The Ultimate Guide to Getting Pregnant

Getting pregnant - Reproduction is a natural component of all life.   Every living organism is the result of reproduction.  When you're struggling to conceive or if you are experiencing recurrent pregnancy loss, the process certainly doesn't seem natural or straightforward.  

Why? Because it's not! The journey to pregnancy requires hope, determination, and support.  Sometimes, achieving pregnancy requires assistance from fertility supplements or, in more extreme cases, fertility experts.  

Fast Facts about Getting Pregnant

• Each month, young fertile couples only have a 20-25% chance of conceiving.
• The chances of a woman's eggs being abnormal increases as she ages. Abnormal eggs make conceiving more challenging and miscarriage more probable.
• An increasing percentage of couples are utilizing Fertility Supplements to assist in their reproductive journey.  In women, supplements can help to improve egg quality, ovarian response, and fetal development.  
• Experts agree that male factors contribute to approximately 1/3 to one-half of all cases of infertility.  Nutrients found in male fertility supplements can improve the morphology (shape), count, motility, and DNA of sperm.  
• In more extreme cases, fertility treatments can help to overcome both male and female causes of infertility.

Getting Pregnant Naturally - The Basics

Although some couples seem to get pregnant just by thinking about it, conception is a whole lot more complicated than that, miraculous even.

For a healthy pregnancy to occur, the following critical elements are essential:

• Healthy egg
• Ejaculate containing healthy sperm
• Properly timed intercourse
• Healthy open fallopian tubes
• A healthy uterus that can sustain a pregnancy
• Hormones to support the conception process and pregnancy
• Healthy mother

A Healthy Egg and Ovulation

For conception to occur, the ovary must release a healthy egg.  Females are born with around 2 million potential eggs.  The question is, how many of these future eggs will be ‘healthy’?  Unfortunately, not all of them.  Even women in their 20s produce some genetically abnormal eggs. There’s no bloodwork or particular test that will tell us if your eggs are genetically healthy.  It is impossible to test egg quality without actually fertilizing the egg. 

One thing we are sure of is that the older you are, the more genetically abnormal eggs you produce. One's ability to get pregnant depends on their egg quality. If the ovulated egg is genetically abnormal, it will likely fail to fertilize, fail to implant, or result in a miscarriage.  The good news is there are fertility supplements available to help women increase their egg quality.  

For an egg to fertilize, it must release from the ovary in a process known as ovulation.  Structures on the surface of the ovary, called follicles, contain immature eggs.  The endocrine system releases hormones to assist with follicle development and about midway through each menstrual cycle, the largest follicle releases an egg. The egg then travels into the distal portion of the fallopian tube.  Here, the egg waits for fertilization to occur.  Typically, women ovulate around day 14 of a 28-day menstrual cycle; however, not everyone has a 28-day long cycle.  Cycles can range from 21-days to 36 days.  As such, ovulation timing varies from woman to woman.  Women are most fertile during ovulation. 

Medical conditions, such as PCOS, can cause women to experience irregular ovulation.  Irregular ovulation can make achieving pregnancy difficult, but there are various medications available that hat can help the body to ovulate.  

Healthy Sperm in Ejaculate:

Each time a man ejaculates, they release around 100 million sperm. Of course, not all sperm are healthy, and they won't all travel through the vagina, cervix, and uterus, finally entering the fallopian tube. But only one sperm needs to reach the egg.  Experts believe this journey is nature's way of ensuring only the healthiest sperm fertilizes the egg.

The characteristics of healthy sperm are sufficient sperm count, motility, morphology, and volume.  The higher the concentration of sperm cells in a semen sample, the better the sperm quality.  Morphology refers to the shape of sperm under a microscope—specifically, the shape of the sperm head and the size. Round heads and long, strong tails are characteristics of healthy sperm.  Head shape affects the sperm’s ability to dissolve the outer surface of an egg and fertilize it.  Motility refers to the sperm’s movement, which determines its ability to reach the egg.  There is a minimum volume of semen required to carry sperm cells through the female reproductive tract—all of these characteristics influence sperms’ ability to get to and penetrate an egg.

Learn more about the supplements we have available to help! 

Properly Timed Intercourse:

Timing is everything!  Sperm must be present just before or as the egg is released for pregnancy to occur. Healthy sperm survive for up to 5 days in a woman’s body, but an egg lives for only 12-24 hours after ovulation.  If an egg goes unfertilized, it disintegrates into the uterine lining and sheds during the woman's next period.  Fertility doctors recommend having intercourse 2-3 days before ovulation.  Ideally, sperm is ready and waiting in the fallopian tubes just before the egg is released.

Remember, after sperm releases, they still have a long way to swim before they reach the fallopian tubes.  Our male fertility supplement includes Selenium, Co-Q10, and L-Carnitine, which help to improve sperm motility making the journey easier!  

