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Conceiving

Be well prepared

Studies have shown that couples who are well-prepared while trying to conceive have higher chances of producing a healthy child (and later, a healthy adult). Fourteen weeks before conception, the oocytes and sperm cells that may result in a child are produced. During this period, less than ideal circumstances may influence the development of both oocytes and sperm cells. This means that, even before you get pregnant, imperfect circumstances can affect your chances of a successful pregnancy and a healthy baby.

A thorough preparation includes being aware of your lifestyle. Are there any factors in your lifestyle that can influence your chances of (successful) pregnancy? Examples of this would be smoking, use of alcohol, diet, use of folic acid and your weight. Have children in either your family or your partner’s been born with congenital defects? If yes, this may indicate hereditary issues in your family. If you’re suffering from an infectious disease (such as HIV or Hepatitis), or a chronic illness (such as diabetes, high blood pressure or epilepsy), or you’re using certain medications, it might be a good idea to ask your general practitioner or gynecologist for advice before attempting to conceive.

We refer you to the following websites: 

Both of these websites were developed by the Erasmus Medical Center, located in Rotterdam. On them, you’ll find a questionnaire relating to all the factors that may be having an influence on your chances of conceiving and sustaining a successful pregnancy.

In order to conceive, several factors are necessary. These will be highlighted below.

  • Ovulation is necessary, and a mature oocyte must be released during it.
  • Sperm cells that are capable of fertilizing the oocyte.
  • A uterus where the pregnancy can develop.
  • Traversable fallopian tubes
  • Intercourse during the fertile period


Ovulation

In most cases, ovulation takes place once a month, 10-14 days before menstruation starts. In order to have a shot at conceiving every month, it’s important that you ovulate every month. A regular menstrual cycle should take between 21 and 35 days and is regulated by different hormones. The hormone known as FSH (follicle stimulating hormone) stimulates the maturing of an oocyte inside an ovary. That oocyte develops inside a follicle (a small sac containing the oocyte), which grows as the oocyte matures. A maturing oocyte produces the hormone estrogen.

Estrogen is needed for a number of things: 

  • It causes the endometrium to build up inside the uterus (this is where a fertilized oocyte will lodge);
  • When estrogen levels rise, less FSH is produced (this means that usually, only one oocyte will mature at a time);
  • It causes an increase in the cervix’s production of slime (sperm cells use that slime to enter the uterus);
  • Right before ovulation, estrogen levels peak. This incites the production of the hormone LH, which stimulates ovulation.

After ovulation, the leftover follicle will turn into a corpus luteum, which produces progesterone. Progesterone causes the endometrium to change, so that a fertilized oocyte will be able to lodge in the uterus.

An oocyte can be fertilized for 12-24 hours after ovulation has taken place. If an oocyte has been fertilized and lodged itself in the uterus, the pregnancy will start to produce the hormone hCG, also known as ‘pregnancy hormone’. hCG stimulates the corpus luteum to keep producing progesterone, preventing menstruation. If there’s no pregnancy, no hCG will be produced and progesterone levels will start to fall. This causes the endometrium to be rejected by the uterus and discharged. That is menstruation.


Sperm cells

Ejaculate consists of sperm cells (spermatozoa) and fluids. The production of sperm cells takes place inside the testicles. After that, the sperm cells move to the epididymis, where they can mature. During ejaculation, the sperm cells are propelled out through the vas deferens (ejaculatory duct) and the urethra. Along the way, fluids are added to the cells by the vas deferens and the prostate. This mixture of sperm cells and fluids is known as sperm. It provides the best environment for sperm cells, allowing them to survive outside the testicles. When we examine the sperm to determine the quality, we judge how many milliliters the ejaculate is, the number of sperm cells per milliliter and the agility of the sperm cells. If the quality of the sperm is average, the ejaculate contains at least 15 million agile sperm cells.

