Increase your odds of getting pregnant

April is National Infertility Awareness Month. Infertility is defined as the inability to get pregnant after having unprotected, regular sex for six months to one year, depending on your age. Roughly 10 to 15 percent of couples in the United States are infertile. But as many as one in five couples diagnosed with infertility become pregnant without treatment, according to a report published by the National Institutes of Health.

Dr. Alison Zimon offers nine tips on things women can do to improve their odds of getting pregnant.

1. Get healthy! Get your health in order and see your primary medical doctor to be sure your health screening is up to date. Many very common health issues such as obesity, diabetes and hypothyroidism (insufficient amount of thyroid hormone) can prevent pregnancy if undiagnosed or untreated.
2. Think baby ready. Begin to do the things you would do once pregnant. Take prenatal vitamins with 800 mcg of folic acid, cut back on caffeine, limit alcohol, quit smoking if you smoke, maintain a healthy balanced diet and stick to a regular consistent exercise plan.
3. Understand the birds and the bees. In a regular cycle, it takes approximately two weeks for a developing egg in the ovary to be ready for ovulation. Once ready, there is a rapid increase in a hormone called the luteinizing hormone — the LH surge — which triggers ovulation. Immediately after ovulation, the egg enters the fallopian tube and may be fertilized if sperm is present and waiting. Once fertilized the egg becomes an embryo. It travels along the fallopian tube to the uterus where it is implanted about five to six days later.
4. Know your cycle. Chart your cycle month to month. Most women ovulate on cycle day 12 to 16 which is usually 14 days before their next period. Correlate this timing with symptoms that signify ovulation such as stretchy egg-white cervical mucus, transient twinging ovarian pain (called Mittelschmerz) and increased sex interest libido.
5. Time intercourse during your period of fertility. Timing is everything! The ovulated egg survives for approximately 12 to 24 hours and sperm survives for at least two to three days. Having intercourse every other day during your fertile phase is the best way to ensure that the sperm and egg connect allowing fertilization to occur.
6. Pinpoint ovulation. If your cycles are less predictable or you want to hone in on your ovulation window, use ovulation predictor kits (OPK or LH-kits) which detect luteinizing hormone (LH) in the urine. When the kit reads a positive result, you are having your LH surge and you will ovulate within 24 to 48 hours. Have sex the day of and the day following a positive OPK test.
7. Be patient. Getting pregnant can take time. Even under the best of circumstances, the chance for pregnancy in any given month is only 20 percent and somewhat lower in women over the age of 35 years. It is normal to take a number of months before conception occurs. In the meantime, be good to yourself and embrace activities that help you de-stress, such as relaxation, listening to music, exercise, yoga, massage and sleep.
8. Run a checklist of barriers to conception. Conditions that may indicate a barrier to pregnancy include history of pelvic infection, pelvic scarring from surgery, fibroids, irregular or infrequent menses, very painful periods, breast discharge, uncontrolled diabetes and thyroid problems. If you have these or other signs of infertility, see your physician or a fertility specialist sooner rather than later for an evaluation of your fertility potential.
9. Know when too long is too long. Eighty-five percent of women under age 35 will conceive within one year. You may have infertility or subfertility, a decreased, but not a complete inability to get pregnant. If you have not conceived after a year of trying you should definitely consult with your doctor or a fertility specialist. If you are over 35 years of age, you should seek guidance after six months of trying in order to avoid delaying fertility treatment while you still have good fertility potential.

Dr. Zimon is board certified in reproductive endocrinology, a surgical subspecialty of obstetrics and gynecology. She practices at Boston IVF, which is affiliated with Beth Israel Deaconess Medical Center in Boston.