Life Kit - Want to get pregnant? There’s more to it than you think

Episode Date: July 9, 2026

Whether you’re ready to become pregnant today or thinking about the future, there’s a lot to learn about your fertility. In this episode, a reproductive endocrinologist and a reproductive psychiatrist walk through the basic factors that contribute to your ability to get pregnant — and explain the best ways to get your timing right.Sign up for Life Kit's skin care newsletter.Follow us on Instagram: @nprlifekitSign up for our newsletter here.Have an episode idea or feedback you want to share? Email us at [e-mail] the show and listen to it sponsor-free by signing up for Life Kit+ at plus.npr.org/lifekitSee pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

It's so interesting to me how we think about pregnancy and sex. Like if you don't want to get pregnant, it feels like it could happen so easily. Basically, if you let your guard down at all. Yeah. As a woman, especially, like my whole life, you know, I'm thinking about that very first sex ed class that I think was like in seventh grade. The messaging was like, it is so easy to get pregnant, no matter how careful you are, no matter how much protection you use. you know, if someone just looks at you a little too long or whatever. Yeah, or you're like in a hot tub with a boy.

Yeah. But yeah, then for a lot of women, when the switch flips and they're actually ready to get pregnant, it doesn't happen right away. And they're like, what's going on? Which is why we're doing this whole episode about what it actually takes to get pregnant through sex. By the way, you're listening to Life Kit. I'm Mariel Segarra, and I'm talking to Life Care reporter Andy Tagle. That's right. And there's more to getting pregnant than you think. For some people, it can be that simple, but everyone's going to have a different experience based on a lot of different factors. To give you an idea from a statistical standpoint, at what's considered peak fertility, we're talking about people in their early 20s to early 30s having regular unprotected sex to try and conceive. You only have around a 25 to 30% chance of getting pregnant in any given month. Wow, I've been lied to.

I know, isn't that? I was shocked by this. But as the experts I talked to told me, that huge gap between what you're taught in high school or middle school and what you actually experience when you're trying to conceive can be really jarring for a lot of people. Here's reproductive endocrinologist, Dr. Lucky Sikon. A lot of people feel like their bodies are broken or that they've done something wrong. I've had patients even say, is it because I drank too much in college? And I think it is a very natural human nature tendency, especially for women, I might add, to kind of internalize things and blame themselves and take on more responsibility for things when in reality so much of our fertility is not in our control. That's actually really helpful to know because I can hard relate to that saying, is it because I drank too much in college?

You know, did I cause this problem? Right. Is it me? But you know, Mariel, one antidote to feeling disempowered is information. And this episode is absolutely fertile with know-how. That can help if you're thinking about getting pregnant. All right, what are some of the topics you're going to get into? We'll do a little conception science crash course.

We're going to cover the basic factors that can and cannot affect your ability to get pregnant. We're going to help you think about your timing. Lots, lots, lots more. That's coming up after the break. A lot of us have basically a mini beauty product. store in our bathrooms. And it's easy to feel like if you don't use the right serums, creams, acids and toners, you're somehow doomed to having bad skin. But do you really need all those products? Life Kit made a special newsletter series to help you figure out your skincare goals and what you

actually need. Sign up at npr.org slash skincare or find the link in the description for this episode. One thing I do want to quickly note up front for listeners, this episode is going to focus on the so-called traditional way to make a baby, meaning through heterosexual intercourse. We want to acknowledge, of course, there are lots of ways to make a baby and endless ways to make a family. And we plan to give that non-traditional baby making its own spotlight with a companion episode to this one in the near future. So keep an ear out. All right, I'm pretty sure I know why a lot of you are listening right now, so let's cut to the chase. You want to know when you should start trying, right?

You want to know if you need to worry. Like, if you were to walk into your doctor's office, you might say, I'm not ready yet. But I want you to do whatever testing you can, and I want you to tell me if I'm good, and how long I'll be good for, and I just want to make sure I'm not going to have any issues. That was Dr. Lucky C. Con again. She's a New York City-based infertility expert and author of the aptly named new book, The Lucky Egg, which is a fertility guidebook of sorts. Lucky says she gets this request from patients all the time.

