trying to conceive 101

A proactive guide to getting pregnant

Tharni Vasavan

Written by

Dr Tharni Vasavan, BSc (hons), MSc, PhD

Medically reviewed by

Dr. BenJAMIN JONES

Published May 9, 2022

Last medically reviewed May 9, 2022

Written by

Tharni Vasavan

Dr Tharni Vasavan

BSc (hons), MSc, PhD

Medically reviewed by

Dr. BenJAMIN JONES

Published May 9, 2022

Last medically reviewed May 9, 2022

Whether you’ve been trying to conceive for a while or are just starting on your fertility journey, the last thing you want to hear is ‘just relax’ or ‘keep trying and wait and see.’

Traditional healthcare makes women waste a full year proving they can’t get pregnant before taking action. But we say, enough with the waiting. Enough with the unanswered questions. Enough with putting your fertility future in someone else's hands. Why can’t you find out where you’re at now? Well actually, you can. That’s where we come in.

Short on time? Here are our top takeaways on knowing where you’re at when it comes to your fertility

Trying to conceive?

(or thinking about it soon?)

Here’s what you need to know.

Struggling with fertility is common

1 in 7 couples struggle with infertility so please know you’re not alone if it’s taking longer than you’d hoped. You’re here, so you’ve already taken the first step towards getting answers, well done.

Knowing your egg count alone is not enough

There are multiple reasons you might struggle to conceive (more on this later) but the sooner you take a fertility test to identify the issue, the sooner you can start doing something about it.

The key is being proactive

We can help identify potential factors that might be affecting your fertility in just 10 days. In fact, we’ve helped 64% of our Hertili-Team community discover at least one hormone that was out of range and supported 29% of our users on the journey to getting a diagnosis for a previously undiagnosed reproductive health condition such as PCOS.

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Right, let’s get back to basics.

To understand how a fertility test for women works, first you need to understand what fertility is and how it works. Put simply, fertility is defined as your ability to conceive a child. But despite the messaging we’ve all grown up with, it’s anything but simple. If you’re biologically female, also known as assigned female at birth (AFAB), your fertility will depend on different aspects of the reproductive system playing their part to make sure the following steps take place:

Ovulation (release from the ovary) of a good quality egg

Sperm swimming up the vagina and cervix to fertilise the egg

The Fallopian tube being clear to allow the sperm to fertilise the egg

The uterus being able to receive and implant the embryo and grow a foetus

However, a fertility test for women will only investigate half of the equation. It’s important to know it takes two to tango and we also know that one third of infertility cases in heterosexual couples are related to male causes such as low sperm count or poor quality sperm. So the other half of the fertility equation is having enough quality sperm in the right place at the right time.

We know periods can be a bloody pain but they are key to successful conception. So, let’s get you up to speed. We’re all born with all the eggs we will ever have, and after puberty, most of us will start having menstrual cycles which lead to eggs being released in a process called ovulation.

The menstrual cycle is composed of two different parts which work together: the ovarian cycle, which matures and releases the egg from the ovary, and the uterine cycle, which thickens the uterus to prepare for pregnancy. These intricate processes are carefully curated by your hormones, including follicle-stimulating hormone (FSH), estradiol (E2) and luteinising hormone (LH). We call these your menstrual cycle hormones or your cycling hormones. If any of these hormones are out of whack, then your menstrual cycle and therefore your fertility will be compromised.

This is why our online health assessment will take into account all the information about your period and menstrual health to see exactly what’s going on (or potentially going wrong). We’ll then check in on your menstrual cycle hormones as well as your thyroid hormones (which also impact your menstrual cycle and fertility) and ovarian reserve (an indication of how many eggs you have left) by sending you an at-home sample collection kit that you’ll pop in post to our lab to get analysed. This ultimately means that one of our private gynaecologists that reviews your results will have a 360-degree view into your health and fertility and can start giving you clarity into what’s going on and what you might need to take action on if you’re trying to conceive.

