So, you finally made the decision to come see us, but you have a lot of questions about fertility. That’s OK. I can assure you, the following will cover at least the top five questions asked during the first encounter with our patients. The common theme of these various questions is: how can I optimize natural fertility?

  1.       Does age affect fertility? There is always a concern with age. You may already know that fertility declines with age.  Regardless of age, the likelihood of conception is highest in the first three months of unprotected intercourse or exposure to sperm. Eighty percent of couples conceive within the first 6 months.
  1.     What is the optimal frequency of intercourse? A common myth is that frequent ejaculations decrease male fertility. A retrospective study suggests that men with normal semen quality continue to have normal sperm concentration and motility after daily ejaculations. Interestingly enough, men with low sperm count have improved sperm concentration and motility with daily ejaculation. Of note, abstinence longer than 5 days may adversely affect sperm count. In summary, having intercourse daily vs on alternating days will result in similar fertility outcomes. Just make sure intercourse is more frequent than once a week.
  1.     When should you have intercourse? In many movies, there is a frantic phone call placed to the partner in a state of panic. It is always the successful professional in her late thirties commanding her husband to get home because she is ovulating. Scientifically speaking, it works little differently. The fertile window is defined as the 6-day interval leading up to the day of ovulation. Intercourse is most likely to result in pregnancy within the 3 days prior to ovulation, and the likelihood of pregnancy is greatest if intercourse falls on the day prior to ovulation.

The fertile window is defined as the 6-day interval leading up to the day of ovulation. Intercourse is most likely to result in pregnancy within the 3 days prior to ovulation


  1.     How do you know you are 3 days away from ovulation? You can use your menstrual calendar, cervical mucus, body basal temperature, or an LH kit to predict ovulation. Overall, the highest pregnancy rate is associated with intercourse on the day of peak ’thin and clear’ cervical mucus.


  1. How about diet and lifestyle?  Smoking accelerates time to menopause by adversely affecting the ovarian physiology. In addition, miscarriages are more common among women who smoke. Effects of alcohol on fertility is not as clear. High levels of alcohol consumption are best avoided while attempting pregnancy. More than two glasses of wine a day may be considered a high level of consumption. For fetal well-being, all mothers are advised that no alcohol should be consumed during pregnancy. So, do you need to give up your latte or cappuccino while trying to conceive? Caffeine consumption is associated with decreased fertility. This does not mean you must suffer from droopy eyes and yawning all day long. The magic number seems to be 500 mg of caffeine, or 5 cups of coffee, per day. Limiting the consumption is always less challenging than giving up your daily routine.


This is a brief summary of what may be impacting your natural fertility. The scientific evidence behind these recommendations is presented in a committee opinion by ASRM.


Dr. Kay Waud, MD, PhD