And it's great to plan ahead, but the problem is there's no such thing as an all-encompassing female fertility test. Sorry to break it to you. No nasal swab, no blood draw. The best test for fertility is to try, which is the most annoying, unhelpful answer, right? But it's kind of this confluence of factors, and you have to actually try and see how those factors come together. The first of those factors you need to understand is the process of reproduction itself, because it can be tricky. Each egg that you ovulate each month is kind of like a long shot. So I feel like I need to get that put on T-shirts because it's like one of my slogans at this point.

And that leads us to our bit of a downer, but crucial to know up front, takeaway one. Human reproduction is inefficient and not totally in your hands. I talk about it in my book as being a sort of reproductive slot machine where pulling the lever is timing when to try, but whether everything after that lines up is so out of our control. This part, ovulation, I'm assuming you already know about. Every cycle, a single egg cell, chosen at random, travels down in the fallopian tube where it can live for 12 to 24 hours. Around that time or a little before, you want to shoot some millions of sperm cells up the vagina. through the cervix to meet it. Those guys can live in the reproductive tract for about three to five days. So there's this very narrow fertile window, this narrow window of opportunity each cycle. But get this. Just getting the egg and sperm in the right place at the right time doesn't guarantee a

connection will take place. It's like saying going on a date guarantees you're going to find your life partner. That's not true. And the same is true of the chemistry between the egg and the sperm. And it's like maybe 70, 80% of the time, the timing is right, an egg might fertilize successfully. This is extrapolation from what we see in an IVF lab where we really try to orchestrate that meeting happening. If sperm and egg do hit it off, there's still a few more hurdles before you've made it to the finish line. Only about half of the time a fertilized egg will continue to grow and make it to the next step, which is called the blastocyst stage. It takes about a week. That blastocysts then also has to find its way to the uterus. Sometimes it gets lost along the way. And once it arrives at the uterus,

it has to implant and keep growing there. And so it takes a lot of energy and a lot of them just don't make it to that stage. So suffice it to say, there's a lot that has to go right in order to get pregnant. It is no exaggeration to call it the miracle of life. And I know that all might feel a bit discouraging or intimidating, but it might help you set more realistic expectations. He minimise any shame and blame if you understand up front what the odds are. According to the American Society for Reproductive Medicine, approximately 80% of healthy heterosexual couples will conceive in the first six months of attempting pregnancy. From there, stats vary a bit, but some recent cumulative conception research has shown

some 85 to 90% will conceive within a year, and 95% will get pregnant within two years. So your next question, of course, what do you need to get pregnant when you want to? Like, should you be running straight to your Obi-guines office right this very minute? You know what I like? I like before even going to a doctor. It's like learn about your cycle. I want you to know how long your menstrual cycle is.

Dr. Sarah Oric is a mother of three and a reproductive psychiatrist. Which means that I specialize in how female reproductive hormones, impact mental health throughout the life cycle. She brings us to a quick takeaway too. To track a true period, get off of hormonal birth control. Now, tracking your cycle isn't hard to do. You start by just marking the first day of your period on a calendar. But this might be a bigger ask for some than others.

Because in order to track your period, you have to have one. And a true period at that. Not just the light or complete lack of a period you might enjoy if you have an IUD, the irregular spotting you might get with a depot shot, or what's called withdrawal bleeding, which is actually just a reaction to a drop in hormones, not a result of ovulation, if you're using the pill, the patch, or a vaginal ring.

So if you're using a hormonal birth control method, like other millions of American women, this first, so-called simple step might be less so. You may find that the hormonal birth control was sometimes helping your mood, If you potentially had more premenstrual symptoms, some of those might come back. Oh, this was helping my skin a lot and I hadn't realized. It might not be super fun to remove the barrier to a lot of pain, discomfort, or oily skin.

