After all, I was only 29, fit and healthy, when my husband and I started trying for a baby not long after we got married in 2009. I’d been on the contraceptive pill, Cilest, for years and when I stopped taking it my periods didn’t resume. 

After months and months of trying to conceive with no luck, I went to my GP who referred me for tests. These showed it was likely I had PCOS (polycystic ovary syndrome) and I was eventually referred for IVF.  

Back then I only knew one person who’d had IVF and because, aged 29, I was still relatively young fertility wise, it didn’t seem real that I would need something which seemed so huge and terrifying.  

We were living in Hammersmith, London, at the time and fortunately, we qualified for one round of IVF funded by the NHS which we opted to have at Guys and St Thomas’ Hospital in London – primarily so that it would be closer to my office but also because our research suggested it had good results. 

When we went for our first IVF appointment in January 2012 it was made very clear that success was by no means guaranteed and so I made the decision not to tell many people, apart from a few close family and friends.  

The truth was I was terrified that the treatment wouldn’t work. I couldn’t cope with having to tell everyone the bad news if it failed.  

Soon my life revolved around week after week of injections, appointments, internal scans, and worry. Fortunately, I was extremely lucky.  

Despite being warned that the handful of embryos harvested were not good quality ones, we had two embryos transferred and one was successful.  

I can still remember that moment in the bathroom of our house in Hammersmith when the test came up positive. 

My husband was away with work, and I had woken up extra early to do it on the date the hospital had advised. 

When it came up positive, I broke down in tears of utter relief as I phoned my husband, unable to believe it was really true. That we were going to have a baby. 

Fortunately, my pregnancy progressed as normal, and our son was born in December 2012. He was my world, and I felt lucky that breastfeeding went well, and I savoured every second of being a mum (well, apart from the sleepless nights which nothing could have prepared me for!) 

I stopped breastfeeding when he was a year old, and my periods returned. With them, I dared hope that maybe I would get pregnant naturally this time. 

And after months of periods, when one month my period didn’t come, I did a pregnancy test and couldn’t believe it when it was positive. 

Sadly, my joy was short-lived when less than two weeks later I started bleeding and when I did another pregnancy test it was no longer positive. 

Another four months later the same thing happened – a late period, a positive pregnancy test, my daring to believe I might have another baby. And then two weeks later I started bleeding. 

Some people might have given up trying then, considered themselves lucky to have one healthy child. I really did consider myself incredibly lucky, but I also wanted another baby and a sibling for our son. 

So using some savings we paid over £5,000 to return to Guys and St Thomas’ Hospital for another round of IVF. 

And in October 2014 we started the cycle of injections, scans and egg harvesting. Because the embryos from our first round hadn’t been good enough quality to freeze, we had to do it all from scratch again. 

By now I was working part time from home, so it was easier this time than trying to make it to hospital appointments before I went into the office in the morning. 

I was heartbroken when neither of the two embryos that were replanted took, and we had none good enough to freeze. 

Not long after, we moved from London to Oxfordshire and I had become obsessed with getting pregnant again.  

We used the last of our savings to have another round of IVF at a local Fertility Clinic in Oxfordshire 

This time I did everything in my power to try and make it work – I had reflexology and saw a fertility nutritionist about diet changes to make. Determined to give myself the best chance. But, yet again it didn’t work. 

Afterwards I was utterly devastated.  

I researched online for anything that could help and read about a natural killer (NK) cells test which I paid around £300 for at a hospital about an hour away. During this I was given a mid-luteal endometrial biopsy, or an ‘endometrial scratch’ to enhance the uterine decidual response and advised to take progesterone supplements. 

The following cycle I fell pregnant naturally. Whether it was that, or just luck, no one will ever know for sure. But every day that followed I was on tenterhooks, waiting for the inevitable bleeding to start like it had done so many times before. 

One month passed, and then another. The bleeding never came. In May 2016, two weeks overdue, my second son was born after a natural delivery. 

Until I held him in my arms I couldn’t quite believe here was here. Not a day has gone by since then when I don’t count myself incredibly lucky. 

Now my sons are 8 and 12 and I love telling people about my two miracle boys – both remarkable in different ways. And I love sharing my story with anyone who will listen, because when I was in the depths of infertility despair it was stories like mine that kept me going. 

IVF, or In Vitro Fertilisation, is a fertility treatment used to help couples achieve a pregnancy – by taking the tricky part of the baby-making process outside of the body. In Vitro, a Latin term, literally means ‘outside the organism’.  

However, while it might be the most high profile and talked about treatment for couples experiencing fertility issues, it’s important to note that IVF isn’t the only fertility treatment available and, if you’re only beginning to look into assistance with conceiving, there may be other options that are more suitable for your circumstances.  

But if your doctor advises that IVF is the right next step for you, this guide brings together everything you need to know about what it’s really like – with honest insights and advice from incredible women in our MadeForMums community who’ve been through it themselves, alongside expert input from an NHS doctor and a clinical embryologist. 

1. IVF can take a long time, so don’t put your life on hold  

Each woman’s IVF journey can vary a huge amount in length, from months to decades so, if possible, you need to try and continue to live your life and enjoy the things you normally do and give yourself an outlet outside of the IVF experience.  

“The cycle length from first consultation until pregnancy test can vary greatly,” says Philippa Lowen, Clinical Embryologist at TFP Fertility. “This is due to patients presenting with different reasons for infertility and clinics tailoring the treatment to them.  

“Prior to commencing an IVF cycle, some patients will require further investigation and treatment, others may opt to use donor gametes, which requires further appointments and time to find a suitable donor.  

“Once you are ready to proceed, you will need to wait for the right phase of your menstrual cycle to commence. The stimulation regime used and how quickly your follicles respond to the hormones will determine how quickly you can proceed to egg collection.

“Taking this into consideration, theoretically, you could be taking a pregnancy test a couple of months after your initial consultation, but for most patients, it will be longer. However, if the cycle is taking longer, remember your clinic wants you to have a successful outcome, and the delays are because we are trying to optimise your success.” 

Many women we spoke to admitted they hadn’t realised how much waiting would be involved or how long their journey would be before they started.  

2. Be prepared for the disappointment of the IVF funnel 

There are many highs and lows in the IVF process but one thing that many women aren’t prepared for is the loss of eggs and embryos throughout each stage of an IVF cycle – also known as the IVF funnel.  

“The IVF funnel refers to the natural loss of eggs and embryos at different stages of development prior to transfer,” says Philippa Lowen. “This can happen for a number of reasons; for example, not all follicles drained will yield an egg; some of the eggs collected will not be mature and capable of fertilisation; and some mature eggs may fail to fertilise. 

“Most fertilised eggs will divide to form embryos, but a few do not, and some embryos will stop developing. This is a normal phenomenon and can be seen as a natural selection process, as not all eggs have the potential to fertilise and form viable embryos.

“However, the degree of loss and where eggs or embryos fail to develop further can vary between women. On average, around 80% of eggs collected are mature, of these, 66% fertilise normally, 95% of fertilised eggs form embryos and up to 60% of embryos continue to develop until the blastocyst stage.” 

One day you might be being told you’ve had a very successful egg collection only to realise that of these eggs only one or two, or perhaps none at all, are viable for implantation.  

“Don’t be shocked by the drop off on eggs,” says Laura Coyle, who had 2 rounds of IVF. “I think I had 13 eggs retrieved, 7 fertilised, 6 made it 24 hours and by day 4 I only had 1 embryo. But it only takes one – the proof is the 3-week-old currently snuggled in my arms!”  

Katy Hill agrees: “I had 12 eggs harvested so thought that would equate to 12 embryos – it doesn’t! I think we ended up with two potentially useable embryos, one of which is my almost 5-year-old.”  

Try not to be disheartened if the very first stage doesn’t yield many eggs either, as the IVF funnel is different for every woman. “Don't worry if you don't have lots of follicles, or lots of eggs retrieved,” says Jayne G, who went through 6 rounds of IVF.  

