Understanding Fertility and Pregnancy

The menstrual cycle is the monthly hormonal cycle that prepares the female body for the chance of pregnancy. This process is controlled by hormones like estrogen and progesterone, which increase and decrease through the phases of this cycle. On average, the menstrual cycle lasts 28 days; although, it may be shorter, longer or irregular in some individuals. Particularly if the menstrual cycle is irregular (or inconsistent), it can be more challenging to understand when is the proper time to conceive.

Our team respects and supports each individual’s gender identity and preferred pronouns. The use of gender-specific terms to explain the menstrual cycle is for editorial clarity and consistency only.

Menstruation: Days 1 to 6

The menstrual cycle begins when the lining of the uterus sheds, causing a flow of blood from the body through the vagina. This is commonly called a woman’s “period,” and it only happens if she is not pregnant. The first day of a woman’s period is Day 1 of her menstrual cycle.

Follicular Phase: Days 6 to 14

Following the period, hormone levels rise. As this happens, the lining of the uterus thickens and a fully mature egg develops in one of the ovaries.

Ovulation: Day 14

Now that the newly developed egg is mature, it’s released from the ovary and gets taken up into one of the fallopian tubes.

Luteal Phase: Days 15 to 28

The egg travels through the fallopian tube to the uterus. While the egg is in the fallopian tube, there is a possibility that it may become fertilized by (or joined with) a sperm. This is the first step in pregnancy.

However, if the egg is not fertilized, the woman is not pregnant. The menstrual cycle starts over, hormones decrease and the uterine lining sheds again during the woman’s next period.

Sexual intercourse leads to pregnancy when an egg and sperm meet in the fallopian tube and the resulting fertilized egg (embryo) successfully becomes implanted in your uterus. Many of us have been told that getting pregnant is easy and that simply having sex ensures that an egg will be fertilized. However, in addition to timing, there are many health factors in males and females that play a role in determining whether or not a sperm can find and fertilize an egg. Furthermore, there are additional factors that help determine whether a fertilized egg can successfully become implanted in the uterus for a viable pregnancy.

If you’re having regular intercourse and you’re not getting pregnant, your doctor can conduct an evaluation and order tests to help figure out exactly why. Additionally, for people who are not able to conceive through sexual intercourse, intrauterine insemination (IUI) and in vitro fertilization (IVF) are common options for getting pregnant.

One way to improve your chances of getting pregnant, and often one of our first suggestions, is to try timed intercourse. This means having sexual intercourse near the time of ovulation — generally a few days before ovulation and on the day of ovulation. Since sperm can survive roughly five days traveling through the vagina, uterus and fallopian tubes, the goal is to narrow down the days when a sperm is most likely able to find and fertilize your or your female partner’s egg.

Your doctor can help you understand how to track the menstrual cycle and identify your target window for timed intercourse. Some common options include using a calendar or an app that estimates when ovulation may occur, or using an ovulation predictor kit.

To further increase your chances of getting pregnant through timed intercourse, your doctor may also prescribe fertility medication to help the ovaries mature more eggs and/or trigger the ovaries to release the egg into the fallopian tube.