Patient Factsheet teaser

Optimizing Natural Fertility

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Revised 2023


What can I do to improve my chances of getting pregnant naturally?

Before attempting pregnancy, an individual should make sure one is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. Regarding all supplements, there is no scientific evidence currently promoting their use in enhancing fertility. If one has a medical or genetic condition (or is at risk for one), one should seek advice from a medical professional before conceiving (becoming pregnant).

What are my chances of conceiving?

While there is no simple way to answer this, the two most key factors influencing the success of conception are the age of the individual and the number of months one and their partner have been trying to become pregnant. Young people with female reproductive anatomy with regular menstrual cycles have a 20 to 37% chance of becoming pregnant within the first 3 months, an 80% chance after one year, and a 90% chance after two years.

People with female reproductive anatomy over the age of 35 and individuals with male reproductive anatomy over the age of 50 tend to have lower fertility rates and higher rates of complicated pregnancies.

How often should a couple have intercourse?

The highest pregnancy rates are seen when partners have intercourse every 1 to 2 days during the fertile window. Surprisingly, lengthy periods of abstinence (not having intercourse) can decrease the quality of sperm. Infrequent intercourse may decrease the chance that intercourse will happen around the time of ovulation.

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What is the fertile window?

The fertile window is the time in a cycle when pregnancy can occur. It is usually the 6 days just before the day of ovulation. Ovulation occurs around 14 days before the next menstrual period, so an individual with a 28-day cycle will ovulate around cycle day 14 (that is, 14 days after the start of their last menstrual period). That means that pregnancy is most likely to happen if intercourse occurs within the 6 days right before the day of ovulation.

How do I know when I am ovulating?

Because the fertile window is set by the day of ovulation, it is important to know when an individual is ovulating. There are several methods of determining ovulation. Cervical mucus and vaginal secretions start to increase 5 to 6 days prior to ovulation and peak 2 to 3 days before ovulation. These changes can be monitored to identify the fertile window in many individuals and can even be tracked using smartphone applications. Additionally, there are modern applications specifically designed for tracking ovulation, leveraging current technology to provide accurate and user-friendly monitoring. Urinary ovulation predictor kits can also be used to detect the rise in luteinizing hormone (LH) that happens just before ovulation. LH is the primary trigger that results in the eggs being released from the ovary (see ASRM fact sheet titled “Am I ovulating?”).

Are there (intercourse) practices that can improve our chances of conceiving?

Sperm ejaculated or released into the vagina reach the fallopian tubes within minutes regardless of position during intercourse. There is no evidence that sexual position, orgasm, or prolonged rest after intercourse increases the chance of conception. Some lubricants (Astroglide®, KY® Jelly, KY® TouchTM, saliva and olive oil) used during intercourse may decrease sperm motility (movement) or survival. This should be avoided if possible. Others (Pre- Seed®, mineral oil or canola oil) have no such effect and can be used as needed.

Fertility is decreased in people with female reproductive anatomy who are very thin or obese, but there is no evidence that normal diet variations affect individuals who are of normal weight (body mass index 19-25) and having regular periods. The one exception is that a diet rich in mercury (found in some seafood) is associated with infertility.

Does diet affect fertility?

Smoking, heavy alcohol consumption (> 2 drinks per day), heavy caffeine consumption, and the use of recreational drugs such as marijuana have all been associated with reduced fertility. Therefore, individuals considering pregnancy should reduce alcohol and caffeine use and avoid smoking and all recreational drugs while trying to conceive.

Are there reasons to see a healthcare professional sooner rather than later?

Some individuals or couples have a health history that warrants consulting a healthcare professional either before or early in the process of trying to get pregnant. These warrants include:

Menstrual and Ovulatory Health

  • Irregular or no menstrual periods
  • Negative luteinizing hormone tests for ovulation

Sexual Health History

  • History of sexually transmitted infection

Pelvic and Abdominal Health

  • Prior pelvic or abdominal surgery for any reason

Previous Infertility History

  • Prior history of infertility

Partner’s Reproductive Health

  • Known problems with the testicles or genitals
  • Hypospadias (opening of the urethra not in the end of the penis)
  • Sexually transmitted infection
  • Problems with ejaculation
  • Prior history of infertility

Fact Sheets/Booklets

View more fact sheets and booklets written by the ASRM Patient Education Committee.
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Menopausal Transition (Perimenopause): What Is It?