“On round 1, I only had 2 eggs retrieved. Both fertilised but weren’t amazing quality and one was put back in at 3 days post fertilisation. She’s now a very sassy 8-year-old! 

3. Talking to other IVF parents is a lifeline 

Until you’re part of the IVF club, it’s impossible to know how it feels to be on this unique rollercoaster ride of emotions, hormones, hopes, wishes, disappointments, fear and waiting. As well as talking and opening up to your partner, it’s important to find other people you can talk honestly to and who will understand exactly how you feel.  

“Find other IVFers to talk to,’ says Jayne. “They'll understand and you won't feel guilty for talking to them about it all. I didn't tell anyone when I was going through treatment, I couldn't handle their excitement because they "knew it was going to work this time". But IVF forums helped me.”  

“This did put a strain on our relationship because I didn’t want to be around them.”, says Kelly, “I found it super difficult going through IVF alone. I had no friends who had been through it or were going through it, so I joined some Facebook groups.” 

And Emerald Devonshire, who conceived through IVF, wishes she’d found her tribe sooner: “I didn’t know there were other women a few roads away from me who were using the same clinic, doing the same tests and treatments as me. I’m now lifelong friends with these people after meeting them at baby groups, but we could have supported each other before the babies came, when we needed more support. It’s incredibly lonely sometimes.” 

Many of the IVF parents we spoke to found a lot of comfort in speaking to others on Instagram and in Facebook groups, and the beauty of online communities is you don’t have to share your real name if you want to talk anonymously. Or if you prefer meeting people in real life, ask you clinic if they have fertility circle or support group of other IVFers that you can join.  

“After my first round was unsuccessful, I found a huge IVF/infertility community on Instagram,” says Vicky “I then started sharing my journey and following others on theirs. Unless someone has been through it themselves, they will never fully understand.” 

Kassie also found comfort and support in podcasts, as well as groups: “I would recommend the Big Fat Negative Podcast. Start at the beginning when the presenters start their journey too and it really helps you feel like you’re not alone!” 

4. Take all the counselling you’re offered  

All licensed IVF clinics in the UK are required to offer counselling to their patients, but while some provide it for free, at others you may have to pay extra for it. 

You could also ask your GP about NHS counselling services or opt to see a counsellor privately outside of the IVF space.  

Whichever route you choose, it’s important to realise that even if you feel strong and mentally prepared for IVF, counselling could make a huge difference to your overall experience.  

“IVF can be difficult both physically and psychologically,” says NHS GP Dr Philippa Kaye. “If you are having treatment with a partner, then this stress affects both of you, and it is important to recognise this. Stress and mental health are not a competition, instead try to view this challenge as a team.  

“Just as it is important to look after your body physically, it is also important to try and protect your mental health. Counselling is recommended as part of treatment, but it is only mandatory if you are using donor sperm, eggs or embryos. So, keep talking and reach out if you need extra support.” 

Katie Chapman, who had 7 rounds of IVF and had a little boy after 15 years of trying, found counselling invaluable: “IVF is one of the hardest experiences to go through. It’s full of hope, love, dreams and extreme amounts of heartache and worry.”

Tina Jurado, mother of two children conceived through IVF treatment says: “I wish I’d known what a huge emotional rollercoaster it would be and what a strain it would put on my husband and I’s relationship.” 

“We had to talk regularly and remind ourselves why we were doing it. We had to try and not take our frustrations out on each other. We’re stronger now because of it but at the time it was so tough.” 

5. You can help improve your chances before IVF starts  

IVF is a two-way street and you need to work with the doctors and scientists to give yourself the best chance possible of conceiving. Being as healthy as possible before you start treatment (and during it) is important and will help you deal with any physical or mental hurdles to come.  

“This means stopping smoking, if you are a smoker, as well as decreasing alcohol intake (which should be stopped completely during treatment) as well as decreasing caffeine. 

”If you have obesity or are overweight, then trying to lose weight (and I appreciate that this is difficult) can be helpful. Try to eat a healthy, balanced diet, exercise and move your body regularly and don’t forget to take your folic acid.   

“Your medical team will take your full medical history as part of your assessment and there may be some conditions which need to be treated before IVF can start. For example, your medical team may recommend optimising blood glucose control if you have diabetes. They will also review your medications to see if they are all ok to continue during pregnancy and if not discuss options with you.” 

Some of the women we spoke to agreed that prioritising their health helped: “Work as much as you can holistically to build the quality of your egg and sperm,” says Mirfat Band, who has been through IVF treatment. “It just takes ONE good quality egg and sperm to make a baby. It’s the quality that matters and not the quantity.” 

“You need to be in good health.” says Laura. “I’m overweight and was 42 when I had IVF, but I’d made sure I’d taken the recommended supplements and had cut right back on caffeine and alcohol and I don’t smoke or vape.” 

6. You may need to advocate for yourself  

While your medical team will do everything possible to help you have a positive outcome and IVF experience, you aren’t their only patient, and they will only have a certain amount of time and resources to dedicate to your individual case.  

It’s important to advocate for yourself and ask questions about any treatments or procedures you might want to explore. 

“Research, research, research,” says Mirfat. “Your clinics, your treatment plan, your condition, food to eat and supplements to take. And advocate for yourself, especially when paying private. Don’t be afraid to seek second and third opinions.” 

Kassie, who experienced IVF, agrees that you shouldn’t be afraid to speak up. “Push for as much testing as possible,” she says. “Make sure your partner (if male) is getting tested too. A lot of focus early on is on the female, whereas the male just has semen analysis.” 

“Advocate for yourself,” agrees Juliet. “If you want the extra tests, and can afford them, then go for it. Find out as much as you can during each transfer.” 

7. Non-NHS funded IVF is a money-making business  

As well as being an innovative and life-changing way to help couples conceive babies they wouldn’t otherwise be able to, IVF is also a money-making business, so it’s important to be aware of this before you part with more of your savings than you need to.  

Private clinics are free to set their own costs, so if you’re funding your treatment, you will have to shop around and read up on each clinic’s success rates versus cost of treatment to decide. 

All private clinics in the UK must adhere to HFEA (Human Fertilisation & Embryology Authority) legislation and will only suggest and charge you for treatments or add-ons after explaining the likelihood of it helping you to conceive a baby.  

There’s also a colour-coded ratings system for add-ons based on their effectiveness that you can find here. However, there are lots of other unregulated fertility products on the market that are designed to get your hopes up and get you spending money.  

“Instead, it’s best to just stay calm, stay focused, utilise your team and let science and medicine do its thing.”, says Jayne, “It really is amazing!” 

If there are treatments you want to pay extra for, do your own research and make a considered judgement on what’s right for you: “Research any add-ons that you are offered,” says Katy.  

“We paid extra to have an embryoscope (for closer monitoring of the developing embryos) and for us it was totally worth it. We were sent the footage afterwards, so I have a video of my daughter from two cells old!” 

8. IVF on the NHS isn’t just a postcode lottery    

As well as taking into account where you live, there are other criteria and limitations as to who can receive IVF or other fertility treatments on the NHS, and this may come as a shock if you’re told you’re not eligible. 

This was the case for Fleur Ashley, who has a baby boy after 3 rounds of IVF: “I wish I had known that the number of rounds of IVF offered by the NHS varies, depending on where you live. Even then, there is no guarantee you will be offered treatment.  

“I was told that we would not be offered treatment on the NHS, as they felt the odds of success were too much against us and the money, they had to invest wasn’t worth it for them! In the end we paid to go private… had 3 rounds of IVF, resulting in 3 pregnancies but only one beautiful boy made it.” 

If you are eligible for IVF treatment on the NHS, you’ll want to do your homework and find out exactly which elements of your treatment are included, how many cycles and what exactly is involved in one “cycle”, as different areas of the country have contrasting definitions.  