But it can be extremely useful, even critical to your future reproductive health to get an idea of your sensitivity to hormones. Maybe, for example, you find you have really significant mood symptoms in the two weeks before your period. There's a chance you have PMS. there's a chance you have premenstrual dysphoric disorder, which is like really escalated mood symptoms during that time. And having all that information is actually important because sometimes that PMDD can kind of have you in a risk bucket for maybe increased risk of pregnancy or postpartum, depression or anxiety. Another thing about getting off of birth control, with the

exception of the depo prevaris shot, you're going to want to consult your doctor if this is your chosen method. You don't have to plan for any ramp up time when getting off of it. Most people getting off of the pill will get their period, you know, pretty much within a month or so. Now, I should say this isn't a hard and fast rule. Like if you've been on birth control for decades, Lucky says there is a minority of people that might need somewhere between three to six months to get their pituitaries to fully wake up and get back to work, so to speak. Having said that, there are many people whose bodies will just snap back into the normal routine. And so unless you're prepared to get pregnant or you're prepared to use a backup method, right?

like condoms, don't get off the pill, you know, if you're using it for contraception. Copy that. All right. Now that you've brought back Aunt Flo, let's learn what she has to share. Takeaway three. Track your menstrual cycle for clues about your reproductive health. Sarah says there are a few good reasons why anyone with a uterus should track their menstruation. For one, if you do want to start trying for a baby soon, once you have a general sense of the length of your menstrual cycle, it should be easier to pinpoint when you're ovulating, which,

generally happens around two weeks before the start of your next period. Start to learn. Do I have a 26-day cycle? Do I have a 29? Is mine pretty regular? I say like even by ovulation test kits and see if you ovulate. Check in with your body for signs and then track them. One way you might have heard of is through your basal body temperature, which is just the temperature of your body when it's fully at rest. You want to take it every day as soon as you wake up and then monitor for changes. Because when you ovulate, your basal body temp will increase slightly. And we're talking super light here, like from 98 degrees to 98.5 degrees. And ovulation is likely over when that high temperature has stuck around for three days or more. Another way to tell. Learning what your cervical

mucus changes. I mean, I think many of us say, oh, something's kind of different. But if you have that sort of egg white textured your cervical mucosa, it's likely that you're ovulating. Another important reason to track is to spot and get ahead of any potential problem areas. For example, if you always get terrible cramps or your period never arrives on time, that could be signaling something about your ability to get pregnant in the future. If they start to note early on that these patterns are thrown off and there really isn't a pattern, this tells us that it could be more challenging and it makes sense to get to the bottom of what's going on now so that you have a plan to hit the ground running with once you are in a position to start trying.

Heavy, irregular, or painful periods could point to potential threats to fertility, like anemetriosis or polyps or PMOS, formerly known as PCOS. Or these symptoms could be no problem at all. But you can't know until you start tracking. So do you have that first day of your period marked? Good. Now just do it again. Give yourself at least three months, four months of tracking your cycle and collecting data

to really be able to understand your reproductive rhythm reliably. A dot and red pen on your calendar and some notes in your planner are a fine way to start. But there are lots of online tools that can help here too, of course. If you go this route, be sure to note up front how any interface will use and share your personal medical data. There are apps that can log symptoms, predict fertility, help you spot patterns, even share your cycle tracking with a partner. Which reminds me. Thus far, we've really only been talking about the person who carries the baby. But as we know, they're only half of this equation.

I think boys should be educated around all of these issues as well. And then when it comes to fertility, it's really important to note that about 50% is male factor in fertility. Male reproductive health. We'll jump into that after the break. You're listening to Life Kit and it's time for Takeaway 4. Fortility is 50-50. Both sides can make lifestyle choices to boost their odds. So let's talk sperm, shall we? Where female fertility remains at least somewhat of a question mark until go time. I'll expand on that in a bit. Male fertility is extremely testable, largely non-invasive,

and the big one here is that a lot of the things that we see are reversible. Maybe you go in to get tested and your doctor says you have low motility or tells you that your sperm count is lower than the minimum threshold of 15 million sperm per milliliter. I've had couples where the husband was like a professional biker and that repetitive stress in that area, we think, led to lower sperm quality. And they'll say, okay, I'm going to stop doing this. Then Lucky will retest two or three months later and see a big turnaround in the quality of the sample. Some other potentially reversible lifestyle factors for men, testicular trauma, overly tight underwear or other similar chronic scleral exposure to heat. And yes, the rumors are true, cannabis. Research shows cannabis

is strongly linked to reduce sperm count and concentration. But the effects aren't permanent. The same goes for excessive alcohol consumption and nicotine in all forms. Top of the list for women who want to get pregnant in the near future is taking a daily prenatal vitamin, starting at least one to three months before trying to conceive. Ingredients to look for include folic acid, iron, and DHA. All right, so now let's jump into lifestyle factors for both men and women. To start, a general rule of them.