Healthy, Patent Tubes:

The fallopian tubes play many critical roles in reproduction, such as picking up and transporting the egg from the ovary, fertilization, and embryo transport to the uterus.

You can think of fallopian tubes as a fertility superhighway. Sperm, egg, and the eventual embryo need open roads to travel. The fallopian tubes have to be healthy with no scarring, adhesions, damage, or blockages for the road to be clear.  “Patent” means open, but open tubes don’t necessarily mean functioning.  Open tubes may have scarring, keeping them from performing optimally.  Tubal patency can be measured by the following tests: hysterosalpingogram (HSG), a sonohysterosalpingogram (SSG, or Saline Sonogram), or a Laparoscopy.

Healthy Uterus:

A healthy uterus is essential for embryo implantation and the development of a fetus.  The uterus is a growing baby's first home. The factors that determine a healthy uterus are a 7 to 8 mm thick and "receptive" endometrium (the lining of a woman’s uterus), absent of uterine fibroids, adhesions, scar tissue, and endometriosis, which might impair implantation and growth. 

Exercise can help increase blood flow and reduce stress in women looking to get pregnant.  Fertility specialists recommend incorporating low-intensity exercise and movement into your daily routine.  Yoga, walking, and stretching are just a few easy ways you can get moving.

Balanced Hormones:

Hormones play a pivotal role in ensuring the successful implantation and growth of an embryo.  Men need appropriate levels of testosterone, FSH, and LH to produce healthy sperm. Women need appropriate FSH, LH, estrogen, and progesterone levels to trigger follicle growth, ovulation, endometrial growth, and other events in the conception cycle.  Small hormonal imbalances can disrupt the process and affect a woman's ability to conceive.  

Healthy Mother:

 Fertility experts agree that preconception health is essential to getting pregnant.  Women attempting to get pregnant should:

• Avoid smoking or using recreational drugs and limiting alcohol consumption.
• Discuss any prescription drugs you are taking with a medical provider. 
• Not work with or use hazardous chemicals at home or work.
• Reduce stress and relax with yoga, acupuncture, and massage.
• Avoid high levels of caffeine.
• Exercise at a low intensity daily.
• Track your menstrual cycle.
• Get enough sleep.
• Take verified fertility supplements.
• Maintain a healthy weight.

It’s important to start incorporating these lifestyle changes about three-months before trying to conceive as egg development begins about 90 days before conception.

Getting Pregnant Naturally - Key steps

For successful conception to occur, everything must happen precisely when and where it’s supposed to. 

Development of Eggs and Sperm Without Major Genetic Abnormalities

As mentioned previously, all women have the potential to produce some genetically abnormal eggs, even young fertile women.  As women age, their egg quality naturally declines, and the likelihood of abnormal egg production increases.  This is why women in their forties struggle more often to conceive with their own eggs compared to younger and more fertile women.  

Similarly, men also produce a higher percentage of genetically abnormal sperm as they age. Usually, only about 4-15% of a man's sperm is considered normal.  For sperm to be considered normal more than 4% must be deemed “morphologically normal.” Since men produce so many sperm, 4% may be all it takes for successful conception. Many factors cause sperm abnormalities, the most common being age and genetics. 

 

That being said, many men have the potential to father children into their 70s and even older. While women produce just one egg a month, men release millions of sperm in that same time. It only takes a small percentage of several million sperm to fertilize an egg successfully.  And lucky for men, new sperm are produced about every three months.

A Mature Egg Is Released

For women who ovulate normally each month,  the Follicle Stimulating Hormone (FSH) is released from the brain and causes immature follicles within the ovary to start developing. These developing follicles, in-turn, produce estrogen.  Estrogen then signals the uterus to prepare for pregnancy.  One (sometimes two) large follicles release an egg. The other follicles do not reach maturity and reabsorb into the body.  The brain also produces the Luteinizing Hormone (LH), which causes the egg to mature and the follicle to rupture. Finally, the egg releases from the ovary.

The Fimbria Moves The Egg to the Fallopian Tube

 Fimbria are finger-like projections from the fallopian tube.  They move and sweep the egg as it releases from the ovary into the end of the fallopian tube. The ovulated egg is met by sperm that is either already waiting or arrives shortly after.  Once the sperm meet the egg, fertilization can occur. Ideally, intercourse occurs 72-hours before ovulation; this helps to ensure that sperm are present at the time the egg enters the fallopian tube.  Once the egg is released, the ruptured follicle transforms into the corpus luteum and releases progesterone and estrogen, which are essential for implantation in the uterus.