9. You need to be really organised  

It might be time to brush up on your spreadsheet and diary organising skills, because going through IVF treatment requires a level or organisation above and beyond the everyday. You may be required to have tests before you even start the cycle and will need multiple appointments at your clinic throughout.  

The number of appointments or procedures involved will depend on the type of fertility treatment needed and what is required,” says Dr Philippa Kaye. “Most involve initial investigations and appointments to discuss options.  

“Once a course of action is decided they tend to involve medications and monitoring with ultrasound scans. So, there can be lots of appointments even if a first course of treatment is successful. Unfortunately, it can take multiple courses of treatment so there may be lots of appointments.” 

If you work, you’ll want to think before you start treatment about how to divulge to your employer (and your colleagues) and whether they have any policies in place to support you.  

“If you are able to speak about this at work then do so,” says Mirfat. “This will hopefully stop you stressing about the appointments or project deadlines you might have to miss or delay due to appointments. There will be lots of scans and blood work – so be prepared!  

Remember some procedures will also involve time off work and time to recover: “The most invasive procedure for a woman undergoing IVF is the egg collection,” says Philippa Lowen.  

“During this procedure a vaginal ultrasound probe with a needle attached is used to enter the ovary and collect the fluid and eggs from the follicles.  

“Due to the invasive nature of the egg collection, it is usually performed under sedation or more rarely anaesthesia. Prior to sedation, you will need to fast, and it is recommended that you are not left unaccompanied and do not drive for the first 24 hours.” 

You’ll also need to be organised with your injections: “The medications weren't too bad for me as I'm not needle phobic,” says Jayne, “but there can be a lot, so a diary and alarms to help remind you to take them is useful. Especially for that Trigger Shot.” 

“Check out your work policies,” says Juliet. “They might cover IVF and so you might be entitled to extra time off for appointments. And there will be a lot of appointments at the clinic in the run up to embryo transfer.” 

10. The meds can take their toll, but the needles aren’t as bad as you’d think 

“Some IVF protocols involve downregulation,” says Philippa Lowen. “The drugs used to downregulate your normal menstrual cycle can cause menopausal symptoms including headaches, hot flushes, mood swings and poor concentration.  

“The hormones used to stimulate the follicles, which are used in all but natural cycles, can cause breast tenderness, bloating and occasionally nausea. These hormones can also make you more emotional. Finally, the hormones used to maintain the lining of the womb can cause breast tenderness, bloating and constipation.” 

“The meds can knock you a bit,” says Laura. “My first round I felt nauseous and had headaches and tummy cramps. But the needles are not as bad as you think. They are tiny - I’ve had worse blood draws and vaccinations than the IVF injections.” 

Kelly agrees: “From someone who has a fear of needles, they don't hurt as bad as you would think... thankfully!” 

“It is very distressing and puzzling when you have previously found it easy to conceive naturally,” says leading fertility expert Dr Carole Gilling-Smith, CEO and Medical Director of the Agora Clinic. 

“Secondary infertility is defined as the inability to conceive after previously having one or more successful pregnancies. Research indicates that approximately 10–15% of couples experience it.” 

However, don’t just assume you’re experiencing secondary infertility if you’ve been trying for longer than you did first time, as there could be many other reasons, and secondary infertility is only diagnosed after a set period of time. 

“A couple would be diagnosed with secondary infertility if they haven’t conceived after trying naturally for at least 12 months,” says Dr Carole. 

“That 12-month timeframe is a bit arbitrary and really depends on the couple. We’d always recommend getting a fertility check-up—or MOT—if the woman is 35 or older, as fertility does decline with age. It’s also worth checking in sooner if either partner has a medical condition that could affect fertility—like recent surgery to the ovaries, uterus or testicles, irregular periods, or complications from a previous pregnancy or delivery that could have affected the fallopian tubes or uterus.” 

What causes secondary infertility? 

If your first baby came easily, it can feel confusing—and frustrating—when the second takes longer. But if there’s a big age gap, or you’re trying again later in life, it could be down to changes in your fertility. 

“A woman’s egg genetic health declines with age over 35, and a man’s sperm genetic health declines over the age of 45,” explains Dr Carole Gilling-Smith. You’re also more likely to develop fibroids as you get older, which can interfere with conception. 

And it’s not just age. 

“This rush can mean they’re not giving their bodies a full 18 months to recover from the first birth, which could be affecting things,” explains Zita. 

There’s also a difference in mindset the second time around. “Before trying for the first baby, many parents have eaten healthily, watched their weight, and avoided drinking or smoking—but second time around, complacency may have set in,” Zita adds. 

Dr Carole agrees: “Lifestyle factors such as obesity, smoking, excessive alcohol consumption, and high stress levels can all impact fertility.” 

Then there’s the emotional and physical toll of parenting itself. “There’s also the tiredness and stress of looking after your first, which may interfere,” says Zita. “Especially if it stops you having sex as regularly as you did before becoming parents.” 

Sometimes, complications from your previous birth may be part of the picture too. “Previous pregnancy complications such as miscarriages or complications during delivery can play a role in future fertility,” says Dr Carole. 

Underlying health issues may also affect your chances. “Medical conditions such as polycystic ovary syndrome, endometriosis, thyroid disorders and pelvic infection can affect female fertility, while in men, varicocele or sexually transmitted diseases—and even taking antidepressants—can impact sperm health,” she adds. 

And if you’re still breastfeeding, that could be a factor too. “The prolactin hormone interferes with ovulation and may also stop you conceiving,” says Zita. “However, reducing feeding times, especially at night, may help regulate things again.” 

Could it be PCOS? 

Polycystic ovary syndrome (PCOS) is a common condition where small cysts develop on the ovaries, which can affect ovulation and make it harder to conceive. And while it’s often talked about in relation to first-time fertility issues, it can also be the reason you're struggling to get pregnant again. 

“Sometimes it goes undetected in a first pregnancy and only causes problems when a woman tries again,” says fertility expert Zita West. 

One of the key symptoms of PCOS is weight gain, which can make other symptoms worse—including irregular periods, acne and excess hair growth. All of these can impact your chances of conceiving naturally. 

Where to get help if you think you have secondary infertility

Unfortunately, there’s less support available for secondary infertility, as priority is given to childless couples.  

After one to two years of trying for a second baby, without a pregnancy, a GP will normally agree to start testing for abnormalities.

Couples will be tested to check the woman is ovulating properly and that the man’s sperm is normal. 

If you’re over 35 you may be tested sooner because the longer you wait the less chance you have of being successful. 

Treatment options for secondary infertility  

If tests show you have a problem, you will need to look into the four main fertility treatment options.  

These are Clomid, tablets to stimulate your ovaries, IUI, when your partner’s best sperm is selected and placed in your uterus, IVF, injections to stimulate egg production, which are then collected and mixed with your partner’s sperm, and ICSI where a single sperm is injected into each egg collected. 

Your treatment will differ depending on the reason for your infertility, but the majority of primary care trusts won’t fund treatment for couples that already have a child. Check out the Fertility Network for info on what funding is available to you. 

“For women with polycystic ovary syndrome, hormone treatment can help to regulate ovulation,” says Dr Carole.  

“In vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) are often advised to overcome issues such as blocked fallopian tubes, male factor infertility and unexplained infertility (when no cause is found). And surgery is sometimes advised for conditions like endometriosis or uterine fibroids. 

“Success rates for treatments depend on numerous factors including age, the specific cause of infertility, and overall health. There is no compelling evidence to show that success rates are lower in secondary infertility and, many couples achieve successful pregnancies through these interventions.” 

At-home tips that could make a difference 

Making a few lifestyle changes can go a long way in supporting your fertility—and often, it’s the best place to start. Eating a balanced diet, exercising regularly, and avoiding smoking, alcohol and recreational drugs can all boost your chances of conceiving. 

“Lifestyle modifications such as weight management, stopping smoking and recreational drugs, and dietary changes can all improve fertility,” says Dr Carole Gilling-Smith. “But you need to work on these consistently for at least three to six months to see an effect.” 

