Optimising Natural Fertility

The aim of optimising natural fertility is to help couples conceive naturally without the need for more invasive treatment.

Understanding your fertility, whether by identifying the ovulation window, confirming that intercourse is taking place at the right time, or assessing factors that may affect either partner’s fertility, can provide valuable insight into why pregnancy has not occurred.

Sometimes, this may be all that is needed to help a couple conceive.

Understanding Your Fertility and
the Natural Conception Process

Natural conception depends on a few important steps happening in sequence.

An egg is released
from the ovary.

Sperm reaches the egg and fertilises it.

The resulting embryo travels to the uterus and implants.

If there is difficulty at any point, the chance of pregnancy may be affected.

This is also why fertility should not be treated as a concern belonging to one partner alone. Natural conception depends on both female and male factors working together.

Female fertility changes with age because both the number and quality of the remaining eggs decline over time. This becomes more significant from the mid-30s.

Not every woman over 35 will struggle to conceive. However, age may affect how long a couple should continue trying before seeking advice.

It also means that couples may wish to start trying for a baby earlier, as conception generally becomes more difficult with age.

The menstrual cycle is the interval from the first day of one period to the first day of the next.

Ovulation happens when an egg is released from the ovary. It does not necessarily take place on Day 14. The timing differs between women, and it can also shift from one cycle to another.

Regular periods often suggest that ovulation is taking place. Conversely, irregular or absent periods may mean that ovulation is not happening consistently.

The fertile window is the six-day period ending on the day of ovulation. The chance of conception is usually highest during the two days before ovulation.

Couples are advised to have intercourse every one to two days during this window. The estimated day of ovulation can be calculated based on the menstrual cycle.

Ovulation tests can help identify the hormonal rise that happens shortly before ovulation. Changes in cervical mucus, body temperature and menstrual-cycle patterns may also provide useful clues.

What Can You Optimise Naturally?

The practical approach is to support your overall reproductive health, address any factors that may be affecting conception, and seek a fertility assessment when appropriate.

1. Build a Healthy Foundation

Being significantly underweight or overweight may affect ovulation, hormone regulation and pregnancy risks.

The goal is not rapid weight loss or weight gain but to work towards a healthy and sustainable weight through balanced eating and appropriate physical activity.

For some women with polycystic ovary syndrome, or PCOS, improving metabolic health may also help support more regular menstrual cycles.

2. Prepare Nutritionally for Pregnancy

3. Understand Female Fertility Factors

Endometriosis may affect fertility through inflammation, ovarian cysts, pelvic scarring or changes around the fallopian tubes.

Some women experience painful periods, pelvic pain or pain during intercourse. Others may have few obvious symptoms.

When endometriosis is known or suspected, it may be helpful to seek advice earlier rather than continuing to try without understanding how it may be affecting fertility.

Egg quality is strongly influenced by age. While healthy habits can support overall reproductive health and prepare the body for pregnancy, no food, supplement or lifestyle programme can reverse age-related changes or guarantee a healthy embryo.

Rather than focusing only on improving egg quality, it may be more helpful to understand whether age, ovarian reserve or another medical factor could influence your next step.

4. Include Male Fertility from the Start

Fertility difficulties are not only related to women.
Sperm count, movement, shape and function may all affect conception. Male fertility may also be influenced by medical conditions, smoking, recreational drugs, heavy alcohol use, certain medications and excess weight.

Where there is a concern, a semen analysis provides far more useful information than symptoms or supplements alone.

Both partners should be assessed from the beginning. Otherwise, months may be spent investigating one side while a factor affecting the other remains unidentified.

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5. Optimal Ejaculation Frequency

Sperm quality is generally at its best when ejaculation occurs every two to three days.

Regular ejaculation helps clear older sperm from the reproductive tract while supporting the continuous production of new sperm in the testes. As a result, fresher sperm may have better motility (swimming ability) and lower levels of DNA damage, both of which may improve the chance of successful fertilisation.

What Dr Chua Looks at First

Before recommending treatment, Dr Chua looks at the overall clinical picture rather than focusing on one result in isolation.

He may consider:

● The age and medical history of both partners
● How long the couple has been trying
● Menstrual regularity and signs of ovulation
● The timing and frequency of intercourse
● Previous pregnancies or miscarriages
● Symptoms suggesting PCOS, endometriosis or another condition
● Previous pelvic infection, surgery or fertility treatment
● Whether semen analysis or further testing would be useful

For some couples, the next step may simply be to continue trying naturally with better timing. For others, it may involve treating an underlying condition or discussing fertility treatment. Any recommendation should follow the findings of a proper fertility assessment.

When Should You Visit a Fertility Specialist?

As a general guide:

Women under 35 may seek an evaluation after 12 months of regular unprotected intercourse without pregnancy.
Women aged 35 or older should consider an evaluation after six months.
Women over 40 are recommended to see a fertility specialist without waiting.

An earlier assessment or review may be appropriate at any age if periods are irregular or absent, endometriosis is suspected, if there is a known reproductive condition, or there are concerns about male fertility.

Fertility testing can help a couple understand whether they should continue to try naturally and whether there is anything that should be addressed sooner.

Frequently Asked Questions

Start With Understanding

Trying to conceive can feel overwhelming, especially when every source seems to offer different advice.

You do not need to try everything at once.

Whether you are preparing for pregnancy or have already been trying for a baby for some time, Dr Chua can help you understand the factors affecting your fertility, identify what can reasonably be optimised and decide on the most appropriate next step.

Optimising Natural Fertility

Understanding Your Fertility and
the Natural Conception Process

Why Age Matters in Fertility

The Menstrual Cycle and Ovulation

The Fertile Window