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Guide

How to Get Pregnant: The Complete Evidence-Based Guide

Last updated 6 April 2026
This content is for informational purposes only and does not replace professional medical advice. Always consult your midwife or GP.
At a glance

Medically reviewed content. Last updated: April 2026.

In this guide

How to Get Pregnant: The Complete Evidence-Based Guide

Medically reviewed content. Last updated: April 2026.

Whether you have just started thinking about having a baby or have been trying for a while, understanding the science behind conception can help you feel more in control. This guide covers everything from how your cycle works to when to seek help, all based on current NHS and NICE guidance.

How does conception actually work?

Conception happens when a sperm fertilises an egg. It sounds simple, but the timing has to be precise. Each month, one of your ovaries releases an egg during ovulation. That egg survives for just 12 to 24 hours. Sperm, on the other hand, can live inside the body for up to five days. This means you have a window of roughly six days each cycle where pregnancy is possible.

Once fertilisation occurs, the resulting embryo travels down the fallopian tube and implants into the lining of the uterus. This implantation process takes around 6 to 12 days after ovulation and is when pregnancy officially begins.

When are you most fertile?

Your most fertile days are the day of ovulation and the five days leading up to it. This is known as your fertile window. Studies published in the New England Journal of Medicine found that the highest chance of conception occurs when intercourse happens one to two days before ovulation.

For most people with a 28-day cycle, ovulation typically occurs around day 14. But cycles vary widely, and ovulation can happen anywhere from day 11 to day 21, depending on your cycle length. This is why tracking your own patterns is more reliable than following a fixed calendar.

How to track ovulation

There are several ways to identify when you are ovulating. You can use one method or combine a few for greater accuracy.

Ovulation predictor kits (OPKs)

These urine-based tests detect the surge in luteinising hormone (LH) that happens 24 to 36 hours before ovulation. They are widely available from pharmacies and supermarkets in the UK. A positive result means ovulation is likely within the next day or two, making it a good time to have sex.

Basal body temperature (BBT)

Your resting body temperature rises by about 0.2°C after ovulation due to increased progesterone. By taking your temperature first thing each morning before getting out of bed, you can identify a pattern over several cycles. The limitation is that BBT only confirms ovulation after it has already happened, so it is more useful for understanding your cycle over time than for predicting ovulation in real time.

Cervical mucus changes

As ovulation approaches, cervical mucus becomes clear, stretchy, and slippery, often compared to raw egg white. This type of mucus helps sperm travel more easily towards the egg. After ovulation, mucus typically becomes thicker and less noticeable. Checking your mucus daily can help you spot your fertile window without any special equipment.

Cycle tracking apps

Digital trackers can help you log your period dates, symptoms, and other fertility signs to predict your fertile window. Nuhah's pregnancy tracker includes ovulation tracking features that can help you identify patterns over several cycles.

How often should you have sex?

The NICE fertility guideline (CG156) recommends having vaginal intercourse every two to three days throughout the month, without timing it specifically to ovulation. This approach ensures sperm are consistently present in the reproductive tract, which means you are less likely to miss your fertile window entirely.

If you prefer to focus your efforts, aim for sex every day or every other day during your fertile window (the five days before ovulation and the day of ovulation itself). Research shows no significant difference in pregnancy rates between daily and every-other-day intercourse during this window.

There is no evidence that specific sexual positions improve your chances of conceiving. Likewise, staying lying down after sex has not been shown to make a difference. The most important factor is regular, timed intercourse.

How long does it take to get pregnant?

For most couples, conception happens within 12 months. According to NHS data:

  • About 84 out of 100 couples will conceive within one year of regular, unprotected sex
  • Of those who do not conceive in the first year, about half will conceive in the second year
  • Around 1 in 7 couples may have difficulty conceiving

Your age plays a significant role. Fertility naturally declines over time, particularly after the age of 35. Here is a general picture of how age affects monthly conception rates:

  • Under 30: approximately 20 to 25% chance per cycle
  • 30 to 34: approximately 15 to 20% chance per cycle
  • 35 to 39: approximately 10 to 15% chance per cycle
  • 40 and over: approximately 5% or less per cycle

These are averages, and individual experiences vary widely. Many people conceive quickly after 35, and some younger people take longer. Try not to compare your timeline to anyone else's.

What can you do to boost your chances?

While there is no guaranteed way to speed up conception, several evidence-based steps can help create the best conditions.