Timing matters too. Having regular sex—ideally every couple of days—can help maximise your chances, as sperm can survive for up to four days in the Fallopian tubes, waiting for the egg to be released. 

And don’t underestimate the impact of stress. Secondary infertility can be emotionally draining, so anything that helps you feel calmer—whether it’s acupuncture, aromatherapy, meditation or yoga—might be worth exploring. 

Where to get support with secondary infertility  

The emotional toll of secondary infertility is often underestimated. Many parents struggling to conceive again feel isolated, frustrated—and even guilty. 

Susan Seenan, former chief executive of leading fertility charity Fertility Network UK, says these feelings are incredibly common, but no less valid than those experienced by first-time hopefuls. 

“Secondary infertility can be every bit as painful and difficult to deal with as primary infertility, and couples suffering from secondary infertility deserve support and understanding, just as much as anyone who is trying to conceive for the first time,” she says. 

There’s also a unique emotional layer that comes with already having a child. “There is often a sense of guilt about this—a feeling that you should simply be grateful for the child you have when others are still trying for a first.” 

Existing children may also add unintentional pressure. “Often, there can be the added pressure of existing children asking why they can’t have a brother or a sister. This can exacerbate the emotional impact felt when trying for a second baby: not only is there the pain and longing for another child, there is the feeling of guilt that you can’t provide a brother or sister and that your only child may be missing out.” 

And for couples who conceived quickly the first time, the change can feel jarring. “It may be incredibly difficult to deal with the fact that it's not happening for them in the same way again,” she adds. 

Pics: Getty 

Read more:

• Ovulation symptoms: 10 signs of ovulation to know
• What is early menopause and how can it affect fertility?
• Can Vitamin D supplements help me get pregnant?

Women can only conceive in the days around ovulation – the release of a mature egg from the ovaries – which typically occurs once a month and, as well as tracking your menstrual cycle on a calendar, there are often certain physical signs of ovulation you can look out for to help you pinpoint the exact date each month.

To help you work out when you're ovulating and give you the best chance of conceiving each month, you'll find everything you need to know about ovulation below, with expert advice from Dr Amin Gorgy, fertility consultant and co-director of the The Fertility & Gynaecology Academy in London.

What is ovulation?

Ovulation is the name given to the phase of a woman's menstrual cycle when an ovary releases an egg, also known as an ovum. It usually happens in the middle of a cycle, although this can differ depending on each individual.

"Most people ovulate two weeks before they start their period. So, for example, if you have regular 28-day cycle you will ovulate around day 14," says Dr Gorgy. When the egg is released it travels down the fallopian tube where it waits to be fertilised by a sperm.

Want to dig a bit deeper and know the science behind this fascinating monthly occurrence? Ovulation is triggered by a hormone released by the brain's hypothalamus region, which causes your pituitary gland to secrete two hormones: FSH (follicle-stimulating hormone) and luteinizing hormone (LH). FSH causes follicles in one ovary to mature while LH makes the ovary release the egg. If the egg is fertilised your body will then start producing more progesterone to help the uterus prepare for pregnancy.

How long does ovulation last?

The process of ovulation typically lasts for between 12 and 24 hours, after which the released egg will die if it is not fertilised by a sperm.

If the egg isn't fertilised your body reabsorbs it and the egg and the uterine lining will be shed in the form of a menstrual period around two weeks later. Twelve to 24 hours might seem an impossibly short amount of time to try and conceive, but the good news is that sperm can live much longer than eggs so even if you have sex a few days before you ovulate, live sperm may still be ready and waiting for the newly released egg.

"Normally sperm will live in the reproductive tract for up to five days," says Dr Gorgy. "So, you don’t have to have sex on the spot when you think you’re ovulating. Having intercourse just before ovulation is the best time, but there's no need to get yourself too stressed about the timing. If you have unprotected sex twice a week throughout the cycle that should be more than enough."

While noting physical changes in your body is a great way to see when ovulation occurs, you might also want to track ovulation by charting your menstrual cycle for a few months before you start trying for a baby. By charting your menstrual cycle you'll be able to see how long your usual cycle is and which day you are most likely ovulating on, so you can then keep an eye out for the physical symptoms.

Ovulation symptoms

So how exactly do you know when you're ovulating? Is it possible to feel ovulation happening? And if so, what does ovulation feel like? As with most things to do with the menstrual cycle, the signs of ovulation differ from woman to woman but there are some common symptoms that many women experience.

The majority of these ovulation day symptoms are very subtle and until you start looking out for them you may never have noticed them before. You'll find that many of the symptoms we've listed below happen in the five days before ovulation, on the day itself and sometimes the day after too.

However don't worry if you don't experience any of the below: "Some women won’t experience any ovulation symptoms, but it’s not a cause for concern," says Dr Gorgy. "It’s just the way it is."

10 signs of ovulation

1. Changes in your basal body temperature

Your basal body temperature (BBT) is the lowest temperature your body reaches when at rest and usually occurs after a period of at least three hours sleep.

If you're tracking your BBT to help you see when you're ovulating you'll want to take your temperature as soon as you wake up after a night's sleep and before you get out of bed. Over the course of your menstrual cycle you basal body temperature will change and on the day after you ovulate it will go up by around 0.2-0.6°C due to a rise in the hormone progesterone. It may also dip slightly just before you ovulate. Your BBT will then remain slightly elevated until your next period.

While tracking your BBT can't help you predict ovulation if you record your temperature when first wake up for a few months you'll start to see a pattern and be able to work out which day of your cycle you normally ovulate on. As the temperature increase isn't huge you can buy specific basal body temperature thermometers that can accurately record your temperature to two decimal places.

2. Changes to your cervical mucus/discharge

If you're trying to conceive you'll want to keep an eye on your underwear (no one said trying to conceive was glamorous!) as your vaginal discharge will change over the course of your cycle, alerting you to when you're close to ovulation. After your period ends you'll have a dry spell with little or no discharge followed by a few days where the mucus is sticky, and white or cloudy in appearance.

In the week before you ovulate however, you'll notice an increase in the amount of discharge, which reaches its peak in the 2-3 days before you ovulate. The texture of this discharge will change too – becoming thin and watery around the time of ovulation similar to the consistency of egg white. If you hold this mucus between your fingers you'll be able to stretch it out a couple of centimetres without it breaking. Once ovulation has occurred the discharge will reduce significantly in amount again and become thicker.

3. Appetite and mood changes

One of the most annoying phrases known to womankind – "Is it that time of the month?" – actually has some legs to it (although we'll never admit it to men!) because throughout your menstrual cycle, different hormones can alter both your mood and your appetite.

Everyone knows about PMT (pre-menstrual tension), but conversely, when you're ovulating you're actually likely to be in a much better mood because of a rise in oestrogen, which is linked to the production of serotonin (also known as the happy hormone). Serotonin can make you feel more self-confident and more attractive and so sex may feel different when you're ovulating as you may be more aroused.

Just before you ovulate you may have a few days of reduced appetite and naturally just eat less because the surge in oestrogen can cause appetite loss. However, after ovulation, the rise in progesterone has the opposite effect and you'll suddenly feel hungrier and may have one of those days where you just can't stop raiding the fridge.

4. Breast tenderness

Another sign of ovulation that you can use to track your cycle in the months before you try to conceive is breast tenderness. Just after ovulation, the rise in progesterone can lead to increased breast soreness and tenderness, especially around the nipples and the feeling of heavier or achier breasts.

5. Mild lower abdominal pain

Can you feel ovulation actually happen? According to some women and doctors, yes you can, and it feels like a mild, dull ache or sharp pain on one side of the abdomen. This is called Mittelschmerz and happens when the ovary releases the egg. It can last mere minutes or a couple of hours and if you are one of the women that experiences this sign of ovulation then it's an excellent indicator that you should have sex pronto!

6. Changes to the cervix

A less well-known symptom that you're in your fertile window and ovulating is that your cervix changes shape. During ovulation, your cervix becomes softer and wetter as well as higher and more open.