Uterus

A normal uterus will react to the changing levels of hormones that influence the menstrual cycle. These hormones stimulate both the growth of the endometrium and the changes in the endometrium that allow a fertilized oocyte to lodge itself there. Having an irregular uterus may influence your chances of conceiving. Examples of irregularities are polyps or myomas in the uterus.


Fallopian tubes

When ovulation occurs, the oocyte is expelled into the fallopian tube, which is where the fertilization of the oocyte by a sperm cell will take place. A sperm cell must swim from the vagina, through the uterus, all the way to the end of the fallopian tube in order to reach the oocyte. After the oocyte is fertilized, it will be transported through the fallopian tube into the uterus. As you can see, the fallopian tube plays a very important part in the process of conception. If there are irregularities or other issues with the fallopian tube, its ability to do its job may be impaired, possibly preventing the sperm cells from reaching the oocyte.


Intercourse during the fertile period

In order to achieve a pregnancy, it’s important that sperm cells are brought into contact with the mature oocyte during the fertile period. The chances of this happening are highest when there is an ejaculation inside the vagina. The more sperm cells reach the oocyte, the higher the chances of a pregnancy.

Since sperm cells are able to survive for 2-4 days, and oocytes can only survive for a maximum of 24 hours after ovulation, having intercourse prior to ovulation will give you better odds of conceiving than intercourse after it. The period of time during which sex yields the highest chance of achieving a pregnancy is called the fertile period.

After there’s been an ejaculation inside the vagina, the sperm cells will arrive at their destination in just a few minutes. The other fluids that are released during an ejaculation will not be absorbed by the uterus and leak back out of the vagina. The chances of conceiving will not be increased by laying back after sex with a pillow under your hips or your legs in the air.

Further information

Improving her lifestyle

The chances of conceiving correlate closely with the quality of the available reproductive cells. Every improvement of oocyte quality will cause an increase in her odds of conceiving. This way, not only does she have higher odds of conceiving naturally, her chances of having a healthy baby will increase too. A healthy lifestyle will impact oocyte quality. Changes in lifestyle are relatively simple to implement and will often provide a huge improvement of the quality of oocytes.

It’s important for you to realize that, since the development of an oocyte takes roughly three months, changes in lifestyle will take at least that long before a measurable impact on oocyte quality can be detected.


Calculating your fertile days

The chances of conceiving increase with the presence sperm cells during and around the time of your ovulation. Having sex during the fertile period will maximize your chances of getting pregnant.

Basic information: 

  • The oocyte can be fertilized for 12-24 hours after ovulation
  • Sperm cells can survive inside a woman’s body for at least 48 hours
  • Having sex 1-2 days prior to ovulating yields the highest chances of conceiving.

Calendar method:

Ovulation takes place ten to fourteen days prior to the start of your menstruation. The period between ovulation and menstruation (known as the luteal phase) always takes the same amount of time, although it varies between people. It can be between ten and fourteen days, although it’s usually fourteen. The period between menstruation and ovulation (known as the follicular phase), on the other hand, varies between menstrual cycles. A menstrual cycle starts on the first day of your menstruation and continues until your next menstruation. The first day of your menstrual cycle is the first day you’re really menstruating instead of just spotting.

A few examples:

  • If a cycle lasts for 28 days, ovulation will take place 14 days prior to the next menstruation – so on the 14th day of the menstrual cycle.
  • If a cycle lasts for 24 days, ovulation will take place 14 days prior to the next menstruation – so on the 10th day of the menstrual cycle.
  • If a cycle lasts for 35 days, ovulation will take place 14 days prior to the next menstruation – so on the 21st day of the menstrual cycle.

As you can see, the moment of your ovulation varies with the length of your menstrual cycles.

Very few women have a menstrual cycle so regular that it is exact same length every time. Usually, there’s some variation in the length of your menstrual cycle, and therefore also in the moment of ovulation. This means that, when determining your fertile period uding the calendar method, you’ll have to take both the shortest and longest cycle into account. You can then calculate when ovulation will take place for both, using the same method we did in the examples mentioned above. You’ll ovulate somewhere in between those two days.

