Fertility and cycle
The cycle and its disorders, the fertile window, preparing for a pregnancy and the point at which further assessment makes sense.
Most couples who want a child need no medicine for it – only time and a realistic picture of when in the cycle a pregnancy can arise at all. In very few women does ovulation fall on day 14. This overview sorts what you can do yourself, what you should prepare and when waiting is no longer the best strategy.
The fertile window spans six days: the five before ovulation and the day of ovulation itself, because sperm survive up to five days but the egg only one. Where that window lies depends on your cycle length – the second half of the cycle is the same length in almost every woman, the first half is not. The ovulation calculator works out the window and your next six cycles from your cycle length. How a cycle works, what disturbs it and what cycle apps can and cannot do is explained in Cycle and conception.
Preparation begins before conception: folic acid from four weeks before you stop contraception, not only when the test is positive; check your immunity to rubella and chickenpox; review thyroid values, weight and medication. Which examinations make sense before a pregnancy is shown by the screening planner.
When assessment makes sense. After twelve months of regular intercourse without contraception – from 35, after six. Not out of impatience, but because fertility falls with age and the commonest causes are easy to find: cycle disorders, polycystic ovary syndrome, a thyroid disorder, and in about half of cases part of the cause lies with the man. That is why a semen analysis belongs in from the start.
What happens at the practice. Consultation, ultrasound of the uterus and ovaries, cycle monitoring, hormone tests, screening for infection – and, where needed, referral to a fertility centre with findings that do not have to be repeated there. The practice is a private (Wahlarzt) practice; the amounts are listed under Fees. Make an appointment.
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Frequently asked questions
How long does it normally take to become pregnant?
Among couples under 35, about one in three conceives in the first month and a good eighty in a hundred within a year. From 35 these figures fall noticeably – hence the shorter wait before assessment.
On which days is the chance highest?
On the two days before ovulation. Intercourse every two to three days across the whole window is simpler and just as effective as hitting the one day – and takes the scheduling stress out of it.
Do I have to take folic acid?
Yes, 400 micrograms a day, starting at least four weeks before conception and continuing to the end of the first trimester. It reduces the risk of neural tube defects by more than half – but only if taken in time.
When is an irregular cycle a problem?
If it is shorter than 21 or longer than 35 days, if periods are missed or if the length varies greatly from cycle to cycle. Then there is often no regular ovulation, and that can be assessed and usually treated.
What can I do after a miscarriage?
At first nothing, except give yourself time. A single miscarriage is common and says nothing about the next pregnancy; a new attempt is possible after the next period. Only from the third in a row is targeted assessment worthwhile.