So you've made the big decision -- you're going to start a
family! But while you were certain that getting pregnant would be fast and
easy, after six months of trying it's just not happening.
Could something be wrong? Of course that's always a
possibility. But if you are young (between 18 and 34) and you and your partner
are generally healthy, doctors say more often than not some simple problems --
with easy fixes -- may be standing in your way.
Irregular or abnormal ovulation accounts for 30% to 40% of all cases of infertility. Having irregular periods, no periods, or abnormal bleeding often indicates that you aren't ovulating, a condition known clinically as anovulation.
Although anovulation can usually be treated with fertility drugs, it is important to be evaluated for other conditions that could interfere with ovulation, such as thyroid conditions or abnormalities of the adrenal or pituitary glands.
Among the most common: Miscalculating your most fertile time of
"By far, the single most important thing stopping healthy
couples from getting pregnant is they are not having intercourse at the right
time -- and the reason for that is many women simply aren't calculating their
ovulation time, or most fertile period, correctly," says Steven Goldstein,
MD, professor of obstetrics and gynecology at NYU School of Medicine in New
Goldstein says that, while most women know they must ovulate in
order to conceive, many don't realize that waiting for this to happen before
having sex causes them to bypass their most fertile time.
"After ovulation, an egg is only viable for about 24 hours
-- so if you are waiting until you ovulate to have intercourse, chances are you
are going to miss the opportunity to get pregnant that month," says
Since sperm can live in your reproductive tract for up to 72
hours, doctors say having sex beginning at least three days before
ovulation dramatically increases your chance of conception.
"I tell my patients to start having sex a full five days
before they expect to ovulate -- this way even if they are off a day or two in
calculating their ovulation, the bases are still covered. It's better to have
sex too early, than too late," says Sharon Winer, MD, an obstetrician at
Cedars Sinai Medical Center in Los Angeles.
Indeed, a 10-year study published in the New England
Journal of Medicine in 1997 found that having sex beginning six days prior
to ovulation is the most conducive to achieving conception. In the same study,
not one pregnancy occurred when sex took place 24 hours after ovulation.
But how do you know when you are about to ovulate? Goldstein
tells WebMD you should keep an accurate menstrual calendar, tracking your
period for at least two or three months prior to when you want to conceive.
"Ovulation takes place 14 days before you get your
period, so you need to keep an accurate calendar for a couple of months,
marking down when your period arrives -- and day one is always the first day of
bleeding," says Goldstein.
Then, he says, when you are ready to get pregnant use the
calendar to predict when your next period will arrive, and simply count back 14
days from that date. "This will be your projected ovulation date -- and you
should begin having sex several days prior to that date, " says