The only way you'll be able to use this as a sign that you're ovulating is by acquainting yourself with your cervix at different points in your cycle. With clean hands insert a finger into your vagina and if your cervix feels hard and closed you're probably not ovulating or near your fertile window whereas if it feels soft and open then it's a good time to have sex.

7. Spotting

Another symptom that can help you know if you're ovulating is if you see any spotting in your underwear when you're not due on your period or at the point when you don't think you could be pregnant yet. When the follicle ruptures and releases a mature egg this can cause a small amount of bleeding that'll show as spotting or brown discharge by the time you see it. Lots of women don't experience any spotting at ovulation though and as spotting can occur at other points of the cycle this isn't a particularly reliable way to check that you're ovulating.

8. Heightened senses

Some studies show that women who are ovulating or in the second half of their menstrual cycle (the luteal phase) have a heightened sense of smell, which is believed to help them become more attracted to the male pheromone called androstenone. Some women even have a stronger sense of taste and sight during ovulation too.

9. Increased libido

Wondering why you suddenly want more sex? That's probably because you're ovulating. It's nature's way of keeping the human race going by encouraging the body to want sex right at the time you're most fertile. The increased sex drive usually kicks in at the same time as the luteinizing hormone, so a few days before ovulation and lasts until just after ovulation – perfect timing for baby-making sex!

10. Feeling bloated and retaining fluid

You can blame those hormones for this not-so-pleasant sign that you're ovulating... bloating and fluid retention. The side effects of all those clever hormones working in tandem inside your body to release an egg can also lead to slower digestion and wind!

How to predict ovulation

There are a number of ways you can predict when you're ovulating, including tracking your menstrual cycle on a calendar or online tracker for at least three months before you start trying to conceive and working out your own body's cycle.

A normal cycle is between 25 and 35 days with ovulation occurring around 14 days before menstruation. Once you get to this point in your cycle you can then use the signs and symptoms above such as increased discharge, tender breasts, and cramping to predict when ovulation occurs.

To narrow down your fertile window even more you might want to consider buying an at-home or over-the-counter ovulation predictor kit. Ovulation Predictor Kits measure the amount of luteinizing hormone in your urine and, like pregnancy tests, are most effective first thing in the morning. A positive result on an OPK indicates that you are likely to ovulate within the next 24 to 36 hours. If you have charted your cycle and know the week you're likely to ovulate, you'll know when to start using the OPKs and will avoid using a whole month's worth each cycle!

"Ovulation prediction kits look at hormone levels to tell you when you're about to ovulate and for use at home they are good enough," says Dr Gorgy. "However, occasionally women will see hormone levels rise, but the follicle does not rupture and release the egg. As the prediction kit is monitoring hormone levels, it will not tell you that you have ovulated, just that it is likely that if you will ovulate. The best way to tell that you're actually ovulating is more medicalised, however – having scans and blood taken."

You might also want to consider using a fertility monitor to help you work out when you're ovulating. Fertility monitors are more expensive as many of them record your data from the months you use them to really help you pinpoint the best moment to have sex. There are a range of different fertility monitors including ones that you wear overnight to measure your BBT, ones that test hormones in your urine and ones that monitor your vaginal mucus.

Remember that not everyone will experience these signs of ovulation but if you don't, it doesn't mean that you're not ovulating or in your fertile window. Try not to get too stressed about predicting your exact ovulation day and instead enjoy the process of trying for a baby with your partner!

What are the signs you might not be ovulating, and what can you do about it?

If you're struggling to get pregnant even though you've been having unprotected sex at least twice a week for several months you might be wondering if you're ovulating at all! "Women are meant to ovulate each month," says Dr Gorgy, "but occasionally there may be a cycle or two every year that they don’t ovulate in. The frequency of cycles that women don’t ovulate in often increases with age or if you have a cycle that is longer than 35 days the potential for anovulation is higher."

If you've been monitoring your cycle and tracking ovulation and you think something might be wrong then it's best to speak to your doctor. "Current CDC guidelines state that if you are 34 or less and you have been having unprotected sex for a year and not getting pregnant you need to seek medical advice," says Dr Gorgy. "From 35 to 38 that goes down to six months and from 38 to 40, it's 3 months because as you get older the problems that can stop you from getting pregnant accumulate."

And if you're over 40? "Some people advocate that if you’re over 40 maybe you need to seek medical advice before you try to get pregnant because time is against you," says Dr Gorgy. "You could have tests to check your ovarian reserve such as an Antral Follicle Count where the follicles in each ovary are counted as well as a blood test called an AMH test (Anti-Müllerian hormone test). Another test can see if your Fallopian tubes are patent. Sometimes a woman can have a subclinical (meaning you don't feel anything at the time) infection that can cause damage to her Fallopian tubes."

The two main reasons you might not be ovulating are Polycystic Ovary Syndrome (PCOS) and low ovarian reserve. In these cases: "doctors can give something to make ovulation happen or monitor exactly when you ovulate, so you can use that time to have sex or intrauterine insemination (IUI), where we inject the sperm into the uterus," says Dr Gorgy.

Pics: Getty Images 

Read more:

• What is early menopause and how can it affect fertility?
• Can Vitamin D supplements help me get pregnant?
• Is it safe to drink when you're trying to conceive?

Early menopause is believed to affect around 1 in 100 women before the age of 40 and with the average age of first time mothers in the UK hitting an all time high of 32, this can have major implications for fertility.

To find out more about why early menopause affects some women and not others, what the signs and symptoms are, whether you can do anything to prevent it and what it can mean if you're trying to get pregnant we spoke to Dr Philippa Kaye, author of brand new book, The Science of Menopause: Understand Your Body, Make the Right Choices, Over to you Philippa...

What is early menopause?

The word menopause means the final period, and you have been through the menopause when you haven’t had a period for twelve months. Females are born with all the eggs they are ever going to have in their ovaries (in an immature state) and essentially, when you run out of eggs, the menstrual cycle and therefore the periods stopped.

The average age for the menopause is often quoted as 51, but this is the average age in Caucasian women. Research has shown that African American and Hispanic women go through the menopause approximately 9 months earlier, and globally the average age is even younger.

An early menopause is defined as a menopause under the age of 45, and occurs in approximately 1 in 20 people. A premature menopause, premature ovarian insufficiency is one under the age of 40, which affects 1 in 100 people. It can and does occur at younger ages, though becomes less common the younger you are, affecting 1 in 1000 people under the age of 30 and 1 in 10,000 people under the age of 20.

What is the difference between early menopause and perimenopause?

An early or premature menopause is one where the last period occurs before a certain age. The perimenopause is a period of years in the lead up to the final period, where you may have regular or irregular periods, and may have symptoms due to fluctuating and decreasing levels of hormones during this time.

Importantly, you can have treatment for your symptoms, whether or not you are still having periods!

What are the main symptoms of early menopause?

The symptoms of the perimenopause and menopause do not differ depending on the age at which they happen. The symptoms are due to changing levels in hormones oestrogen, progesterone and testosterone which affect all areas of the body.

However, symptoms can be more severe if you have a premature menopause, particularly if you have a surgical menopause, where the ovaries are removed during surgery (perhaps due to cancer). The symptoms can be more severe in this case and start very suddenly, as essentially the day before the surgery your ovaries may be working and producing hormones and the next day not, so instead of a gradual decline in levels of oestrogen the hormone levels suddenly plummet.

Physical symptoms include hot flushes and sweats, changes to your periods, headaches, joint aches and pains and more, while psychological symptoms include worsening PMS, irritability, anxiety, low mood and depression.  Some symptoms can be both physical and psychological including insomnia, fatigue and loss of libido. There can also be other changes such as weight gain and changes to your skin and hair.

Not all people will have symptoms related to the perimenopause and menopause. Approximately 1 in 4 or 5 women will not have, or have very few symptoms, while approximately half will have moderate symptoms and about a quarter will have severe symptoms.