The menopausal transition (perimenopause) is the period that links a woman’s reproductive (childbearing) years and menopause.
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Osteoporosis

Osteoporosis and osteopenia are conditions of having low bone mass (density).
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Hyperprolactinemia (High Prolactin Levels)

Prolactin is a hormone produced by your pituitary gland which sits at the bottom of the brain.
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Stress and infertility

It is not clear how exactly stress impacts fertility.

Resources For You

The American Society for Reproductive Medicine (ASRM) is committed to providing patients with the highest quality information about reproductive care.

Infertility

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SART Fertility Experts - Military Families and Fertility

Active-duty individuals in the military sometimes face unique circumstances when seeking fertility care. Learn more with a former military fertility physician. Listen to the Episode
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SART Fertility Experts - Q&A on Infertility

Infertility can create many questions for a patient.  Listen to common questions and answers about infertility, egg freezing, and genetic testing.   Listen to the Episode
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Fertility Care Gets Important Win in California

ASRM celebrates California's SB 729, expanding IVF coverage for same-sex couples and singles, advancing equitable fertility care access.

View the Press Release
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National Infertility Awareness Week

April 20-26, 2025, is National Infertility Awareness Week (NIAW)! 

View the NIAW Toolkit
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ASRM announces support for HOPE with Fertility Services Act

The American Society for Reproductive Medicine is proud to endorse the HOPE with Fertility Services Act (HR 8821).

View the Press Release
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SART Fertility Experts - Environmental Impacts on Fertility

In this episode, the fertility experts discuss the impact of the environment, including air, climate, and chemical exposures on infertility.   Listen to the Episode
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SART Fertility Experts - Recurrent Pregnancy Loss and Implantation Failure

"I can get pregnant, but I can't stay pregnant," is echoed by patients with recurrent pregnancy loss.   Listen to the Episode
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SART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise

Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the Episode
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SART Fertility Experts - Navigating IVF as a Couple

Mary Casey Jacob, PhD is interviewed by Dr. Daniel Grow, and together they explore the emotional and practical support that couples need. Listen to the Episode
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Male Fertility Journey

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.

View the Patient Journey
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Female Fertility Journey

If you've been trying to get pregnant for more than a year, you may have infertility. Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.

View the Patient Journey
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Stress and infertility

It is not clear how exactly stress impacts fertility. Read the Fact Sheet
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Hyperprolactinemia (High Prolactin Levels)

Prolactin is a hormone produced by your pituitary gland which sits at the bottom of the brain. Read the fact sheet
Patient Ed Icon

Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheet
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Optimizing Male Fertility

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors. View the fact sheet
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Defining Infertility

Infertility is “the inability to conceive after 12 months of unprotected intercourse.” View the Fact Sheet
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Fertility Rights and Responsibilities

Can a fertility program or clinic deny treatment to patient(s) if there is concern about the ability to care for the child(ren)? Yes. Fertility programs can withhold services if there are signs that patients will not be able to care for child(ren). View this Fact Sheet
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Male Fertility Evaluation: What do I need to know?

Infertility is the inability to achieve pregnancy after one year of unprotected sex. View the fact sheet
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Smoking and infertility

Most people understand that smoking increases the risk for heart, vascular, and lung disease. View the fact sheet
Patient Ed Icon

What are fibroids?

Uterine fibroids (also called myomas or leiomyomas) are benign (noncancerous) tumors of muscle tissue found in the uterus. View the fact sheet
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Infertility Counseling and Support: When and Where to Find It

Infertility is a medical condition that touches all aspects of your life. View the fact sheet
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What is In Vitro Maturation (IVM)?