Without ovulation (ie: release of an egg), there will be no successful pregnancy. But how do you know if and when ovulation occurs? For most people who have regular periods, ovulation occurs around the middle of the cycle, around 2 weeks before the start of your next period. Determining your exact ovulation day is tricky but there are certain signs to watch out for to hint that ovulation is near or has just happened.

Whilst ovulation pain and pregnancy success do not always have to go hand in hand, a sharp pain in the lower abdomen (also known as mittelschmerz) can be a signal to some women of ovulation. Other ways to confirm you are about to ovulate or have ovulated include testing the levels of LH and/or progesterone in your blood or urine, tracking basal body temperature (which increases after ovulation) and tracking the cervical mucus (which has an egg white-like consistency before ovulation occurs).

Knowing when you have ovulated can be a useful way of predicting when you’ll be the most fertile. In fact, there are only 5-6 days during your menstrual cycle where you can successfully conceive, which is often called the “fertile window”. Its length is determined by how long the egg and sperm can survive in the reproductive tract without being fertilised, which is 12-24 hours and 5 days respectively.

Causes of infertility

While there are lots of stories of couples conceiving without any problems, it’s important to get to grips with the facts. It’s estimated that 1 in 7 couples 1 experience infertility. One third are due to female factors (e.g: issues with ovulation, blocked Fallopian tubes), one third are due to male factors (e.g: low sperm count, poor sperm quality) and the final third is either a combination of both or could have an unknown cause called unexplained infertility.

There are many different causes of female infertility, the most common can broadly be split into the following categories:

  • issues with ovulation
  • poor egg quality
  • structural problems in the uterus
  • blocked fallopian tubes

Warning signs of infertility

As women, we’re so used to putting up with symptoms but it might be that your body is trying to tell you something. And from our experience, it often is. 64% of Hertility users who haven't had a diagnosis but suspect something is up, go on to have at least one out of range hormone. The takeaway? Listen to your body as there are many symptoms that could be a sign of a hormonal imbalance or an underlying reproductive health condition which may affect your fertility. Let’s look at them in more detail.

Warning signs of infertility

As women, we’re so used to putting up with symptoms but it might be that your body is trying to tell you something. And from our experience, it often is. 64% of Hertility users who haven't had a diagnosis but suspect something is up, go on to have at least one out of range hormone. The takeaway? Listen to your body as there are many symptoms that could be a sign of a hormonal imbalance or an underlying reproductive health condition which may affect your fertility. Let’s look at them in more detail.

POTENTIAL CAUSES FOR INFERTILITY

We know, this is a lot to take in and keep tabs on. So to take the pressure of you being a full time investigator, we’ve taken the latest clinical guidelines and created a digital screening tool. All you need to do is complete our 5 minute online health assessment and our algorithm will flag whether you might have one of 9 most common gynae conditions that might be impacting your fertility. It currently takes an average of 2-8 years to diagnose a reproductive health condition, but we can get you answers in 10 days to get you to specialist care sooner.

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What are the options for fertility treatment?

The most well known options for fertility treatment are either medication, assisted reproductive technology or surgical procedures. Let’s start by taking a look at medications. Medications, such as Clomid, Metformin and Gonadotropins encourage ovulation and so are often used for people who do not ovulate regularly and are having trouble conceiving.

There are several options when it comes to assisted reproductive technology. A commonly used treatment is Intrauterine Insemination (IUI), which is a procedure where the best quality sperm is directly inserted into the uterus. It is often recommended when donor sperm is required or there is a problem with having sexual intercourse. There is also In Vitro Fertilisation (IVF) or Intracytoplasmic Sperm Injection (ICSI) which are other common procedures. They are often recommended for those who have a problem with their eggs and/or sperm. These procedures involve harvesting both the eggs and sperm (either from yourself or a donor), fertilising the egg with the sperm in a laboratory, and then transferring a resulting embryo back into the body.

