting in your fallopian tube when the egg emerges.

The problem is that even the best technology and careful tracking aren't always accurate. If you're only having sex on the few days each month you think you're fertile and you're off by a bit, you may be out of luck.

When to have sex. So what do doctors recommend? One strategy is to have sex every other day starting either right after the end of your period or the week before you expect to ovulate. If that feels too calculated, you can just make sure you're having sex at least 2 or 3 times every week.

Is having sex every day bad when trying to get pregnant?

You may have heard that too much sex leads to a lower sperm count and lower chances of getting pregnant. But research has found you're a little more likely to get pregnant if you have sex every day instead of every other day. However, that can backfire if sex becomes a chore and makes you anxious and stressed.

How long does it take for the effects of birth control medication to wear off?

It's actually possible to get pregnant immediately after you go off the pill—as soon as the artificial hormones are out of your system—although it may take a few months before you ovulate normally.

Is it safe to conceive right away?

Yes. You're as likely to have a healthy baby as you are if you wait a few months. It's just harder to pinpoint your conception and due dates if you haven't had a period.

If everything lined up just right, the fertilized egg will be implanted by day 21 of your cycle, and you'll officially be pregnant. But it may take a little while to find out.

When do you start feeling pregnant?

It's possible you might feel a little pain or have some spotting when the egg implants in your uterus. But you also might not notice anything different until weeks after you have a positive pregnancy test. Early signs you may be pregnant include:

  • Missing your period
  • Feeling tired
  • Sore or swollen breasts
  • Needing to pee more often
  • Nausea
  • Cramping or spotting
  • Moodiness

How long after getting pregnant will I get a positive pregnancy test?

A hormone called human chorionic gonadotropin is made by the placenta, the organ that grows inside your uterus to supply your baby with oxygen and nutrients. When enough of this hormone builds up in your system, you'll get a positive pregnancy test. That takes about 11-14 days after conception for an at-home urine test. A doctor's blood test may pick it up slightly sooner.

Having gender-affirming therapy doesn't mean you can't get pregnant, as long as you still have a uterus and ovaries. Testosterone stops you from ovulating. But research has shown that once you stop taking it, your body can go back to making a normal amount of healthy eggs.

Testosterone is dangerous for an unborn baby, though, so you should stop taking it before you try to conceive. You may get a period right away, or it may take several months.

There are some extra things to consider about getting pregnant if you're transgender or nonbinary.

Health care

It's important to find a health care team that you're comfortable with. Good prenatal care is crucial for your and your baby's health, and negative experiences shouldn't stop you from getting what you need. It make take extra work on your part to find a fertility specialist, OB/GYN, or pediatrician who can support you. Places to go for a referral include:

Once you have a lead on a potential provider, here are some things you can do to figure out if they're right for you.

  • Check their website to see if it has information on inclusive family-building.
  • Be clear about what name and pronouns they should use to address you, and notice whether they stick to that.
  • Ask if they've treated other trans or nonbinary people or have any special training.
  • Discuss what steps they would take to make sure you're comfortable during examinations and the labor and delivery process.

Don't hesitate to doctor shop until you find a good fit. And speak up if someone at a practice or health care facility treats you with disrespect.

Emotional health

The surging hormones that go along with pregnancy can do a number on your emotions. It may be worse if you were taking testosterone and stopped.

The way you feel about your yourself and your body may change. Other people may perceive you differently while you're pregnant, and you may struggle with relationships or social interactions.

Moodiness is a normal part of pregnancy. Knowing that and being prepared for it can help you manage. But it's not unusual to go beyond that to depression and anxiety. So it may help to line up extra support from family and friends or a therapist in case you need it.

Breast/chestfeeding

If you've had chest reconstruction surgery, you may or may not be able to nurse your baby, depending on what procedure you had. That's something you'll need to discuss with your doctor.

You should also talk to your doctor about the benefits and possible risks if you want to restart testosterone therapy after you deliver. It can keep you from making milk. It also gets passed to your baby through breast milk, and very little research has been done into whether that's safe.

Timing is a big part of it. But there are other things you can do to help your chances of getting pregnant.

  • Have a checkup to make sure you don't have any health problems that could get in the way.
  • Check your meds to see whether they affect fertility.
  • Get to and stay at a healthy weight.
  • Exercise but watch the intensity. Very strenuous exercise can keep you from ovulating.
  • Stop smoking.
  • Avoid alcohol.
  • Limit caffeine to less than 2 cups of coffee a day.

Folic acid

It's a good idea to start taking this supplement as soon as you're ready to start trying to get pregnant. Folic acid helps prevent certain very serious birth defects.

According to the American College of Obstetricians and Gynecologists, most couples that have sex regularly and don't have health problems get pregnant within 6 months of trying. Talk with your doctor if it's been a year and you haven't had success. If you're over 35, don't wait more than 6 months.

You should also see your doctor if you have a health condition that could affect your pregnancy, like diabetes, or if you or your partner have a family history of a genetic problem that could be passed on to your baby.