Dear Dr. Maslow,

My wife and I would like to start a family soon. I hear terms like “the fertile window” and abbreviations like TTC and OPK, and I’m embarrassed to say that I’m totally clueless! I know we learned this in biology once, but putting it into real life feels very confusing. Searching the web for advice has led us in circles. What can we do to maximize our chances of success?

Dear Fertile Window Pain,

Congrats on taking this exciting step in your relationship! Thinking about trying to conceive (TTC) can be daunting. While there are many variables to consider, remember that most couples will successfully conceive without special interventions, even ovulation predictor kits (OPK). So, it may be best not to let yourself get too concerned at this juncture. That being said, understanding the fertile window and ovulation is a crucial aspect of optimizing your chances of conception and one that can undoubtedly be confusing.

The fertile window refers to the timeframe during which a woman has the highest chance of achieving a pregnancy. It typically spans a few days around ovulation, when the egg is released and available for fertilization. To maximize your chances of conception, it’s important to identify this window accurately. Start by tracking the menstrual cycle to identify patterns and estimate the length of the cycle. Day 1 is the first day of the period, and the cycle ends just before the start of your next period. Note that cycles may vary in length from person to person.

In a natural cycle, the egg will grow and mature as it leads to ovulation. When it’s ready, the brain will signal the ovary to release the egg with the “Luteinizing Hormone Surge” or LH surge, which detects ovulation. This hormone surge can be tracked using the OPK kits previously mentioned. Ovulation will precede the next period by approximately 14 days. In a typical 28-day cycle, ovulation may happen around day 14. However, it’s essential to remember that cycles can vary. For example, someone with a 36-day cycle likely ovulates closer to day 22, and someone with a 24-day cycle may ovulate as early as day 10. This is especially important to note for couples who observe the laws of taharat hamishpacha. If ovulation occurs before the mikvah, I recommend speaking with a rabbi and a physician.

In addition to tracking cycles, some women experience physical symptoms like increased cervical mucus, mild pelvic pain, or breast tenderness during ovulation. This may be a less intense method of helping identify the “fertile window.” As mentioned above, ovulation predictor kits (OPKs) can help, but they aren’t effective for everyone, and many find them cumbersome or stressful. In addition, fertility tracking apps can also help depending on what information they are tracking.

Once you’ve identified your fertile window and potential ovulation date, there are several steps you can take to maximize your chances of achieving pregnancy. Studies have shown that having sperm present in the reproductive system within the 48-72 hours before ovulation leads to the highest chance of conception, with the day of ovulation and the day after having slightly lower but still good chances for about 48 hours following ovulation. At that point, the “fertile window” essentially closes for that cycle.

Remember that many factors besides timing can impact success on any single cycle. This is why individual cycle pregnancy rates are much lower than most people think. Even in young couples (when the female partner is >35), only about one out of every 4-5 couples attempting conception will succeed in any given cycle. Approximately 80% of these couples will become pregnant in 6-12 cycles though, so it may take a few tries!

Generally, you do not need to drastically alter your diet or lifestyle to conceive successfully, but trying to maintain a balanced diet, healthy levels of exercise, and good sleep habits are always helpful. Most significant restrictions you read about online are excessive and unnecessary (you have my permission to enjoy that morning coffee while you are TTC). I recommend avoiding smoking, excessive alcohol consumption and illicit drugs, not only for female partners but particularly for men, as these can adversely impact male fertility.

If you’ve been trying to achieve pregnancy for a while without success, consider consulting with a fertility specialist. They can provide personalized guidance, conduct fertility tests, and explore potential underlying factors hindering conception.

Understanding the fertile window and ovulation is vital for couples trying to achieve pregnancy. By tracking menstrual cycles, adjusting timing for cycle length, and paying attention to ovulation signs, you can better identify the most fertile days. Remember to time intimacy accordingly and maintain a healthy lifestyle. And if you encounter challenges, don’t hesitate to seek professional assistance. Wishing you the best of luck on your journey to parenthood!

Dr. Bat-Sheva L. Maslow, MD, MSCR, is a reproductive endocrinologist and an expert on the intersection of reproductive medicine and Jewish life. To schedule an appointment with her at Reproductive Medical Associates (RMA) of New Jersey’s Englewood or the brand-new Jersey City location, visit www.rmanetwork.com/NJ. If you are interested in inviting Dr. Maslow to speak in your community or to learn more about her educational projects, visit www.batshevamaslow.com  and @blmaslowmd on Instagram.