Sperm's Journey Through the Cervix, Uterus, and Into the Fallopian Tube

Sperm's venture is long and has a low individual success rate.  Of the thousands of sperm that make it past the cervix and into the uterus, only a small fraction will make it up and to the waiting egg at the end of the Fallopian tube.  A sperm count of 20-40 million is necessary to ensure there is enough sperm to survive the journey.  

To naturally improve the health of your sperm, check out our male fertility supplements.

Sperm and Egg Meet and Fertilize

The remaining sperm “attack” the egg to penetrate its outer layer so fertilization can occur.  It only takes one sperm for the egg to fertilize.

The Embryo Travels into the Uterus

After fertilization, the egg continues to develop within the fallopian tube as it travels towards the uterus. The egg cells divide and begin to create new cells that will become the embryo and placenta. Around Day 3 of development, the embryo is composed of eight cells and is called a cleavage stage embryo.  The cleave stage embryo enters the blastocyst stage around 5-8 days after fertilization. The blastocyst is approximately 150-250 cells. The blastocyst transfers into the uterine cavity, where it will hatch and begin to implant.

Embryo Implants and Thrives in Uterus

Six days after ovulation, implantation occurs.  The embryo receives signals from the endometrium, which pulls it in to implant. The thicker the lining, the better chance the embryo has to implant successfully.  After implantation, hCG (Human Chorionic Gonadotropin) releases.  At-home pregnancy tests look for hCG, the “pregnancy hormone.”  hCG supports the corpus luteum enabling it to release estrogen and progesterone, which supports the endometrium and nourishes the embryo to develop until the placenta forms.

Odds of Getting Pregnant by Age

Now that you understand the timing and precision that are necessary to achieve pregnancy, it’s simple to see why getting pregnant isn’t easy for women at any age.  Even the youngest, healthiest, most fertile women only have a 25% chance of achieving pregnancy each month.  

A woman's odds of conceiving over a six month or year period are much higher than the single chance she has each month.  As demonstrated in the figures above and below, a woman between the ages of 20 and 24 only has a 25% chance of conceiving by natural pregnancy each month; those odds increase to 80% over twelve months. 

Why Pregnancy Rates Decline Over Time

Egg Quality

Over time, our eggs age right along with the rest of our bodies.   As women age, they produce more chromosomally abnormal eggs. Small errors in the DNA, known as abnormalities, affect cell function and may prevent the egg from fertilizing correctly.  For a woman in her 20s, 90% of her eggs are genetically healthy.  That same woman is likely to have less than 20% healthy eggs in her 40s.

We recommend our female fertility supplements for any woman, regardless of age, who is looking to improve her egg quality.

Egg Count

As women approach menopause, egg quantity declines just the same as egg quality.  A decreasing number of eggs over time makes conception less and less likely.  Declining ovarian reserve is unavoidable and affects all women as they age.  Around the age of 35-37, egg reserve drops sharply.  At age 40, ovarian reserve is even lower, and by the early to mid-40s, most women only have about 5,000 eggs left in reserve. By comparison, the ovarian reserve of a healthy 25-year old may contain over 100,000+ eggs.

Doctors can measure ovarian reserve with a simple blood test called a Anti-Müllerian Hormone (or AMH) test.  AMH is a hormone that’s produced by the cells inside a woman’s follicles where eggs mature.  AMH levels are directly correlated to the number of eggs in a woman's reserve.

Although egg count is not the same for all women, declining egg quality occurs in all women as they age.

 

When to Seek Help if you're not getting pregnant naturally?

Under 35

Fertility specialists recommend the 12-month rule for heterosexual couples where the woman is under the age of 35.  If you and your partner are unable to achieve pregnancy after a year of unprotected sex, consider visiting a fertility specialist.  

Over 35

Fertility specialists recommend that if the woman is over the age of 35 and has been unsuccessfully trying to conceive for six months, they should consider getting help.  If you’re over 40, specialists commend seeking out a reproductive endocrinologist as the first course of action.  

People Who Should Seek Fertility Help As Their First Step

• Women over 40
• Single Parents
• LGBTQ Couples
• Trans Couples
• Anyone with a diagnosis that is known to impact fertility negatively

Diagnoses Known to Affect Fertility:

• Infrequent or absent menstrual cycle
• Hormonal imbalances, especially low testosterone
• Polycystic Ovarian Syndrome (PCOS)
• A history of endometriosis
• A diagnosis of cancer
• A history of serious infections, mainly sexually transmitted infections (STIs)
• Pelvic Inflammatory Disease (PID) or pelvic infections
• Erectile dysfunction that stops you from having intercourse or ejaculating
• A history of multiple miscarriages
• Three or more past abortions
• Endocrine system disorders
• Past organ transplants
• Certain genetic disorders
• Family history of early menopause or premature ovarian failure

Basic Fertility Testing When You're Not Getting Pregnant:

Once you’ve decided it’s time to seek help from a fertility specialist, you might wonder what kind of tests are available to assess you and your partner's likelihood of conceiving. 

