Conception

Planning on getting pregnant | Signs of ovulation | Fertility treatments | Ovulation calculator

Problems getting pregnant

When to see your GP | Top ten Mumsnetters' TTC tips

Even if you're highly attuned to every fluctuation in your body's menstrual cycle and are having sex a couple of times a week, it may still take a while to get pregnant. Try not to panic because this is normal.

That said, there are factors that can make getting pregnant more problematic:

Irregular periods

Hormones regulate your menstrual cycles so any hormonal imbalances can make your periods irregular. This has nothing to do with the length of your cycle (some mums on Mumsnet have reported 50-day cycles). Irregular periods can mean ovulation isn't taking place every month (known medically as anovulation).

Medical conditions

Polycystic ovary syndrome, Hughes syndrome, thyroid disorders, endometriosis, pelvic inflammatory disease (PID) and blocked fallopian tubes (often caused by chlamydia) are some of the disorders that can complicate getting pregnant.

"It is quite possible to conceive if you don't have periods. I have PCOS, and have always had either none (for over a year) or erratic periods but have had three pregnancies. PCOS is incredibly common, easily detected by an ultrasound/blood tests and there are a wide range of remedies from dietary changes, Clomid to ovarian drilling (literally drilling a space into all the cysts)." evangelina

"Make sure your GP knows that you are trying to conceive if you have thyroid problems, even minimal ones, as it affects your treatment." duchesse

Implantation

Sometimes fertilisation takes place but the egg doesn't implant securely in the womb lining and is lost in the next period. This can be linked to the length of your luteal phase.

"It is better to have a long luteal phase. If it's less than 10 days, that may not be enough time for the egg to implant in your uterus. 12-14 days is the norm, and anything 11 days or over should be absolutely fine." Wavedancer

Age

The older you get, the slimmer your chances of getting pregnant (about the only thing that gets slimmer as you get older). That said, many women over 35 have healthy pregnancies and babies.

Sperm

The quality and quality of your partner's sperm can affect your chances of getting pregnant. Sperm production can be affected by untreated sexually transmitted infections, excessive heat (such as hot baths), smoking, drinking and taking drugs, mumps and injuries to the testicles.

But sometimes the reason why there aren't enough healthy sperm for conception can't be found.

When to see your GP about problems conceiving

If you've been having regular, unprotected sex and you're still not getting pregnant, there may (only may) be a problem your GP or a fertility clinic can diagnose and treat.

Sadly, about 15-20% of infertility cases have no obvious cause and are classed as unexplained infertility. Don't despair: even if this is your diagnosis it doesn't necessarily mean you'll never get pregnant, particularly if you've only been trying for a year or so.

Many doctors prefer you to have been having sex without contraception for at least a year, several times a week, before referring you for fertility tests. But if you've already been diagnosed with something like endometriosis and you're over 35, your GP may refer after six months.

"My top tip is to lie to the GP about how long you've been TTCing. Get your foot in the door for any investigations sooner rather than later." Marina

"It's incredibly frustrating even when you are in the system, as things cannot go quickly enough. Every month is an ovulation that has been and gone, and an opportunity that has gone forever." MrsTittleMouse

Mumsnetters' top ten things they wished they'd known before TTC

One thing that really helped me emotionally was to take control of things myself. Rather than wait for medical things to be 'done' to me, I/we made some choices and made huge lifestyle changes. We were determined that if we were going to have IVF, we would make sure we were in the best physical state possible. Littlefish
I would really recommend buying a fertility monitor to anyone who has irregular cycles - it gives you a better indication of when you may be ovulating and what is going on with your cycles. Well worth the money just to help plot your cycle. Bluebutterfly
I was surprised that various tests could be done at the GPs (ie bloods etc) rather than the hospital and that he could prescribe Clomid without the consultant intervening. If I had known this before, it could have saved us a lot of time. DonDons
Acupuncture really helps - it worked for us not only in terms of conceiving but also as a way of dealing with some of the stress of ttc. Puddlet
I'd say the most important thing is to make sure that you hang on to your relationship. Infertility is so incredibly stressful and it seems to eat into every aspect of your life. It's so easy to take it out on each other and forget that you're a team pulling in the same direction. MrsTittleMouse
It really helps to talk to virtual people who are going through the same thing. Unless your freinds are having trouble conceiving too, they just won't understand, and will do insensitive things like sending you an email at work to announce that they are pg again, cos, whoops, the pill doesn't always work, when you've spent 2 years TTC. cmotdibbler
If you have any trouble TTC make sure you know what's normal/not normal and what tests need to be performed, as an uninformed GP can delay the process of seeking help and cause further delays. pinkmook
Give very careful consideration to who you want to tell that you are trying to conceive / that you are having problems. Even the most well-meaning people can come out with very ill-considered and hurtful comments. TheRedQueen
Make sure your partner tells you about good friends' pregnancies when you're at home alone, not when you're out in a pub. I cried over every pregnancy I heard about, no matter how much I liked the people concerned. I was so torn - pleased for them, and devastated for me. Littlefish
Don't have sex 'just' to get pg, it undermines everything. ditheringdora

Your GP will probably examine your pelvis to check for tenderness, which can be a sign of endometriosis or PID.

He or she will also probably recommend a blood test to check your hormone levels.

"If you have a blood test done ensure that both your LH (luteinising hormone) and FSH (follicle stimulation hormone) are compared against one another. Ideally, these two levels should be the same but if your level of LH is higher than that of FSH this is one possible indicator of polycystic ovaries. I would ask your GP to refer you to a gynaecologist at a subfertility unit as a matter of course." AttilaTheMeerkat

Your GP may then refer you for further tests and procedures, such as:

Pelvic ultrasound - this uses high-frequency sound waves to create an image of your womb and ovaries
Progesterone test - to check you're ovulating
Chlamydia test - if it's positive, chlamydia can be treated with antibiotics
Thyroid function test - it's estimated up to 5% of women experiencing problems conceiving have an abnormal thyroid
Hysterosalpingogram - a type of X-ray of your fallopian tubes, to check for blockages
Laparoscopy - a thin microscope is inserted under your skin to look more closely at your womb, ovaries and fallopian tubes
Dye test - dye is injected through the cervix and then the person doing the procedure uses a laparascope to see whether there are any blockages

The tests you'll be offered will depend on your medical history, for example whether you know you've had chlamydia or endometriosis.

What men are tested for

The GP will test the quality and quantity of your BD partner's sperm. About one in ten men has an abnormal result, so the test is usually repeated. About two in 100 men will have a second abnormal test.

The medical language to do with fertility and infertility treatments is hard to pronounce and pretty difficult to understand. For example, if you hear 'oligozoospermia', the doctor's talking about low sperm count.

Other things that may need to be ruled out for men are hormone disorders and plumbing problems ie blockages in the testicles or problems ejaculating.

"I would prompt anyone suffering from failure to conceive to get themselves to the GP asap - or, if they have the funds, go to a private clinic where they can do all the tests the NHS do in a fraction of the time. It may be that there isn't anything wrong with either partner, and it will just take more time than your super-fertile friends do to get pregnant - but if anything is actually wrong with either of you, all the sex in the world on the right days isn't going to make a blind bit of difference. Best to know this, really. And if all the tests come back fine, then not to worry - and if they don't then at least you know where you are and can plan accordingly." Onlyaphase

Planning on getting pregnant | Signs of ovulation | Fertility treatments | Ovulation calculator