Why do some women experience a premature menopause?

The cause of premature menopause, or premature ovarian insufficiency (POI) is often not known. In fact, somewhere between 70-90% of cases do not have a known cause. It is thought that there is likely to be a genetic component to POI as about 3 in 10 women with POI have a family history of the condition.

It is also associated with autoimmune conditions, which are conditions where the body’s immune system incorrectly attacks itself, for example type 1 diabetes and thyroid disease, and it may be that the immune system incorrectly focuses on the ovaries. Some infections such as TB and mumps are associated with POI, as are some health conditions such as epilepsy.

Medical interventions can also cause POI, for example surgery to remove the ovaries, perhaps due to severe endometriosis or cancer. Treatments such as radiotherapy can also cause POI as can medications such as chemotherapy.

Is there anything lifestyle-related you can do to delay menopause?

It is important to remember that the cause of POI is often not known, however there are some lifestyle factors which may affect the timing of the menopause in general.

Smoking is associated with a slightly earlier menopause, about 18 months earlier than average, though this depends on how much you smoke. Smoking affects the blood vessels of the body, contributing to the fatty plaques that can build up in them affecting blood supply, including blood supply to the arteries.

It may also be that diet plays a part, though lots more research is required into this area. There is some evidence that eating oily fish and legumes is associated with a slightly later menopause (about three years later) and eating white rice and pasta a slightly earlier one – but this study did not show that one caused the other, merely that they are associated. Even if it doesn’t affect the timing of the menopause, eating a healthy diet has lots of known health benefits!

How does premature menopause affect fertility?

POI can lead to infertility and if you have been diagnosed as having POI and are trying to conceive you should ask to be referred to a specialist. If there are no more immature follicles then no more eggs can be produced. It may be that there are follicles but the ovaries have stopped working, and this may not always be permanent.

It is known that pregnancy occurs in about 1 in 10-20 women after being diagnosed with POI, and often in the first year of the diagnosis. For example, if you have been diagnosed with POI due to chemotherapy, it may be that the ovaries recover and start working again after a period of time.

It is complicated and can add to the mental health burden of being diagnosed with POI. On the one hand you are told you have been through a premature menopause and there may be fertility issues, but on the other you are still often told that the ovaries may start working again sporadically (if they haven’t been removed) so there is a risk of pregnancy unless you use contraception.

If you are concerned that you may be in perimenopause and are trying to conceive then please discuss with your doctor, whatever your age.

Are there any ways to find out if you’re likely to experience early menopause?

Although POI does run in families, it doesn’t always mean that it will happen to you and currently there isn’t a test to predict when the menopause will happen to you. What your family history does is give you information, so that if you start to develop symptoms of the perimenopause, perhaps in your 30s, that you are able to tell your doctor that POI runs in your family.

If your periods stop for over six months after they had started (and you aren’t pregnant), please see your doctor. Although blood tests aren’t used to diagnose perimenopause and menopause in women over the age of 45, blood tests are important in POI.  Here two separate blood tests are taken six weeks apart to check the levels of follicle stimulating hormone (FSH) from the brain, which would be high in POI.  Other blood tests are also taken to rule out other causes for your symptoms.

What are the treatments for POI?

If you are able to take it, then HRT is recommended for people with POI and early menopause until at least the age of the average menopause. HRT here replaces the hormones which would otherwise naturally be there in the body at that age, protecting against heart disease and osteoporosis. Or you may be offered the combined oral contraceptive pill/patch/ring, which are then given without a pill free break. Both of these options protect the heart and bones as well as controlling your symptoms.

If you can’t take HRT, perhaps if you have had breast cancer, or the combined oral contraceptive pill is not suitable then there are other non hormonal prescribable options to help control your symptoms. These don’t have the same heart and bone protective effects, so you may be offered a bone density scan to assess your bone health.

What support is there on the NHS for women experiencing premature menopause?

There is medical support and advice, not just to diagnose POI but also to treat it on the NHS.  The Daisy Network is the UK POI charity which offers support, information and advice.

Pics: Getty Images 

• The Science of Menopause: Understand Your Body, Make the Right Choices, is available from Amazon (£13.39)

In addition, it's now known that many women of reproductive age are deficient in vitamin D¹  and that taking daily vitamin D supplement is both commonly recommended for general adult health² and also strongly advised for anyone who is pregnant³. So, if you're trying for a baby, it may well be worth considering taking a vitamin D supplement in preparation for pregnancy. Knowing when you're at your most fertile is key to getting pregnant. From changes in your body temperature to breast tenderness – Discover our guide on 10 signs of ovulation symptoms that you can use to help you conceive.

What the expert says:

We asked our expert GP Dr Philippa Kaye about vitamin D and conception. She said:

Dr Kaye says the science isn't strong enough to confirm a definite, causal link between having good levels of vitamin D and conception success. But she also points out that there is strong evidence that vitamin-D deficiency is associated with pregnancy complications (including gestational diabetes and pre-eclampsia⁴) – which is why pregnant women are advised to take vitamin-D supplements.

And, as vitamin-D insufficiency is really common in the UK, anyone planning to get pregnant may want to get a headstart.

Can vitamin D improve my IVF chances?

Several observational studies have suggested that women seem to have a better IVF outcome when their vitamin-D levels are 'sufficient'. In 2018, a review of 11 of these studies,⁵ on 2700 women, confirmed these findings, saying "the chances of achieving a live birth, a positive pregnancy test and clinical pregnancy [after IVF] are higher in women who are vitamin-D replete when compared to those who are vitamin-D deficient or insufficient".

The British scientists leading this review warned, however, that, though they'd found a link between good levels of vitamin D and successful IVF treatment, it was only an 'association' and clinical trials would have to be carried out before anyone could say that 'correcting' a woman's vitamin-D levels before starting IVF would increase her chances of having a baby.

Can vitamin D help reduce my fibroids?

Fibroids – or, more correctly, uterine fibroids – are non-cancerous growths in your womb. They are quite common (affecting 1 in 3 women at some point in their life⁶) but often cause no symptoms at all. However, if you have a large fibroid, it can make it difficult to get pregnant, as the fibroid may block 1 of your Fallopian tubes (through which your egg needs to travel to your womb) or prevent your fertilised egg attaching itself to the lining of your womb.

Dozens of small studies have suggested that vitamin D can inhibit the growth of fibroids. And in 2018 a review of 45 of these studies⁷concluded that "vitamin D and its analogues seem to be promising, effective, and low-cost compounds in the management of [fibroids] and their clinical symptoms".

But again, the review authors state that more research is required before "vitamin D preparations can become the new tools in the fight with fibroids".

Can vitamin D regulate my menstrual cycle?

If your periods are not regular, it can be more difficult to get pregnant⁷ because you might not ovulate (release an egg) regularly.

There are some studies^8,9 that suggest a link between low levels of vitamin D and what researchers call 'menstrual disorders' but, again, further research has been called for.

Can vitamin D help with my PCOS?

Polycystic ovary syndrome – or PCOS – is a common condition that can affect ovulation and menstruation, and so make it difficult to get pregnant.

Among the studies into the role of vitamin D and menstrual cycles (see Can vitamin D regulate my menstrual cycle?, above), there are some observational studies that specifically focus on women with PCOS – with a range of results. A 2015 overview¹⁰, published in the Indian Journal of Medical Research, says, "So far, the role of vitamin D polymorphisms on metabolic disturbances in women with PCOS remains inconclusive. Further investigations... are necessary."

Although it's far from proved, then, that vitamin D supplements may help fertility issues caused by PCOS, we do have some anecdotal evidence from our MadeForMums community that they might.

Charlotte says: "I was diagnosed with PCOS at 17, didn’t have my 1st period until I was 24 and between then and now (4 years later), I've had a total of 10 periods. My partner and I have never used any contraception: we took the view that it would never happen naturally. A year ago, we started the process of getting fertility treatment but, for one reason or another, it kept getting put on hold. I started to do some research into natural supplements I could take and came across information about vitamin D and fertility. I thought, what harm could it do? I started taking them daily. Lo and behold, 3 months later, I fell pregnant naturally! This could be a complete coincidence but, with how irregular I was, I really feel it played a part."

