Trying to conceive? Join the club!

For most couples trying to conceive, the odds that a woman will become pregnant are 15% to 25% in any particular month. For couples over the age of 35, the average period of time it takes to get pregnant is 1-2 years. 

As many American couples choose to marry and have children later in life, things like financial stability and emotional maturity might increase, but the chances of getting pregnant, right away, might decrease.

When we’re in high school, we’re often taught that if a man and a woman have intercourse without some form of birth control, they will automatically get pregnant. While this is true for many, and certainly an important safeguard against unwanted pregnancies, it can also create some misconceptions around conception. The truth is, fertility is much more complicated than that, and we are only beginning to understand the many factors that lead to whether or not pregnancy occurs. 

This article outlines four surprising facts about fertility that many people do not realize until they are trying to conceive. Through a better understanding of what we know thus far about the science of fertility, we can empower ourselves to avoid some of the emotional pitfalls that come from trying to conceive and not getting pregnant right away. 

Trying to Conceive: A Silent Struggle

There are many reasons why so many people have unrealistic ideas of what it takes to get pregnant. 

First of all, talking about fertility naturally includes talking about sex, which is something that is often missing from our cultural conversation, at least in this context. It’s important to remember that the origins of American culture are rooted in puritanical, religious mores which tend to shun conversations about sexuality. There is also still, in some circles, a great deal of shame associated with sex, particularly when you’re having trouble conceiving. 

The truth is, the fertility journey is something that is not often talked about publicly. It is often a private journey that many people go through alone. Many suffer in silence, and are prone to experiencing depression, anxiety, low self-esteem, and stress.  

Fertility is an incredibly complex topic, and science is only beginning to understand the factors that contribute, or not, to conception. As an example, 30% of people who are trying to conceive are diagnosed with “unexplained infertility” (more on this below); this basically means that everything appears to be functioning normally physiologically, but for some reason, conception is not occurring. 

Finally, we often only hear about the success stories when it comes to getting pregnant. We don’t often hear about the stories of couples who are trying, month after month, year after year, to get pregnant. Often, “we got pregnant right away,” is the story that spreads far and wide, because it’s the story that a couple is more likely to share. So, our understanding of reality can become distorted based on this unequal distribution of storytelling around trying to conceive, and fertility. 

4 Surprising Facts About Fertility

While many people do, in fact, get pregnant right away with ease, the popular notion of unprotected sex immediately leading to pregnancy can cause stress and heartbreak among those who are trying to conceive. 

Below are a few interesting facts about fertility that can help give us a more realistic understanding of what actually happens when you are trying to conceive. 

1. Fertility Declines With Age, But Not As Dramatically As We Think

For many, this is a sensitive topic. But the truth is, based on what we do know about fertility thus far, women are most fertile between the ages of 15-24, the next most fertile between 25-29, then 30-34, 35-39, and finally 40-44. 

While male fertility is also impacted by age and can increase risks of birth defects, a man’s “window of opportunity” is suspected of being more forgiving. 

Two important things to keep in mind about this truth when it comes to women’s fertility:

1. It’s not like once a woman turns 35, her ovaries fall off a cliff. Rather than a steep decline, there is more of a natural, consistent downward slope until a woman reaches menopause. 

2. This, by no means, means that you cannot get pregnant in your late 30’s and 40’s–– it just means that your chances of conceiving are slightly less each cycle, so it might take more time to get pregnant than it would have if you were 20 years old. 

If a woman starts trying to conceive when she is 38, for instance, awareness about her age may increase stress and worry when she does not get pregnant right away. While she may have a shorter window period than she did in her teens and twenties, a healthy dose of patience can most likely serve her well, rather than giving into the fear that it’s “too late.” 

After all, with medical advancements, more and more women are having healthy children well into their 40’s and even their 50’s.

2. Hormones and Ovarian Reserves Do Not Necessarily Predict Whether Or Not You Can Get Pregnant

In the past decade, fertility has developed into a booming market. Many egg-freezing centers and fertility clinics have opened up to support people on their journey towards parenthood. While they certainly serve an essential purpose, new studies have revealed one of the key indicators which were previously thought to detect fertility–– the number of eggs in a woman’s ovarian reserve–– is actually not correlated with achieving pregnancy. 

These findings were published in 2017 in the Journal of the American Medical Association, after 750 women between the ages of 30-44 years who were struggling with fertility were tracked for correlations between ovarian reserve counts and pregnancy success.

