If you’ve been tracking ovulation, timing intercourse perfectly, and still not getting pregnant, you’re not alone. While ovulation is a key part of conception, it’s just one piece of a complex process. Understanding how conception works can help answer questions like "how do you get pregnant?" or "when do you conceive?" and guide your next steps.

How Conception Works

For pregnancy to occur, three key steps need to align:

1. Ovulation: Your ovary releases a mature egg, typically once per cycle.
2. Fertilisation: Sperm meets the egg in the fallopian tube, and fertilisation occurs.
3. Implantation: The fertilised egg (now called an embryo) travels to the uterus and attaches to the uterine lining.

If one of these steps doesn’t occur as expected, conception won’t happen during that cycle.

Common Reasons You’re Not Pregnant After Ovulation

1. Timing Could Be Off

Ovulation creates a narrow fertile window—the five days leading up to ovulation, ovulation day itself, and occasionally the day after. This is because:

• Sperm can survive in the reproductive tract for up to five days if cervical mucus is fertile (clear and stretchy).
• The egg survives for just 12–24 hours after ovulation.

If intercourse happens outside this window, even slightly too early or too late, fertilisation is less likely.

What Can Help?‍

Use ovulation tracking tools like basal body temperature (BBT) charts, ovulation predictor kits (OPKs), and monitoring cervical mucus to better pinpoint your fertile window. Apps with features like a period calendar and ovulation tracker or fertile window tracker can be a useful guide. Regular intercourse every other day during this period increases the chances of conception.

2. Irregular Ovulation

Some people don’t ovulate consistently, even if they have regular-looking cycles. Conditions like Polycystic Ovary Syndrome (PCOS), thyroid imbalances, or stress can disrupt ovulation.

What Can Help?

• Understanding the root cause is key. Fertility tests can confirm whether ovulation is happening regularly.
• Non-invasive approaches, such as lifestyle adjustments and dietary changes, can support hormone balance and encourage regular ovulation naturally. For example, targeted supplementation and nutrient-rich diets may help improve ovulation without immediately resorting to medical interventions. Further evaluation by a healthcare professional can guide the next steps.

3. Sperm or Egg Quality

Even with perfect timing, the quality of the egg or sperm is critical for conception.

• Egg Quality: Eggs are healthiest in your 20s and early 30s. After 35, egg quality naturally declines, which can make conception harder.
• Sperm Health: Low sperm count, poor motility (movement), or abnormal shape can reduce the chances of fertilisation.

What Can Help?

• Reproductive testing can assess your egg quantity (though not egg quality), as well as sperm health.
• Lifestyle changes and targeted supplementation can help improve egg and sperm health. For instance, Vitamin D plays a vital role in ovarian health and hormone regulation, while other nutrients support sperm function. However, supplementation should always address specific deficiencies, as excess amounts can be harmful. A healthcare provider can help create a tailored plan to support reproductive health safely and effectively.

4. Implantation Issues

After fertilisation, the embryo must implant in the uterine lining to establish a pregnancy. If the lining is too thin, unhealthy, or there are structural problems in the uterus, implantation may be more difficult.

What Can Help?‍

Ultrasound scans can check the thickness of your uterine lining and identify any issues like fibroids or polyps. Your doctor can then recommend tailored solutions to improve implantation success.

Next Steps: What You Can Do

1. Get Fertility Testing

Testing can provide valuable insights into your reproductive health. Key tests include:

• Hormonal Evaluations: Assess hormone levels like AMH (ovarian reserve) and FSH (follicle-stimulating hormone) to check for ovulation challenges or conditions like PCOS.
• Ultrasounds: Evaluate ovarian and uterine health, looking for structural issues like fibroids or a thin uterine lining.
• Semen Analysis: Examine sperm count, movement, and shape to identify male fertility factors.

These tests help pinpoint any barriers to conception and guide the next steps. To get started, you can book a couple's fertility screening or in-depth reproductive health screening for women easily with Taylor.

2. Explore Non-Invasive Interventions

If testing reveals challenges, approaches like ovulation tracking and addressing nutritional deficiencies can often be effective without moving straight to medical treatments. Women with PCOS in particular can benefit from medical and dietary guidance to induce regular ovulation and provide necessary support post-ovulation (for example, Taylor's Conceiving with PCOS programme).

3. Focus on Timing

If ovulation is confirmed, ensure you’re timing intercourse correctly. Aim for sex every other day during the fertile window to give sperm the best chance of meeting the egg.

4. Consider Additional Options

If natural methods and lifestyle changes aren’t enough, your doctor may suggest treatments like ovulation tracking paired with timed intercourse or intrauterine insemination (IUI). These approaches can further optimise timing and sperm delivery to improve your chances.

Takeaway: Patience and Testing Are Key

Conception often takes time, even when everything seems to be working well. If you’re feeling unsure, fertility testing is a great place to start—it provides clarity and allows you to take informed steps towards building your family. With the right support and guidance, solutions are within reach, and you’re not alone on this journey.