Start taking folic acid

The NHS recommends taking 400 micrograms of folic acid daily from the time you start trying to conceive until at least week 12 of pregnancy. Folic acid reduces the risk of neural tube defects such as spina bifida by approximately 70%. If you have a higher risk (due to a previous pregnancy affected by a neural tube defect, diabetes, or a BMI over 30), your GP can prescribe a higher 5mg dose.

Take vitamin D

Public Health England recommends 10 micrograms (400 IU) of vitamin D daily for everyone in the UK, and this is especially important during pregnancy planning and pregnancy itself.

Maintain a healthy weight

Both being underweight and overweight can affect ovulation and fertility. NICE guidelines note that a BMI between 19 and 30 is associated with the best fertility outcomes. If your BMI is outside this range, even a modest change of 5 to 10% of your body weight can improve ovulation regularity.

Limit alcohol

The NHS advises that if you are trying to conceive, the safest approach is to avoid alcohol altogether. There is no confirmed safe level of alcohol consumption during conception or pregnancy.

Stop smoking

Smoking affects fertility in both partners. In women, it can reduce egg quality and bring forward the menopause. In men, it can reduce sperm quality and count. The NHS offers free stop-smoking support services across the UK.

Reduce caffeine

While trying to conceive, keep caffeine intake under 200mg per day (roughly one mug of filter coffee or two mugs of tea). High caffeine intake has been associated with longer time to conception in some studies.

Manage stress where possible

While the relationship between stress and fertility is complex, chronic stress can affect ovulation by disrupting the hormonal signals that control your cycle. Finding ways to manage stress, whether through exercise, mindfulness, or simply making time for things you enjoy, is worthwhile for your overall wellbeing as well as your fertility.

What about your partner's fertility?

Fertility is a shared responsibility. Around 30 to 40% of fertility issues involve male factors, and another 20 to 30% involve a combination of both partners. Here are evidence-based steps your partner can take.

Sperm health basics

Sperm take about 74 days to develop fully, so lifestyle changes made now take roughly three months to show their full effect.

  • Avoid overheating the testicles. Hot baths, saunas, laptops on laps, and tight underwear can all raise scrotal temperature enough to affect sperm production. Switching to looser underwear and avoiding prolonged heat exposure can help.
  • Exercise regularly. Moderate physical activity is associated with better sperm parameters. However, excessive endurance exercise (such as long-distance cycling) may have the opposite effect.
  • Limit alcohol. Heavy drinking reduces testosterone levels and sperm quality. Sticking to the NHS guideline of no more than 14 units per week is advisable.
  • Stop smoking. Smoking is directly linked to reduced sperm count, motility, and morphology.
  • Eat well. A diet rich in fruits, vegetables, whole grains, and fish is associated with better sperm quality. Zinc, selenium, and antioxidants (found in nuts, seeds, and colourful vegetables) are particularly important for sperm health.

When should you see a GP?

NICE recommends that you see your GP if:

  • You are under 35 and have not conceived after 12 months of regular, unprotected sex
  • You are 36 or older and have not conceived after 6 months
  • You have known fertility risk factors (irregular or absent periods, previous pelvic infections, endometriosis, previous cancer treatment, or known male factor issues)
  • You have any concerns at all, even earlier than these timelines

Your GP will typically start with basic investigations for both partners. For the person with a uterus, this usually includes blood tests to check ovulation (a progesterone blood test on day 21 of a 28-day cycle) and possibly an ultrasound. For the partner with testes, a semen analysis is the standard first test.

If initial tests suggest a problem, or if the cause is not clear, your GP can refer you to a fertility specialist on the NHS.

What fertility treatment is available on the NHS?

NHS fertility treatment varies by area, but NICE recommends that CCGs (now Integrated Care Boards) should offer:

  • Up to six cycles of intrauterine insemination (IUI) for certain eligible couples
  • Up to three full cycles of IVF for eligible women under 40 who have not conceived after two years of trying or 12 cycles of artificial insemination
  • One full cycle of IVF for women aged 40 to 42, subject to certain criteria

Eligibility criteria differ between regions, which means access to funded treatment is not equal across the UK. Your GP or local ICB can confirm what is available in your area. Private treatment is also an option, with IVF cycles typically costing between £3,000 and £5,000 per cycle.

Common myths about getting pregnant

"You should have sex every day"

Not necessary. NICE recommends every two to three days throughout the cycle. There is no evidence that daily sex improves conception rates compared to every other day.