Are there other reasons for taking vitamin D supplements if I'm trying to get pregnant?

It's not proven, as we've seen, that taking vitamin D supplements will make it any easier or quicker for you to conceive. But, particularly in the winter months, they can do you good, in terms of your general health and many doctors, including Dr Philippa, do recommend taking them from September to March anyway.

And it won't do you any harm (unless your GP advises that it's specifically not recommended in your medical circumstances).

Why particularly in the winter months? Current NHS advice is that every adult needs 10 mcg vitamin D a day.² In the spring and summer, our bodies should be able to 'make' that much vitamin D naturally, as long as we eat a balanced diet and we're outside long enough for our skin to absorb sufficient direct sunlight. But, between September and March, when the sun isn't so strong and we don't go outside as much, our bodies may struggle to make that much vitamin D.

That's why everyone in the UK is advised to consider taking a supplement of vitamin D between September and March²  – and people who have black or pigmented skin, who aren't able to go outdoors or aren't able (for cultural, medical or religious reasons) to uncover their skin outdoors are often advised to take a vitamin D supplement all year round.

Additionally – because low or deficient vitamin D have been shown to increase the risk of some pregnancy complications⁴ – women who are pregnant or breastfeeding are also advised to take a vitamin D supplement every day, regardless of the time of year.

If I'm taking vitamin D supplements, is it safe to take more than the recommended daily dose?

The recommended daily dose of 10mcg should be all that you need – although, if blood tests show you are very vitamin-D deficient, your GP may provide you with a large dose for a short period of time.

It's important, though, not to take higher doses without medical supervision or for a long period of time. Taking too much vitamin D can cause too much calcium to build up in your body (a condition called hypercalcaemia)². This can weaken your bones and damage your kidneys and heart.

Pics: Getty

References

<sup>1 Vitamin D Insufficiency Among Free Living Healthy Young Adults. Tangpricha V et al. The American Journal of Medicine. Volume 112, Issue 8, Pages 659–662. DOI: https://doi.org/10.1016/S0002-9343(02)01091-4
2. Vitamin D: NHS online
3. Vitamins, supplements and nutrition in pregnancy: NHS online
4. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. Aghajafari F et al. BMJ 2013 Mar 26;346:f1169. doi: 10.1136/bmj.f1169.
5. Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis. Chu, J. Human Reproduction, Volume 33, Issue 1, January 2018, Pages 65–80, https://doi.org/10.1093/humrep/dex326
6. Fibroids: overview. NHS online
7.  Vitamin D and Uterine Fibroids — Review of the Literature and Novel Concepts  Ciebiera M et al. International Journal of Molecular Sciences. DOI: 10.3390/ijms19072051
8.  The Relationship between Vitamin D Status and the Menstrual Cycle in Young Women: A Preliminary Study Łagowska, K. Nutrients 2018. DOI: 10.3390/nu10111729
9. Lower plasma 25-hydroxyvitamin D is associated with irregular menstrual cycles in a cross-sectional study. Jukic, AM et al. Reproductive Biology and Endocrinology 2015; 13:20. doi: 10.1186/s12958-015-0012-5
10. The role of vitamin D in polycystic ovary syndrome. Lin MW et al. Indian Journal of Medical Research 2015 Sep; 142(3):238-240. doi: 10.4103/0971-5916.166527</sup>

Read more...

• 8 ways to boost your fertility
• Can taking aspirin help you conceive?
• How having sex every day can help you conceive – but not for the reason you think
• The best pregnancy supplements 2025 - tried and tested by mums

And when we saw this TTC (trying to conceive) poem from Natalie, we just knew we had to share it. It's so honest - and something we reckon lots of you can relate to, as well. Take a look...

A TTC poem

"The TWW [two-week wait] is over, once again.

"Like all the other times, it resulted in my womb destroying its protective layer and my vagina has started literally dripping with blood.

"The frustration, disappointment and failure came flooding along too!

"It's happening again.

"We've not conceived.. again.

"Time to brave the world for another month.

"To fake laugh when they say "Your turn next!", "When are you having one?" when all you wanna do is scream "ITS' NOT THAT EASY!"

"Time to start again, when you've got no hope left inside.

"You both know without actually saying the words, that this chance is over, this month is out. No 2 lines this time.

"You both know inside you're blaming yourself but what if it's not you? You both feel stressed and depressed but it's time to move on because that won't help.

"19 months in, I could have carried two full terms by now. In 19 months time, will this be a bad memory or will it be four?

"We struggle to see:
Where we go from here.
What we say to each other.
How we're going to do this again.
We are struggling to conceive..."

We have to say, we think this will resonate with a lot of people out there who have known the disappointment of not conceiving month after month.

Image: Getty Images

Read more:

• A guide to your first TTC doctor's appointment
• How to kick out stress when you're trying for a baby
• Should you eat fewer potatoes if you're trying to get pregnant?

We’ve noticed quite a few members of our MadeForMums community discussing whether KY Jelly and other vaginal lubricants (aka lube) are ok to use if you're trying for a baby.

We've even seen some concerns from pregnant readers who used it while trying to conceive and are worried that it may affect their unborn baby.

“I was trying to conceive and we were using KY Jelly. I just read that it is not a good lubricant as it kills sperms and can damage DNA in sperms. However, I still got pregnant using it. Is it possible for KY jelly to damage the DNA of the sperm that fertilized my egg?” asked Laura, a member of our MadeForMums community.

So what's the real story? We looked at a number of research results and talked to experts to find out the facts behind these worries...

What is KY jelly?

KY Jelly is a lubricant designed to make sex more comfortable. But it’s not a spermicide. A spermicide is a contraceptive designed to kill sperm and comes in cream, gel or foam form. Lubricants are often recommended by doctors to couples taking a bit longer to conceive – which is ironic if they do have an effect on fertility.

Does the research suggest KY Jelly affects fertility?

Unfortunately, scientific studies have concluded different and contradictory results.

There have been a small number of studies that have examined the effect of lubricants including KY Jelly on fertility.

One US study from 2014 looked at 22 samples of sperm and monitored the effects of 9 different over-the-counter and natural lubricants on the sperm’s motility.

The scientists concluded that the synthetic lubricants KY Jelly and Astroglide, plus sesame oil, did slow the swimming speed of sperm and therefore suggested this could affect fertility. A lubricant called Pre-Seed didn’t have an effect, and this was also true of baby oil, canola and mustard oil. Another study in 2014 found that Pre-Seed and Conceive Plus had the least negative effect on sperm motility.

However, as in similar studies, these experiments had only been done in vitro (eg in a laboratory and outside of a living organism). Some scientists questioned whether they’d see the same effect when a couple are having sex.

A separate US study from 2012 looked at fertility and usage of lubricants in real life.

The study involved 296 couples, 14% of whom used lubricants regularly, 29% occasionally, and while actively trying to get pregnant 25% had used lube. The most commonly used lubricants were KY Jelly (44%) and Astroglide (20%).

The researchers found conclusively that using lubricants did not affect natural fertility, stating: "Lubricants are commonly used by couples during procreative intercourse. Lubricant use during procreative intercourse does not appear to reduce the probability of conceiving."

They proposed three reasons why these results differed from the lab-based ones:

• Firstly, lubricants may not remain in the upper vagina, where sperm is deposited
• Sperm deposited in the upper vagina swims quickly into the cervix
• Lubricants may actually increase the chance of getting pregnant as it may enable more frequent sex

Are any lubricants more suitable for TTC than others?

Studies have shown that in the laboratory experiments Pre-Seed and Conceive Plus had least effect on sperm motility. These are certainly popular and recommended brands with members of our MadeForMums community.