Males:

A semen analysis is the most critical component of male fertility testing.  A semen analysis confirms that there is sperm in the semen and tests the three main attributes of the sperm:

• Sperm Count (number of sperm)
• Morphology (shape and appearance)
• Motility (movement)

A complete semen analysis also measures:

• Volume
• pH (level of acidity)
• Progression (motion and forward progress)
• Semen viscosity (consistency)

Females:

• A review of your medical history and the regularity of your periods.
• Bloodwork to test hormone levels and for specific antibodies.
• Transvaginal ultrasound to assess your ovaries and other reproductive organs.
• Hysterosalpingogram/Saline Sonohysterogram or a Hysteroscopy/Laparoscopy. 

It’s important to remember that there’s no single test available to evaluate every variable that may be causing infertility.

Achieving Pregnancy with Fertility Treatments

Fertility specialists consider your age, bloodwork results, ultrasound test results, and medical history when recommending appropriate fertility treatment.  The three main categories of fertility treatment are:

• Ovulation Induction - Is used for women who have infrequent, irregular, or absent menstrual cycles.  Ovulation induction uses a combination of ultrasound and blood work monitoring and hormone medications to stimulate egg development and ovulation
• Intrauterine Insemination (IUI)-  The goal of IUI is to increase the chances of fertilization by assisting a larger number of sperm to reach the fallopian tubes.  IUI uses a catheter to enable sperm to reach the fallopian tubes without traveling through the vagina and cervix.
• In Vitro Fertilization (IVF) - Is the most effective and usually the last step in infertility treatment.  During IVF, eggs are removed from a woman’s ovaries and are fertilized with sperm in a laboratory.  After the embryos grow for 3-5 days, one embryo (but occasionally two) is transferred back into the woman’s uterus.

Top fertility specialists recommend using our supplements in conjunction with fertility treatments.  

Reproductive Immunology

Reproductive Immunology studies the interactions between the immune system and the reproductive system.  Many fertility experts agree that inflammation is a leading cause of "unexplained" infertility and that the immune system plays a significant role in recurrent pregnancy loss and IVF failures.   Specialists believe that the immune system reacts to an embryo as an “invader” and stops the cells from growing. 

Fertility specialists consider Cannabidiol (CBD) as a highly regarded anti-inflammatory for both men and women.  Derived from the hemp plant (different from marijuana) and having all THC removed, Molecular Fertility CBD helps restore nourishing blood flow and nutrient delivery to the uterus, ovaries, and testicles by reducing damage, increasing circulation, and restricting inflammation.  

Donor Eggs/Sperm

Many couples turn to donor eggs or donor sperm if their sperm or eggs are suspected to be affecting fertility.  Egg quality is directly related to declining pregnancy rates in older women.  If a woman's eggs aren't allowing her to achieve pregnancy, a fertility specialist may recommend donor eggs with IVF.  

Intracytoplasmic Sperm Injection (ICSI solves most male fertility issues, donor sperm may be helpful for some. 

Some common reasons for donor sperm include:

• Same-sex female couples
• Single mothers
• Couples where the male is a carrier for genetic defects

Donor sperm can be used in IUI and IVF treatments.  

Gestational Surrogacy

In gestational surrogacy, an embryo is created via in vitro fertilization (IVF), using the eggs and sperm of the intended parents or donors.  After developing in a lab for some time, the embryo is transferred into the surrogate's uterus.  The surrogate mother is not biologically related to the embryo.  

Surrogacy is a common solution for:

• Women with a hysterectomy or endometrial ablation.
• Women who’ve experienced numerous miscarriages with unsuccessful immunological treatment.
• Women with preexisting medical conditions like diabetes or a heart condition that make pregnancy dangerous.
• Women with a non-functioning uterus. 
• Same-sex male couples or single fathers. 

Pregnancy Loss

Pregnancy loss can be stressful and depressing.  It is essential not to give up and to stay committed to finding out what's going wrong.  Miscarriage is relatively common and often occurs due to genetically abnormal embryos, but recurrent miscarriage is not.  Around 1% of women suffer from recurrent miscarriage (three or more miscarriages in a row).  Specialists recommend that women who experience recurrent pregnancy loss should test for:

• blood clotting disorders
• thyroid or uterine problems
• chromosomal abnormalities that parents may be passing to the embryo

The Bottom Line About Getting Pregnant

Conception is not easy!  It is an overwhelmingly complex process that most people take for granted.  Our mission at Molecular Fertility is to provide you with science-backed, doctor trusted, independently tested, and premium fertility supplements to support your journey, whether that be through natural conception, IUI, IVF, or any other fertility treatment options.  We wish you the best of luck on your fertility journey, and we can't wait to hear about your success!