"Certain positions help you conceive"

No scientific evidence supports this. Sperm reach the cervix within seconds regardless of position.

"You need to lie still after sex"

Studies have found no benefit to remaining horizontal after intercourse. Sperm enter the cervical mucus almost immediately.

"Stress causes infertility"

While chronic stress can affect ovulation, most people who are stressed can still conceive. Stress is rarely the sole cause of fertility difficulties, and telling someone to "just relax" is unhelpful.

"It is easy to get pregnant at any age"

Fertility does decline with age, particularly after 35. This does not mean it is impossible, but it may take longer, and the chance of needing assistance increases.

How to look after your mental health while trying

Trying to conceive can be emotionally challenging, particularly if it takes longer than expected. It is completely normal to feel frustration, sadness, jealousy, or anxiety during this time.

Here are some things that may help:

  • Be honest with your partner about how you are feeling. Trying to conceive affects both of you, and keeping communication open can prevent feelings of isolation.
  • Set boundaries around conversations about babies or pregnancy if they feel overwhelming.
  • Consider joining a support community. Fertility Network UK offers support groups across the country.
  • Speak to your GP if your mental health is suffering. You deserve support, and asking for help is a sign of strength.
  • Take breaks when you need them. It is OK to step back from actively trying for a cycle or two if it is taking a toll on your wellbeing.

Key takeaways

  • Your fertile window lasts about six days each cycle, with the highest chance of conception in the two days before ovulation
  • Having sex every two to three days throughout your cycle is the simplest, evidence-based approach
  • Most couples conceive within 12 months, but age, lifestyle, and underlying conditions all play a role
  • Both partners should take steps to optimise their health: folic acid, vitamin D, a balanced diet, no smoking, limited alcohol
  • See your GP after 12 months of trying (or 6 months if you are 36 or older), or sooner if you have concerns
  • Fertility treatment is available on the NHS, though access varies by region
  • Looking after your mental health during this time is just as important as the physical steps

Sources

  • NHS. Trying to get pregnant. nhs.uk
  • NICE Clinical Guideline CG156. Fertility problems: assessment and treatment. 2013, updated 2017
  • Wilcox AJ, Weinberg CR, Baird DD. Timing of sexual intercourse in relation to ovulation. New England Journal of Medicine. 1995
  • RCOG. Fertility: assessment and treatment for people with fertility problems. 2023
  • Public Health England. Vitamin D supplementation guidance. 2021
  • Fertility Network UK. Support and information. fertilitynetworkuk.org

Frequently asked questions

How does conception actually work?

Conception happens when a sperm fertilises an egg. It sounds simple, but the timing has to be precise. Each month, one of your ovaries releases an egg during ovulation. That egg survives for just 12 to 24 hours. Sperm, on the other hand, can live inside the body for up to five days. This means you have a window of roughly six days each cycle where pregnancy is possible.

When are you most fertile?

Your most fertile days are the day of ovulation and the five days leading up to it. This is known as your fertile window. Studies published in the New England Journal of Medicine found that the highest chance of conception occurs when intercourse happens one to two days before ovulation.

How to track ovulation

There are several ways to identify when you are ovulating. You can use one method or combine a few for greater accuracy.

How often should you have sex?

The NICE fertility guideline (CG156) recommends having vaginal intercourse every two to three days throughout the month, without timing it specifically to ovulation. This approach ensures sperm are consistently present in the reproductive tract, which means you are less likely to miss your fertile window entirely.

How long does it take to get pregnant?

For most couples, conception happens within 12 months. According to NHS data:

What can you do to boost your chances?

While there is no guaranteed way to speed up conception, several evidence-based steps can help create the best conditions.

What about your partner's fertility?

Fertility is a shared responsibility. Around 30 to 40% of fertility issues involve male factors, and another 20 to 30% involve a combination of both partners. Here are evidence-based steps your partner can take.

When should you see a GP?

NICE recommends that you see your GP if:

Sources

  1. NHS. Trying to get pregnant
  2. NICE Clinical Guideline CG156. Fertility problems: assessment and treatment. 2013, updated 2017
  3. Wilcox AJ, Weinberg CR, Baird DD. Timing of sexual intercourse in relation to ovulation. New England Journal of Medicine. 1995
  4. RCOG. Fertility: assessment and treatment for people with fertility problems. 2023
  5. Public Health England. Vitamin D supplementation guidance. 2021
  6. Fertility Network UK. Support and information

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