Ovulation tests (aka LH tests)

Ovulation tests are tests that measure the amount of the hormone LH in your urine. LH is a hormone that is produced by the brain 24-32 hours prior to ovulation. The high LH levels then stimulate ovulation. Using these ovulation tests allows you to accurately predict when you’ll ovulate. Having sex on the day the test result is positive yields the highest chances of achieving a pregnancy.

 Ovulation tests are tests that measure the amount of the hormone LH in your urine. LH is a hormone that is produced by the brain 24-32 hours prior to ovulation. The high LH levels then stimulate ovulation. Using these ovulation tests allows you to accurately predict when you’ll ovulate. Having sex on the day the test result is positive yields the highest chances of achieving a pregnancy.

You’ll start using ovulation tests 1-2 days before your expected ovulation date, assuming your shortest menstrual cycle. You’ll continue using the tests until the result is positive.

There are many ovulation tests on the market, and their cost varies. Check the information that comes with the test for an explanation on how to use it and what positive and negative test results look like.

Physical changes

Some women notice that they have more vaginal discharge during their fertile period. This discharge can be recognized by the fact that it’s clear and can be stretched to form a thread. If you experience this type of discharge 14-18 days prior to when you next expect to menstruate, this change in discharge is a sign of fertility.

Base temperature curve

During the two weeks prior to menstruation, your body temperature will be roughly 0.3-0.5 degrees Celsius higher than during the first part of your menstrual cycle. Measuring your base body temperature should happen rectally, in the morning before getting up.

Your base body temperature will start to rise 1-4 days after ovulating. Therefore, this method cannot be used to predict when you will ovulate. Rather, it’s a tool to inform you in retrospect of when ovulation took place.

We do NOT recommend using this method to predict your fertile period, since this method is not suited to that.

Mobile apps

There are several smartphone applications that can be used to track when your menstruation starts, and the app will tell you when your fertile period is. Be careful: these apps only work for regular periods, since they calculate the fertile period based on the average length of the preceding cycles. These apps are highly inaccurate in predicting your fertile period if your menstrual cycle is irregular.

Highest odds of conceiving

After ovulation, the released oocyte can be fertilized for 12-24 hours. Having intercourse 1-2 days prior to ovulating will yield the highest chances of conceiving. That way, the sperm cells are ready and waiting when the oocyte is released.

Sperm cells can survive inside a woman’s body for at least 48 hours. Having sex every day or once every two days during your fertile period will maximize your chances of conceiving, although having sex every day doesn’t yield better odds than having sex every two days.

The quality of the sperm decreases when there’s an ejaculation more than once a day or fewer than once every five days.

Further information

Optimal sperm quality increases odds of conception and a successful pregnancy. In addition to this, high sperm quality will increase the chances of having a healthy baby.

Changes in lifestyle are relatively simple to implement and will often provide a huge improvement of sperm cell quality. It’s important for you to realize that, since the development of a sperm cells takes roughly three months, changes in lifestyle will take at least that long before a measurable impact on sperm cell quality can be detected.

 

Do not expose testicles to high temperatures

The testicles are located outside the body, inside the ballsac. The temperature inside the testicles is 2 degrees lower than the average body temperature. The best temperature for sperm production is 35°C. if the testicles are exposed to higher temperatures, sperm quality is influenced negatively. Fevers, visiting a sauna, hot baths, tight underwear, electrical blankets, and varicose veins in the ballsac can all harm sperm quality. If you have a fever, you should take fever-stabilizing medicine such as paracetamol or an NSAID (like Naprosyne, Diclofenac, Ibuprofen). If you’ve gone through a period of being feverish (38,5 °C or higher), the quality of your sperm may be influenced for up to three months.

Number of ejaculations

The best sperm quality is achieved when there are two or three ejaculations a week. The quality of the sperm decreases when there’s an ejaculation more than once a day or fewer than once every five days.

Further information

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