Preparing for parenthood is an exciting journey. While so much can’t be planned for—that’s just the nature of babies and kids!—many aspects of conception can be.

Preconception planning goes beyond timing; it involves ensuring your physical and reproductive health are in the best possible shape before trying to conceive (TTC) to lay a strong foundation for a healthy pregnancy.

What happens at a preconception checkup

A great first step once you decide you’re ready to start trying to get pregnant is scheduling a preconception checkup or wellness visit with your provider. During this visit, we’ll assess your overall health and reproductive health and chat through any underlying conditions that could impact your ability to conceive or maintain a healthy pregnancy.

If you have a chronic condition, like polycystic ovary syndrome (PCOS), endometriosis, diabetes or hypertension, managing it before TTC can help reduce fertility challenges and pregnancy complications. Your provider will work with you on a personalized plan.

Also, make sure you’re up-to-date on all of your health screenings, such as Pap smears.

WHA supports all reproductive goals, including for same-gender couples. We offer hormone and fertility testing, as well as ovulation induction medication, based on your needs and preferences. For fertility treatments like IUI or IVF, we can recommend trusted clinics to guide you through the process.

The impact of lifestyle on fertility

While diet and nutrition are always key players in our overall health, their direct impact on fertility varies. Certain conditions, such as PCOS, may benefit from specific dietary adjustments. But for most people, a balanced and nutritious diet is all you need. So focus on foods that support general wellness rather than getting caught up in restrictive fertility diets!

Managing stress is another aspect of preconception care. Although stress can influence certain aspects of the fertility cycle, data shows us it does so transiently and likely doesn’t have a huge impact; it’s not the primary cause of fertility issues for most people.

Instead of aiming for perfection, prioritize balance and self-care by incorporating mindfulness and physical activity into your routine. But, look–stress has always been a part of life, and life has persisted. So don’t worry about worrying! You can still conceive, and have a healthy pregnancy, even with the daily stressors we all carry.

But something that does really help while TTC is a prenatal vitamin containing folic acid, taken daily. This helps prevent neural tube defects and ensures your body is prepared when you do conceive, so providers often recommend people start taking it as soon as they start trying.

How soon you can get pregnant after coming off of birth control

If you’ve been using hormonal birth control, it’s important to understand how fertility returns after birth control, and give your body time to adjust. But know: you can get pregnant immediately after coming off of any birth control!

After stopping hormonal birth control, especially the pill or Depo-Provera, it can take several months for your menstrual cycle to return to its natural rhythm. In some cases, it may take up to six months for regular ovulation and periods to resume, particularly if you’ve been on the hormones for a long time. The IUD may offer a quicker hormone “bounce back” since its delivery is more localized.

During this transition, tracking your menstrual cycle can be incredibly helpful. By monitoring your cycle, you can gain a better understanding of your body’s natural fertility patterns, including when ovulation occurs, which helps with timing sex for conception.

Being in tune with your cycle can make the process of TTC feel more manageable and empowering. Consider using a calendar or ovulation tests to keep track.

When to have sex to get pregnant

Timing sex for conception is key. While the media sometimes likes to suggest we could get pregnant at any time, there is a defined fertility window for the best time to get pregnant.

  • Ovulation typically occurs once a month during your cycle’s follicular phase.
  • Ovulation typically occurs around day 14 of a 28-day cycle. This can vary depending on the length of your cycle, which is anywhere from 21 to 35 days. This is why tracking your cycle is so important when TTC.
  • The 5-day window surrounding ovulation is when conception is most likely: the three days leading up to ovulation, the day of ovulation, and the day after.
  • The highest pregnancy rates occur when the egg and sperm join within four to six hours of ovulation (but don’t torture yourself trying to get this granular).

Looking at this, it can feel like the calendar Olympics trying to get everything just right. But focus on the bigger picture: having sex within that five-day window. Data doesn’t show a difference in whether you have sex everyday or every other. So do what feels best, with a goal to have sex on ovulation day. Tracking your ovulation through methods like ovulation predictor kits can help pinpoint these fertile days for you.