Whatever is better for heart health is typically going to be better and protective when it comes to your fertility and also optimal in terms of setting you up for the healthiest pregnancy possible. You want to try to get in that recommended 150 minutes of exercise a week, keep stress levels low, and follow a heart healthy diet as best you can. You know, eat the rainbow, infomeratrainian style, high protein, low carb, lots of leafy green vegetables. Treating food as medicine is a real thing. And I think, you know, making sure that you are getting enough protein, enough fiber, because that actually helps stabilize your blood sugar. Lucky says this bit in particular can be impactful to fertility if you have a uterus. Because if you're churning out too much insulin, it can act like a growth factor on the ovaries.

And can cause your ovaries to overproduce testosterone. And when an egg is going through an ovulation cycle, and again, when it gets fertilized, it's actually undergoing a massive amount of genetic reorganization. And that's where those errors happen. This is important advice for men too. Maybe you've heard that Mountain Dew or other sodas can shrink your sperm count. That's a myth. No research shows direct links to caffeine intake and fertility.

But consuming lots of sugary drinks, not a good idea for that blood sugar. Lastly, what about environmental factors? BPAs, pesticides, heavy metals, and air pollution have all been shown to disrupt hormonal balances, which can, in turn, affect fertility overall. So do what you can. But also, no, you can only do what you can. Because at the end of the day, as Lucky says, fertility isn't logical.

There's no single lifestyle factor or something that they did, which we can say this is the cause of that. At the end of the day, it's never someone's fault, and it's very, very unfair. And the thing is, you just don't know where you fall until you know. Takeaway 5. Timing Conception is an educated guess at best. The only true way to test female fertility is to try to have a baby.

A lot of it is age, timing, and our genetic makeup. Let's take those in reverse. Fertility red flag number one, genetic makeup. So if you have irregular, heavy, or painful cycles, hopefully you have a good idea of that one now. Or a strong family history of any other major gynecological issues. Whether that be endometriosis, fibroids, PCOS, there's a major heritability factor there. If you have a first-degree relative with some of these issues, it increases your personal risk by several fold. Next, timing.

If you're healthy and under 35, it's recommended you try to get pregnant on your own for at least one full year before seeking out any infertility treatments. If you're 35 and older, you shouldn't wait longer than six months. And if you're in your 40s, you shouldn't wait longer than the three-month mark. Which brings us to our last factor and the tick-top, tick-toc of that pesky biological clock. A lot of people think of turning 35 like being Cinderella at the ball. And it's like poof, now, you know, your carriage turns into a pumpkin. And that's just not what it is. Why age 35 matters, according to Lucky, is that it's considered a turning point.

So if you were to map out on a chart, the health of your egg cells through your lifespan, age 35 is when you start to see a downward slope. And what's happening is the proteins that keep the chromosomes in your egg cells lined up correctly slowly break down with age. But I want to say that nobody has perfect eggs. And even in our 20s, 20 to 25% of embryos will have missing or extra DNA. And that increases to about maybe a third of them at 35. By 37 or 38, your odds are more like a coin flip, 50-50.

Now at 40, this is where the coin flip, it's like a wing. Cated coin and it's flipping in the negative direction. At this point, the split is 70-30, meaning up to 70% of the time an egg cell will have missing or extra DNA. So it's going to be harder to have a viable pregnancy naturally. The other age component you might have heard about is the number of eggs you have available. Egg count is always decreasing and it tends to decrease more rapidly around 35. And by the way, sperm ages two, a little differently.