Finally, surgical procedures may be recommended in those who have a structural issue which is preventing them from getting pregnant. In these cases, surgery may be used to repair Fallopian tubes or remove fibroids, polyps, cysts and endometrial lesions.

Test your fertility

Where are you at right now, when it comes to your fertility?

These fertility treatments are a big undertaking - emotionally, physically and financially. And if you’re not sure why you’re struggling to conceive, how are you supposed to know which fertility treatment is right for you? So, before you start looking into them, why not take a proactive approach to finding out exactly what’s going on when it comes to your fertility? Here’s how Hertility can help.

Take an at-home fertility test

Receive an online health assessment, personalised hormone blood test and comprehensive report from a private gynaecologist without leaving the house.

Rule out having a reproductive health condition

Hertility at-home tests can detect or signpost 9 of the most common gynaecological conditions, such as PCOS, and how they impact fertility.

Get answers in days, not years

Quick referrals to a pelvic ultrasound, fertility counselling, nutritional support or fertility and egg freezing treatment if required.

No lengthy waiting lists, no mounting bills

Get answers in 10 days for a fraction of the cost of a fertility clinic. Private fertility clinics cost over £1,200 but we’re making it accessible with our £149 test.

We’ve helped many women find answers to their health that they deserve

How we’re doing this

FAQS about fertility

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No, having an abortion will not affect your chances of getting pregnant in the future. In the UK, abortions may only be carried out at an NHS hospital or licenced clinic. They are safe and the vast majority of people accessing abortions do not experience any problems.


However, in some cases, the potential complications of an abortion may lead to a womb infection. If left untreated, this may spread to your Fallopian tubes and ovaries resulting in Pelvic Inflammatory Disease (PID) which is known to increase the risk of infertility.

Having a miscarriage does not mean you are infertile. In fact, miscarriages are common, affecting approximately 1 in 6 confirmed pregnancies, rising to 1 in 4 in cases where pregnancy may not be known. Miscarriages can be caused by many different things but, in the majority of cases, it’s not to do with anything you’ve done and unfortunately the underlying cause might not be understood.


However, experiencing recurrent miscarriages (3 or more) is much less common, affecting 1 in 100 pregnancies in the UK. If you’ve experienced recurrent miscarriages, the NHS will provide further tests to try and determine the cause as this could be related to an underlying health condition. Many women (6 in 10) who have had recurrent miscarriages go on to have a successful pregnancy.

Whilst the negative effect of alcohol on the developing foetus is well known, the effect on fertility is less established. Alcohol has been linked to disrupting the levels of cycling hormones, the balance of which, as we outlined above, is important for conceiving. Binge drinking has also been linked to a reduction in Anti-Müllerian hormone (AMH) levels and possibly, your ovarian reserve.


The best bet if you are planning a pregnancy and actively trying is to take a break from alcohol and let your hormones do their job!

Click here to read more about how alcohol can affect your fertility.

To boost your chances of pregnancy and increase fertility, it’s important that you practise good preconception care for at least 3 months before attempting pregnancy. This includes taking a folic acid supplement, eating a balanced diet, regular exercise, stopping smoking, cutting out alcohol, and consulting your GP or clinician if you have an underlying health condition.


If you are on your fertility journey with a male partner, it’s important that both partners practise good preconception care as having both good quality eggs and sperm will increase fertility.

Taking folic acid to prepare your body for pregnancy will greatly reduce the risk of your baby developing neural tube defects, like spina bifida. Some research suggests folic acid may also increase fertility

No, neither the combined pill or the progesterone-only pill will affect your fertility. Once you come off the pill, your cycles will go back to what was normal for you, and you should start ovulating again. In some cases, people have gotten pregnant immediately after coming off the pill.


However, If you do not get your period or your cycles are consistently irregular three months after coming off the pill, you should see your GP as it could be a sign of an underlying reproductive health condition which may affect fertility.