When should I get fertility testing done?

The journey to parenthood can be emotional, especially when faced with unsolicited advice or misconceptions about fertility. Many couples feel isolated during this time, but it’s important to remember that you’re not alone. Seeking emotional support—whether through friends, family, or healthcare providers—can help alleviate some of the stress that often comes with TTC.

If the person who will carry the baby is 35 or under, it’s generally recommended to follow a fertility testing timeline of trying for 12 months before seeking fertility help. Those over 35 should consult a healthcare provider after six months of trying as fertility naturally decreases with age.

If there are known health issues, such as irregular cycles or chronic conditions, it’s best to seek a fertility assessment sooner. Your provider may recommend:

  • Hormone tests for fertility – A blood draw is sent to a lab to measure hormone levels.
    • Follicle-Stimulating Hormone (FSH) – tested on day 3 of the menstrual cycle to assess ovarian reserve and function.
    • Luteinizing Hormone (LH) – tested around day 3 and again mid-cycle (around day 14) to track ovulation.
    • Estradiol (E2) – tested on day 3 to evaluate ovarian function, and may also be tested mid-cycle to monitor ovulation.
    • Progesterone – typically tested about 7 days after ovulation (around day 21 in a 28-day cycle) to confirm that ovulation has occurred.
    • Anti-Müllerian Hormone (AMH) – assesses ovarian reserve (the number of eggs) and can be done at any point in the cycle.
    • Thyroid-Stimulating Hormone (TSH) – checks for thyroid function, which can impact fertility, and can be done at any point in the cycle.
    • Prolactin – too much of this hormone can interfere with ovulation; can be done at any point in the cycle.
  • Semen analysis for fertility – Sperm quality plays an equal role in fertility, and a simple test can provide insight into sperm count, motility and morphology, helping to identify any potential issues early on.
  • Vaginal ultrasound – Provides a visual of the reproductive organs, including the ovaries and uterus to track follicle growth, the ovarian reserve, any uterus abnormalities such as fibroids and the thickness of the endometrium.
  • Hysterosalpingogram (HSG) – A special X-ray used to check the inside of the uterus and fallopian tubes to ensure tubes are open and unblocked and there are no uterus abnormalities.

Though dependent upon a person’s health history, hormone labs and a semen analysis are usually the first steps with fertility testing and can be done at the same time before moving on to the more invasive ultrasound and HSG options.

While understandably upsetting, fertility challenges can sometimes be our body’s way of protecting us, signaling that it’s struggling to manage all the demands placed on it. Everyone should have the opportunity to grow their families, and it’s important to listen to our bodies and seek support if fertility becomes a concern. While WHA does not provide fertility treatments, we may refer patients to specialists for in vitro fertilization (IVF), which is currently the most effective fertility treatment available.

How aging affects fertility

It’s increasingly common for people to start their families in their late 30s, but our reproductive health doesn’t always align with that timeline.

Age-related fertility decline begins around age 27 after peaking in the mid-20s. Though it’s still possible to conceive into your 30s and even 40s, the chances decrease as egg quantity and quality naturally decline with age. Understanding this timeline can help when planning for the future, but it’s important to remember that fertility is different for everyone, and many factors come into play.

Secondary infertility: why does it happen?

Secondary infertility, or difficulty conceiving a second child, can happen due to a variety of factors, including overall health and reproductive age since fertility naturally declines over time.

Also, the physical impact of both pregnancy and parenthood—as all parents know—can affect how “easy” it is to get pregnant again.

In some cases, the timing of the first pregnancy might have been fortunate, masking an underlying issue that becomes more apparent later on. Be sure to speak with your provider if you have any questions or concerns about TTC your second (or next) child.

Preconception care benefits

Preconception care offers significant benefits by helping you prepare for pregnancy with a personalized care plan. Taking this first step allows you to address both your physical and emotional well-being and can help you feel confident that you’re making informed decisions to support your reproductive goals and overall health.

Ready? Schedule your preconception visit or wellness exam today.