In vitro maturation (IVM) is when a woman’s eggs are collected and matured outside the body. This is done as part of an in vitro fertilization (IVF) procedure. View the fact sheet
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SART Fertility Experts - Endometriosis

Endometriosis is a condition that can affect many facets of a person’s life, from pelvic pain to struggles with infertility.   Listen to the Episode
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SART Fertility Experts - Recurrent Pregnancy Loss

Candace discusses her experience with infertility, IVF, multiple pregnancy losses and ultimately a successful delivery with Dr. Julia Woodward.
Listen to the Episode
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SART Fertility Experts - Financial Aspects of Infertility Treatment

“I know what treatment I want and need to do, but how can I afford it?”  This is a common question infertility patients often ask themselves. Listen to the Episode
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SART Fertility Experts - Infertility Advocacy and Government Affairs

In today's episode, Dr. Mark Trolice interviews Sean Tipton about the fact that many infertility patients do not have insurance coverage for treatment. Listen to the Episode
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SART Fertility Experts - Your Infertility Nurse: Partner in Your Care

Infertility nurse practitioner and health coach Monica Moore explains the essential role of the infertility nurse in the IVF process.  Listen to the Episode
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Intracytoplasmic sperm injection (ICSI)

A procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) if a sperm cannot penetrate the outer layer of an egg. Read the Fact Sheet
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SART Fertility Experts - IVF: Cycles of Hope and Heartbreak

Does stress cause infertility or is it the other way round?  Listen to the Episode
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SART Fertility Experts - RESOLVE and Infertility

Due to the unique stress of infertility, patients often look for resources and support in addition to those provided by their medical provider. Listen to the Episode
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What is Recurrent Pregnancy Loss (RPL)?

This is a condition when a woman has 2 or more clinical pregnancy losses (miscarriages) before the pregnancies reach 20 weeks. View the fact sheet
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What is Premature Ovarian Insufficiency (Previously Called Premature Ovarian Failure)?

When a woman’s ovaries stop working before age 40, she is said to have premature ovarian insufficiency (POI).  View the fact sheet
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Saline infusion sonohysterogram (SHG)

Saline infusion sonohysterography (SIS or SHG) is aprocedure to evaluate the uterus and the shape of the uterine cavity. View the fact sheet
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SART Fertility Experts - Safe Surfing: The Pros and Perils of Social Media

Dr. Kenan Omurtag, MD joins host Dr. Mark Trolice to discuss the use of social media in the field of infertility.  Listen to the Episode
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SART Fertility Experts - What is an REI?

These experts in infertility lead IVF programs, perform reproductive surgery, and perform research to enhance the field of reproductive medicine. Listen to the Episode
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Stress and Infertility

Medical procedures, cost, outcome uncertainty, and unwanted or unhelpful advice from friends and family are stressors associated with infertility treatment. Watch Video
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Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
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Male Fertility and Infertility - a patient education video

Male Factor Infertility is responsible for about 30% of infertility cases and can contribute infertility to an additional 20% of cases. Watch Video
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Infertility

Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.  Watch Video
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Basic Infertility Evaluation

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch Video
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Fibroid Tumors

An educational video that answers patient questions about the causes, symptoms, diagnosis and management of uterine fibroids. Watch Video
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Infertility Treatments

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch Video
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Understanding Fertility

In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch Video
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Surviving the Roller Coaster Emotions of Infertility Treatment

The experience of infertility is a rollercoaster of hope and disappointment. Treatment presents an opportunity for hope as well as a new set of challenges. Watch Video
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Acupuncture and Infertility Treatment

Acupuncture is an alternative medical treatment that involves placing very thin needles at different points on the body. View the Fact Sheet
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Sexual dysfunction and infertility

Sexual dysfunction is a problem in a person’s sexual desire, arousal, or orgasm. View the fact sheet
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Coping With Infertility

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses various methods of coping with infertility. Watch Video
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Endometriosis

Endometriosis is a condition in which endometrial tissue, which normally lines the uterus, develops outside of the uterine cavity in abnormal locations. Watch Video
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Causes of Female Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of female infertility. Watch Video
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Age and Fertility (booklet)

Generally, reproductive potential decreases as women get older, and fertility can be expected to end 5 to 10 years before menopause. View the Booklet
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Causes of Male Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of male infertility. Watch Video
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FAQ About Infertility

Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the facts
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FAQ About the Psychological Component of Infertility

Infertility often creates one of the most distressing life crises that a couple has ever experienced together. Learn the facts
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Mary Dolan's Story

I was diagnosed with diminished ovarian reserve/premature ovarian failure at 28 years old.
Read the story
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Infertility Infographics

ASRM has prepared infographics to illustrate the subject of Infertility better. View the infographics

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