but motility can start to decrease after 30, for example. And this is likely an important consideration if you're planning on assisted reproduction of some kind. Egg or embryo freezing or IVF, where egg harvesting is necessary. Because the more eggs I have to work with, the better the chance of getting what I need out of a given treatment cycle. We actually have a whole episode on egg freezing that can give you a lot more on that process if you're interested. And if you just want to arm yourself with as much information as humanly possible, there is one thing you can test that can provide some insight on the state of your egg reserve. It's called AMH, or anti-malarion hormone. It's a hormone produced by the small developing egg follicles in your ovaries. But if you do get it

tested, be careful with some of those numbers because it's a full clinical picture that's really important. Sarah says it can be tempting to put all your eggs in one basket, so to speak. To think of, say, egg or even embryo freezing as an insurance policy, or maybe a low egg reserve as a sign that you have no chance of conceiving. But you can't just use one outcome or one data point to kind of influence all of your decision making. Sarah took the test and found she had low AMH, for example. Those test results helped her and her partner make the calculation

to start trying sooner rather than later. If I didn't have a partner, for example, maybe I would have frozen my eggs, and that would have made sense to me and felt like, okay, this is right. Lucky had her first child the traditional way, then decided to freeze embryos at age 34. When she struggled to get pregnant again in her late 30s, she used those embryos to have her second child.

Which is all just to say, there's no one-size-fits-all here. And unfortunately, no magic calculator to tell you the perfect time to start trying. But hopefully, you now have a starting point or two from making this decision yourself. So you've tracked your cycle, you've cultivated your ideal baby-making environment,

You figured out exactly when you want to start trying. What's left on the checklist? Well, nothing to it but to do it. Take away six. Don't beat around the baby making bush. Before we leave you to go forth and multiply, a few last tips for some successful sexy time. First up, don't do what I just did and lead with innuendo.

Be direct about the change to your sex life. That doesn't mean it has to be a chore. Just setting expectations can be so important. I think we should, you know, have sex during these days of my ovulation window. Maybe we can plan some dates. Now, how often should you be trying? Every day of the month, first thing in the morning, under the light of the full moon. Lucky says your most fertile window is the five days leading up to ovulation and the day of

ovulation itself. So you could have sex every day of the month, but rather than burning yourself out, unless, I mean, there are obviously some people out there that like this is what they would be doing anyway. I don't know those people. So your best bet, sex on a daily basis, the five days leading up to and including the day of ovulation. Another thing you might have heard is that you should save up all those swimmers until that window. You know, hold out so that your sperm is extra strong. Nope. If you are abstinent for too long over a week, you can actually build up dead old sperm cells. They need to get out, right?

And so we actually recommend that they ejaculate at least within a week. That simple schedule should put you in a good position to make a baby. And hey, now that we're on the topic, doc, is there a best baby-making position, like before, during, after? There are no sexual positions that are more effective at helping you get pregnant. than others. You don't have to have an orgasm. You do not need bed rest. You don't need to be in a certain position. So that covers the mechanics. A final tip, if you dare, try to enjoy the process together. I think it's also a nice time to reevaluate and people, I don't think, do this enough of like, what turns you on? Is that, you know, intimacy meaning, you know, chores done at home? Does that mean a date?

You know, really assessing that for yourselves and being able to come to. together and how can we make this still meet some of the criteria, even though there's some goal-directed aspect. Okay, team, let's recap. Takeaway one. Human reproduction is inefficient, and some of it just comes down to luck. Take way two. To track your period, you'll need to get off of hormonal birth control.

Brace yourself. Takeway three, get to know your cycle. It's important information whether or not you're ready to start trying. Takeway four. Fertility is 50-50. Both sides can make life. lifestyle choices to boost your odds. Takeway 5. There's no way to fully test female fertility, but factors like age, timing, and genetics can guide you to an educated decision about when to

start trying. And finally, takeaway 6. Trying to make a baby is probably going to change your sex life. Why not have some fun along the way? That was Life Care Reporter Andy Tagle. Before we go, would you take a moment to rate and review us? Tell us a favorite tip that you've learned or tell us what kind of episodes you like best. We love hearing from you, and when you leave a review, it helps the show grow. This episode of Life Kit was produced by Sylvie Douglas. Our digital editor is Malika Grieb, and our visuals editor is C.J. Riegelon. Megan Cain is our senior supervising editor, and Lauren Gonzalez is our executive producer.

Our production team also includes Claire Murray Schneider and Margaret Serino. Engineering support comes from Sina LaFredo. Fact-checking by Tyler Jones. Special thanks to Maria Good. I'm Mariel Segarra. Thanks for listening.