Infertility: What it takes to get pregnant

By Dr. Andrea Hilborn, ND

In order to conceive, there are a few things that need to be in place: you need to be ovulating, you need to produce fertile quality cervical mucous, your hormones need to prepare your body to sustain a conception and you need to time intercourse correctly. The man in the equation needs to have sperm in his semen.

Ovulation is when a 'ripe' egg cell is released from the ovary and begins its journey from the ovary, down the fallopian tube to the uterus. Fertilization of the egg can happen at any point along the fallopian tube.

When ovulation doesn't happen quite right, it's called 'ovulatory dysfunction'. It accounts for up to 20-40% of infertility in women.

The first clue that someone may be experiencing ovulatory dysfunction is if the person has fewer periods than is normal (oligomenorrhea), or doesn't have periods at all (amenorrhea). Some common causes are polycystic ovarian syndrome, obesity, weight gain/loss, strenuous exercise, and thyroid dysfunction.

There are 3 different types of ovulatory dysfunction: your brain not secreting enough hormones to stimulate your ovaries (rare), the polycystic ovarian syndrome spectrum (common) and 'ovarian failure' (very rare).

If you don't have a period at all, you definitely aren't ovulating. Nonetheless, tracking your cycle can be useful to detect changes as you undergo treatment.

Testing for fertile cervical mucous is an under-explored realm in fertility treatment. Currently, self-monitoring is the only test available, but don't underestimate it just because it is low-tech. Monitoring cervical mucous can provide a lot of information.

Hormone levels can be monitored through urine and blood. Tracking basal body temperature and cervical mucous can also give information about hormone levels.

Learning when to time intercourse is important. In any menstrual cycle, a woman is only fertile around the time of ovulation because an egg cell only lives for up to 24 hours after being released from the ovary.

In fertile quality cervical mucous, sperm can survive for up to 5 days. The combination of the woman's fertility and the man's fertility mean that conception can occur 5 days after intercourse, but only up to 24 hours after the release of an egg. (Sometimes two eggs are released, so the woman could be fertile for up to 48 hours).

Tests for various qualities of semen and sperm abound. The most important question is: does the man's semen contain any sperm or no sperm? The most basic semen analysis will detect this. There are even home test kits now.

With ovulation, fertile quality cervical fluid, proper timing of intercourse and fertile semen, all the elements come together to allow conception!