How Do I Know I'm Fertile?

About one in eight couples struggle with infertility, or the inability to conceive a child despite having regular unprotected sex. This means a majority of couples are fertile, which indicates they're able to have babies. So how do you know if you're fertile? A health care provider can tell you for sure, but these signs are good indicators that you're able to conceive! 

Women who get their periods every 24 to 35 days are probably ovulating normally, says Lynn Westphal, M.D., a reproductive endocrinologist and an associate professor at Stanford University School of Medicine. "A regular cycle is one of the clearest signs that your hormones are working properly and releasing an egg each month," she says.

Aside from cycle length and predictability, being able to detect ovulation is a promising sign of fertility. (Plus, knowing the exact window of ovulation helps you time baby-making sex to boost pregnancy odds.) Most women ovulate 14 days before their next period. In a 28-day cycle, that means day 14. In a 32-day cycle, that means day 18. But unless your cycle is totally regular from month to month, it's hard to know for sure.

An ovulation predictor kit (OPK) can better determine when you ovulate. OPKs work by detecting levels of luteinizing hormone (LH) in your urine; this hormone surges one to two days before you ovulate. Since your body temperature spikes very slightly around ovulation, charting your basal body temperature first thing in the morning is another (though less precise) way to pinpoint ovulation.

Weighing too much or too little can increase your chances of fertility problems (although heavy and thin women get pregnant all the time). In overweight and obese women, excess body fat can disrupt the delicate balance of hormones needed for ovulation and helping a new embryo develop into a healthy pregnancy. On the flip side, women with too little body fat may have difficulty getting pregnant because their bodies are conserving energy to keep everything functioning properly; this can shut down ovulation.

In many cases, having a normal menstrual cycle is the most important clue you're fertile, regardless of what you weigh. But losing or gaining weight to reach a healthy body mass index (ideally 20-24) before trying to get pregnant is a smart move when done in a healthy way. It will also help you have a smooth pregnancy, labor, and postpartum recovery.

Symptoms like pelvic pain and extremely painful, heavy, or long periods are often the main signs of fibroids or endometriosis, although many women don't discover these conditions until they run into difficulty getting pregnant. While fibroids or endometriosis may increase your risk of fertility problems, having them is no guarantee you won't be able to conceive eventually.

Fibroids are benign tumors in the uterus, and their size and location have the biggest impact on fertility. For example, fibroids that jut out into the uterus may disrupt the embryo from implanting and developing properly; other growths may not have any impact at all. If fibroids are uncomfortable or affecting your fertility, they can be removed with outpatient surgery.

Endometriosis is a condition in which the uterine lining grows on organs outside of the uterus, such as the fallopian tubes or ovaries. This can lead to scar tissue that prevents your egg from being released or getting fertilized normally. Taking birth control pills or having outpatient surgery may reduce endometriosis.

Certain bacterial infections, like chlamydia and gonorrhea, can spread to organs throughout the reproductive tract, causing pelvic inflammatory disease (PID). This infection can seriously damage your ovaries, fallopian tubes, and other organs, which significantly increases your risk of infertility. While PID may have symptoms like fever, vaginal discharge, pain during sex and urination, and irregular menstrual bleeding, the infection often goes unnoticed by women and their doctors. If you've never been tested for these STDs, ask your OB-GYN to screen you now. Antibiotics can treat the infection and prevent further damage.

We don't need to tell you that a cigarette habit is bad for your health. But many women don't know that smoking can damage your eggs and derail ovulation, prolonging the time it takes you to get pregnant and increasing the risk of miscarriage. Those odds go up even more if your partner smokes too.