They conclude: 

“Among women aged 30 to 44 years without a history of infertility who had been trying to conceive for 3 months or less, biomarkers indicating diminished ovarian reserve compared with normal ovarian reserve were not associated with reduced fertility. These findings do not support the use of urinary or blood follicle-stimulating hormone tests or antimüllerian hormone levels to assess natural fertility for women with these characteristics.”

It’s important to keep in mind that if, however, a woman decides to undergo in vitro fertilization (IVF) treatments to conceive, these factors are, in fact, relevant. As the study above notes, “Among women with infertility undergoing controlled ovarian hyperstimulation for in vitro fertilization, the AMH [anti–Müllerian hormone] is an excellent predictor of oocyte yield” 

So what does this tell us? Even though a woman’s egg count decreases with age, the total number of eggs she has in her ovaries does not indicate whether or not she will get pregnant. In other words, it only takes one!

3. One-Third Of Infertility Cases Are “Unexplained”

When couples are trying to conceive but have trouble getting pregnant, both partners can go down a rabbit hole of assuming it is their fault, or their partner’s fault, or a mixture of both. Some people assume infertility is because of the female, while others may blame the male. 

The truth is, approximately one-third of infertility cases are attributed to the female partner, one-third are attributed to the male partner and one-third are caused by a combination of problems in both partners or, is unexplained.

After extensive testing, about one-third of couples will find that both their male and female biological functions are seemingly fine, and therefore their infertility is “unexplained.”

So what does all of this tell us? Well, it shines a light on how much we still don’t know when it comes to fertility. How can everything be functioning normally (biologically), but for some strange reason, conception doesn’t occur? How can it occur with medical intervention, or spontaneously, months or years down the road with a little bit (or a lot of) patience? These are the types of questions that leave many couples who are trying to conceive, and their doctors, scratching their heads. 

4. Infertility Doesn’t Mean You Can’t Get Pregnant

When couples have been trying to conceive for at least a year without sustaining a successful pregnancy, they are technically diagnosed as being “infertile.” (For couples above 35 years of age, it’s 6 months). 

For many couples who are trying to conceive, this can seem like a daunting diagnosis. Technical definitions of infertility can even go so far as labeling it as a “disease.” While this may assist with insurance coverage, for many, it can also instill a sense of fear and finality in the diagnosis. Many times, this can contribute to stress, which is understood to further delay the chances of getting pregnant. 

For this reason, many people on their fertility journey choose to use the language of “trying to conceive” (or TTC, for short), instead. 

In actuality, “trying to conceive” might be more appropriate language to use, anyway. Between patience, diet and lifestyle adjustments, complementary therapies, and of course the suite of conventional medicine options including pills to stimulate ovulation, intrauterine insemination (IUI), in-vitro fertilization (IVF), sperm and egg donors, and surrogates;  the vast majority of couples who embark on the journey of parenthood can, eventually, get pregnant. According to the National Institute of Health, 85% to 90% of cases can be treated with conventional medical therapies, such as medication or surgery.

Trying to Conceive: A Reality For More And More People

It’s true–– many people are choosing to have children later in life, and/or that’s just the way life unfolds. For these reasons, and many others, the overall fertility rate in the U.S. has been steadily declining, and actually hit an all-time low in 2018 at 2.1%. The positive news is that this reflects a lower teen birth rate, and is actually more on par with our economic peers, worldwide. 

So if you are trying to conceive, despite what all of your friends’ and family’s Facebook feeds and baby shower invitations might indicate–– you are not alone. 

Our culture is changing in many ways. Yes, we give birth later in life than in previous years, but we also might have increased access to financial stability and maturity than we would have had earlier. The good news is that, every day, we are learning more and more about the mystery of our own fertility, and there is still so much that is not understood. 

For “Type A” types, trying to conceive can be a difficult and mystifying journey. They may be accustomed to settling a goal, working hard toward that goal, and generally achieving it— but  fertility seems to play by a different set of rules. Of course, there are many things we can do to improve our chances of conceiving, but the reality is that conception is dependent on so many complex variables, that much of it is out of our hands. However, as the research indicates, with a lot of patience and willingness to make adjustments and/or seek various treatments, most couples who are trying to conceive can eventually find themselves with children–– one way or another. 

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