STIs are very common and often show no symptoms, which is why they might go undiagnosed. If they are left untreated or you get repeated infections, some common STIs such as chlamydia and gonorrhoea can lead to a condition called pelvic inflammatory disease (PID) which has been linked to fertility issues.


Untreated STIs can also lead to negative pregnancy complications such as miscarriage and premature birth.

No, masturbation will not impact your fertility in any way. Unlike some mammals like rabbits, humans ovulate spontaneously, meaning they don’t need to have sex or be aroused in order to trigger ovulation.


Although it may not increase fertility, there is also no scientific evidence to show that it can have any negative effect on fertility or cause infertility. In fact, self-pleasure can have many benefits including stress relief, better sleep, reduction in period cramps and better self esteem to state a few.

About the Author

tharni author

Written by

Dr Tharni Vasavan, BSc (hons), MSc, PhD

Medically reviewed by

Dr. Ben or Srdjan

Published 09.05.22.

Last medically reviewed 09.05.22

References

Infertility, NHS (2020): https://www.nhs.uk/conditions/infertility/

FAQs about infertility, ASRM: https://www.reproductivefacts.org/faqs/frequently-asked-questions-about-infertility/q01-what-is-infertility/

Irregular periods, NHS (2021): https://www.nhs.uk/conditions/irregular-periods

Menopause, Kimberly Peacock; Kari M. Ketvertis (2022): https://www.ncbi.nlm.nih.gov/books/NBK507826/

Age Related Fertility Decline, Amy Owen; Paul B. Sparzak (2021): https://www.ncbi.nlm.nih.gov/books/NBK576440/

PolyCystic Ovary Syndrome, NHS (2019): https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/

Naz et al. (2020) The Menstrual Disturbances in Endocrine Disorders: A Narrative Review. Int J Endocrinol Metab 18(4). https://pubmed.ncbi.nlm.nih.gov/33613678/

Stopped or missed periods, NHS (2019): https://www.nhs.uk/conditions/stopped-or-missed-periods/

Why does sex hurt? NHS (2021): https://www.nhs.uk/common-health-questions/sexual-health/why-does-sex-hurt/

Infertility treatment, NHS (2020): https://www.nhs.uk/conditions/infertility/treatment/

Infertility: Scenario: Management of infertility, NICE (2018): https://cks.nice.org.uk/topics/infertility/management/management/

Explore fertility treatments, HFEA (2022): https://www.hfea.gov.uk/treatments/explore-all-treatments/

Abortion, NHS (2020): https://www.nhs.uk/conditions/abortion/

Miscarriage, NHS (2022) https://www.nhs.uk/conditions/miscarriage/

How common is misscarriage? Tommy’s: https://www.tommys.org/pregnancy-information/im-pregnant/early-pregnancy/how-common-miscarriage

Miscarriage Statistics, Tommy’s: https://www.tommys.org/baby-loss-support/miscarriage-information-and-support/miscarriage-statistics#general

Van Heerum et al (2017) Alcohol and fertility: how much is too much? Fertil Res Pract 3:10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504800/

Angelis et al (2020) Smoke, alcohol and drug addiction and female fertility. Reprod Biol Endocrinol. 18:21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069005/

Planning your pregnancy, NHS (2020): https://www.nhs.uk/pregnancy/trying-for-a-baby/planning-your-pregnancy/

How can I improve my chances of becoming a dad? NHS (2020): https://www.nhs.uk/common-health-questions/mens-health/how-can-i-improve-my-chances-of-becoming-a-dad/

Gaskins et al (2019) Diet and fertility: a review. Am J Obstet Gynecol. 218(4): 379-389. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826784/

Causes of infertility, NHS (2020): https://www.nhs.uk/conditions/infertility/causes/

Getting pregnant and sexually transmitted infections (STIs), Tommy’s: https://www.tommys.org/pregnancy-information/planning-a-pregnancy/are-you-ready-to-conceive/getting-pregnant-and-sexually-transmitted-infections-stis

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