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How to understand your fertility

Doing some simple maths to work out your most fertile time of the month could help you become parents, without going down the IVF route. Dr Chris Steele explains…
Making babies sounds easy, doesn’t it? Stop using contraception and bingo you’ll get pregnant. Sadly for many couples it isn’t that simple. They keep trying, but each month the hopefully expected missed period that signifies a possible pregnancy just does not happen for them.

On ITV1’s This Morning programme, I have often given advice on how couples can improve their chances
of getting pregnant. As a result, many couples who were struggling to start a family have successfully conceived and delivered a much anticipated little bundle of joy to take home!

Following my advice may help you become pregnant before you start spending a fortune on IVF treatment. It’s all about numbers – once you have calculated the fertility window of opportunity you have each month, your chances of conceiving naturally will be significantly boosted.

Your menstrual cycle
The first thing you must establish is how long your menstrual cycle is. Some women have a regular 28-day cycle; others have a longer cycle with periods every 31-35 days, say; while others have a totally irregular cycle, not knowing when their next period is due and therefore not knowing exactly when they are ovulating.
You are at your most fertile in the time between two days before ovulation and two days after. Not capitalising on this window of opportunity can be a major cause of infertility. So it’s important to calculate when you are ovulating, which depends on the length of your menstrual cycle.

The 28-day regular cycle

You may have a regular menstrual cycle, with a period every 28 days, month in and month out. If so, lucky you, as it means that you are ovulating at a set time every month.

All women ovulate 14 days before the start of their next period. If you have a regular 28-day cycle, this means ovulation is also exactly 14 days after the start of your last menstrual period – making it very easy to calculate.

The regular longer menstrual cycle
Let’s say your periods occur regularly but are starting around every 31 days. In this case, you are still ovulating 14 days before your next expected period, so you are most fertile 14 days before your next period is due. This means that you’re ovulating, and most fertile, on day 17 of your 31-day cycle – 17 days since the start of your last period.

The regular even longer cycle

Now just to test your understanding of this calculation, let’s look at a woman who has regular periods, which only occur every 35 days. Subtract 14 from 35 and you can see she will be ovulating on day 21 of her cycle – 21 days since the start of her last period.

The totally irregular menstrual cycle
This is a trickier situation because if you have no idea of when your next period is due, then you have no way of calculating when you will be ovulating. I would advise you to try ovulation testing kits, which are available in most good pharmacies.

The process of ovulation is controlled by hormones, most notably a hormone called luteinising hormone (LH), which can be detected in the urine. Levels of LH generally increase about 24 to 36 hours before ovulation and home-ovulation testing kits can accurately detect this surge.

You will need to test yourself over several days and therefore you may have to buy two or three kits to try and find out exactly when you are ovulating.

The ovulation process When you ovulate, you are releasing an egg from one of your ovaries. This egg then migrates down one of your fallopian tubes to be available for fertilisation by any sperm swimming upwards through the cervix (neck of the womb) and into the cavity of the uterus (womb). Some sperm will swim into the one fallopian tube which contains the released ovum or egg.

Millions of sperm are released during the male ejaculation, and because they don’t know which fallopian tube contains the egg, they travel up both fallopian tubes to find the ovum and then fertilise it – hopefully producing a fertilised egg, which then becomes embedded into the wall of the uterus.

From this embryo, the foetus will develop into a baby that then grows and enters the world nine months later. So you can see, it’s not such a simple procedure, and it is made even more complicated if your periods are irregular.

Problem spots
If you still have acne (teenage spots) in your mid 20s, you may have polycystic ovaries, which not only causes acne but also excess body hair, irregular periods and most importantly – infertility. So if you have problems becoming pregnant and have acne or excess body hair, you need to have an ultrasound scan of your ovaries to see if you have the condition. Talk to your GP about this as soon as possible.

Having sex
Once you have worked out when you will be ovulating – either by using the calculations I’ve given you or by using a few ovulation predictor kits – you need to concentrate on getting those sperm to find the one egg released each month!

You should aim to be having sex every day, two days before you ovulate, the day of ovulation and two days after. This is what I call the fertility window.

After sex, don’t get up and go to the toilet, as this could cause a lot of seminal fluid containing millions of sperm to leak out of the vagina. You don’t want this to happen as you need as many viable, active, motile sperm as possible to get through the cervix and up into the uterus and fallopian tubes to fertilise that one single egg.

Good luck!
I hope that you achieve your dreams of becoming the proud parents of healthy children. My wife and I have four children who have all brought us tremendous pleasure. Plenty of hassle, too, of course. But they are definitely worth it.

Lifestyle changes to help
If you are really desperate to have a baby before setting off down the expensive and difficult route of IVF, you must follow this advice:

Stop smoking
Smoking in both partners will severely reduce both your levels of fertility. It isn’t easy to quit the cigs but read my article on how to quit smoking on pg 76. It basically comes down to the decision, do you want cigarettes or children? Babies and children will enhance your life forever, cigarettes will shorten your life and severely reduce your chances of enjoying the rest of your lives as happy and fulfilled parents.

Eat a sensible diet
Restrict your intake of junk food and make sure you get your five portions of fruit and vegetables every day. Remember, one smoothie equals two portions of your five a day recommended allowance. Eat oily fish, mackerel, sardines, herring, tuna or salmon twice a week.

Exercise regularly
Walk for 30 minutes, non-stop, every day come rain or shine. Do not over-exercise in the gym, however, as new evidence suggests this can reduce women’s fertility.

Considering your options
If you become pregnant and the timing and the circumstances are all wrong for you, there is help available.

Unplanned pregnancies are incredibly common and can affect women of any age and in varied circumstances. For most women who find themselves pregnant without planning for it, the situation will at first throw up mixed feelings and this can make decision-making difficult. The British Pregnancy Advisory Service (bpas), a not-for-profit organisation that supports reproductive choice advises: ‘Whatever your feelings, everyone will have different reactions. To help you think about how you feel at the moment, many find it helpful to write down a list of different feelings.’

Whatever your circumstances, there are three options available to you. You can continue the pregnancy and place the baby for adoption or fostering; you can continue with the pregnancy and keep the baby; or you can end the pregnancy by having an abortion, if you are legally able to do so. But making this decision can be incredibly difficult and will involve talking it through with those close to you.

What to do next
One way of unravelling how you feel is by talking to a professional about your situation. At bpas, there are trained counsellors who can discuss the options available with you, so you can make an informed decision. For more information go to the bpas website

Photographs: getty images

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