“I switched from Conceive Plus to Pre-Seed and ate pineapple core over 5-12dpo [days past ovulation]! Not sure which of them did the trick but it was our 16th month of trying so I'm sure at least one change played a part,” says Sian.

“I’ve conceived three times using Pre-Seed,” adds Kate. “It is runny, but I only use about 1/3 of what they recommend. You put it in with an applicator before you go to bed so I think it feels very natural.”

“I got pregnant 1st cycle after using Conceive Plus so worked for me,” says Rianna.

Can lubricants actually affect your unborn baby?

At the moment, there’s no evidence to suggest that lubricants can do any harm to your unborn baby.

"As far as I am aware, there is no evidence to suggest that use of lubricants affect development of the foetus,” explains Professor Allan Pacey, spokesperson for the Royal College of Obstetricians and Gynaecologist.

"It would seem reasonable to assume these lubricants do not do any harm if they are used according to the manufacturer's instructions.

“For anyone struggling with a fertility issue, it's a good idea to see your GP if you haven't conceived after one year of trying. Women aged 36 and over, and anyone who's already aware they may have fertility problems, should see their GP sooner."

Can sperm-friendly lubricants enhance fertility?

Lubricants that are specifically sperm-friendly aim to create an environment designed for conceiving.

"Sperm-friendly lubricants work by maintaining the correct PH levels and the appropriate balance of salts and sugars for the sperm to survive,” explains Professor Pacey.

But can they boost your fertility? “As far as I’m aware, they have never been tested in couples to see if they actually enhance conception,” says Professor Pacey.

The bottom line

In the main, it seems that while lab studies have suggested lubricants can affect the motility of sperm, there is no conclusive evidence that using a lubricant will lower your chances of conceiving.

However, certain sperm-friendly lubricants, such as Pre-Seed and Conceive Plus, have been shown to have the least effect on sperm motility, and are certainly recommended in our forum.

We have been in touch with the makers of KY Jelly and are awaiting their response.

Read more

• More sperm secrets revealed
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Mums on our forum have been sharing with each other the ups and downs and disappointment of discovering they haven't conceived after each cycle, after Georgie450 revealed her situation:

"I'm 28 and have being TTC [trying to conceive] since October 2016. Just starting to have tests done which is already stressful and then find out that our best friends have got pregnant after their first month of trying.

"Obviously we are over the moon for them but I just can’t seem to help feeling upset that’s its still not happened for us!

"Anyone else in the same situation? How do you stay positive? x"

While it's certainly a tough situation to go through, it's worth keeping a few things in mind...

Knowing when you're at your most fertile is key to getting pregnant. From changes in your body temperature to breast tenderness – Discover our guide on 10 signs of ovulation symptoms that you can use to help you conceive.

1. Conception doesn't happen quickly for everyone

While it might seem as though everyone else around you is getting pregnant in a heartbeat, the stats show a different story.

While most younger couples (aged 19 to 26) will conceive after 1 year (92%) a further 6% of them will take 2 years and the other 2% will take longer.

For slightly older couples, aged between 35 and 39, 82% will conceive after one year. A further 8% will conceive after 2 years and the other 10% will take longer.

A year can seem like forever if you're trying to get pregnant, and 2 years an eternity - but it's worth remembering that it can still happen for you.

2. Focus on the good things going on in your life

It's easy to get bogged down with the stuff that's not going right - but every now and then it's worth taking a moment to think of a few of the good things you have, to keep you positive.

MrsD90 says: “I find that you need to focus on what you do have:

"A great relationship, nieces and nephews, good friends, comfortable life etc and enjoy doing things with your other half that might be harder when you have a little one!

"Appreciate what you do have now because it will all be worth it (hopefully) in the end and then we'll have even more to enjoy!"

3. It might just happen when you least expect it

We've probably all heard those stories about people who spent years trying to get pregnant and gave up, only to find they were expecting within weeks. It does happen.

Mum Susiegirlygirl tells us: "I am 39 and have a new partner and we had been TTC for 2 years and nothing.

"We had all fertility tests and  were told my partner's sperm count was really low (less than 2 million) and poor motility.

"To top it off I have a Unicornate Uterus which no one picked up on with my first pregnancy. We were told ICSI IVF  was our only option due to my age, and partner's count.

"We were due to look at clinics last week but I had to cancel because WE FELL PREGNANT!!!! NATURALLY XXX

"So despite all odds against us it's happened."

4. Remember, there ARE options out there

If there are medical reasons going on as to why you're not conceiving - help is out there. Susiegirlygirl offers this reminder:

"I'm sure u can get medication called Clomid. They told me my egg reserve was getting lower due to my age."

Susiegirlygirl is right - Clomid is a medication that helps women ovulate more regularly. This means it can help you predict your most fertile days and try and ensure you have sex on those days. Read more about Clomid.

There are plenty other fertility treatment options that could be explored, depending on your personal circumstance - including IUI, and IVF. Find out how IVF works.

5. There are lots of women in the same boat you can talk to

As well as talking to your partner and friends, you can share what you're going through in places like online forums.

MadeForMums has its own really supportive community you can open up about how you're feeling and what you're going through to women who have often experienced exactly the same or very similar things.

Read more:

• Is it safe to use antihistamines when you're trying to conceive?
• Trying to conceive - under 30 and over 30
• Could aspirin really help you to conceive?

[ovulation_calculator widget_title="Ovulation calculator" date_picker_title="When was the first day of your last period?" menstrual_cycle_picker_title="What's the length of your menstrual cycle?" luteal_phase_picker_title="How long is your luteal phase?" button_title="Show my ovulation calculation" /]

How does MadeForMums Ovulation Calculator work?

For the ovulation calculator to work, as you'll see, we need some info from you – which you input into the calculator using the drop-down menu:

• Firstly, input the exact day you started your last period.
• Then, input how long your cycle usually lasts in days. Choose from anywhere between 20 and 40 days.

Your cycle starts on the day your period begins. It ends the day before your next period starts.

Finally, if you know it, tell us how long your luteal phase is.

Don’t worry if you don’t: only those who’ve been TTC and very focussed on their cycle will have any idea what this is.

‘Luteal phase’ refers to the 2^nd half of your cycle, which is when fertilisation and implantation can happen.

How do I make sense of the Ovulation Calculator’s findings?

Once you’ve done all that, a little calendar will pop up – that’s highlighted in pink and orange to show you the important days in your cycle.

The pink highlighted box is used to show the 1^st day of your period, each month. Your most fertile days are highlighted in orange – these are the best days to have sex.

To see your most fertile day, look for the orange highlight with a brown box outlining it: that’s the day you’re due to ovulate.

The 2 days before your most fertile day, the day you’re due to ovulate, are also particularly fertile, so make note of those, too.

I’m not sure about my exact dates/cycle, but I’m pretty regular – can I use the MadeForMums Ovulation Calculator?

Yep, absolutely.

If you don’t have that exact info to hand, or you know your periods come and go like clockwork, then just tell us the date of your last period (or your best educated guess).

Leave the other two options as they are. We’ve automatically filled them with the averages – which is what we reckon most women will experience.

Cycles last, on average, 28 days. Luteal phases last, on average, 14 days.

For the best results, keep a close eye on your next period, the date it starts and how long there is until your next period starts. Then use the calculator again.

My cycle is irregular – can I use the Ovulation Calculator?

Yes, you’ll just need to make a few educated guesses in order to get the most accurate result.

(Keep in mind that, if you are very irregular, it’ll be difficult for the calculator to give you exact ovulation days.)

However, if you know your cycle usually lasts around 32 – 35 days, for example, you can pick a day between then.

Using that example, you’d interpret the results by looking at a couple of days on either side of the orange highlighted days.

You won’t have a longer fertile period, but you will have a roundabout idea of when you’ll be fertile – which is better than nothing!

Read more

• 20 ways to enhance your chances of getting pregnant
• Can taking aspirin really help you conceive?
• Is your body ready to conceive?