Your 28-Day Cycle at a Glance
Hover over each day to see its phase. Fertile window highlighted in green.
1. Start With a Preconception Check
Before actively trying, book a preconception appointment with your GP or gynaecologist. You will discuss: cervical smear status, STI screening (which can cause silent fertility damage if untreated), rubella immunity, blood pressure and BMI, any medications that may need reviewing, and the most important supplement you can take, folic acid (400mcg daily, ideally starting 3 months before trying). If you have a known condition like PCOS, endometriosis, thyroid disorder, or irregular cycles, early specialist involvement can prevent months of frustration.
2. Track Ovulation, Do Not Guess
The most impactful single change you can make is to identify your actual fertile window, not the one your app predicts. Use ovulation predictor kits (OPKs) from cycle day 10, monitoring for your LH surge. Have sex on the day of your positive OPK and the day after. If you have PCOS or irregular cycles, LH strips alone may give false positives, in this case, progesterone testing on day 21 or ultrasound follicle tracking with a specialist gives more reliable confirmation of ovulation.
3. Have Sex at the Right Time
Having sex in the fertile window, the 5 days before ovulation and ovulation day itself, is responsible for virtually all natural conceptions. The peak day (24 hours before ovulation, when the LH surge is maximal) carries the highest individual probability. If you are only going to optimise one thing, optimise this. Everything else on this list is secondary to cycle timing.
4. Optimise Frequency, Not Just Timing
During the fertile window, aim for sex every 1–2 days. Outside the fertile window, regular intimacy (2–3 times per week) keeps sperm fresh and maintains relationship connection. Abstaining for extended periods before the fertile window in an attempt to "save up" sperm actually reduces conception rates, sperm older than 3–4 days have higher DNA fragmentation and lower motility. Fresh, frequent sperm is better than stored sperm.
5. Optimise Male Factor From Day One
In approximately 40–50% of cases where conception is delayed, a male factor is partially or wholly responsible, yet semen analysis is often delayed or skipped entirely. Sperm health can be significantly improved by: eliminating hot baths, saunas, and tight underwear (heat damages sperm production); reducing alcohol to under 14 units per week; stopping smoking completely; avoiding anabolic steroids and recreational drugs; and maintaining a healthy weight. Sperm takes approximately 74 days (the spermatogenesis cycle) to develop, so lifestyle changes take 2–3 months to show effect.
6. Take the Right Supplements
For women: folic acid (400mcg/day, or 5mg if you have a history of neural tube defects or take anti-epileptics), vitamin D (if deficient), CoQ10 (600mg/day has evidence for improving egg quality in women over 35 or with poor ovarian reserve). For men: zinc and selenium (for sperm motility and morphology), vitamin C and E as antioxidants (oxidative stress damages sperm DNA), and CoQ10 (200–600mg/day has good evidence for improving multiple sperm parameters). Avoid megadose vitamin A (retinol), which is teratogenic.
7. Maintain a Fertility-Supportive Diet
The Mediterranean diet has the strongest evidence for both female and male fertility: high in olive oil, oily fish, legumes, whole grains, nuts, and vegetables; low in ultra-processed foods, refined carbohydrates, and red meat. For women with PCOS, a low-glycaemic index diet specifically helps regulate insulin and restore ovulation. Iron from plant sources (non-haem iron) is associated with better ovulatory function than haem iron in multiple prospective studies. Folate-rich foods (dark leafy greens, chickpeas, oranges) support early neural development even before you know you are pregnant.
8. Reach a Healthy Weight Before Conceiving
Both underweight and overweight significantly affect fertility. Being overweight is associated with anovulation (absent ovulation), poor egg quality, higher miscarriage rates, and increased pregnancy complications. Being underweight can suppress the HPO axis and cause hypothalamic amenorrhoea, the body's energy-conservation response that shuts down reproduction. Even a 5–10% change in body weight can restore ovulation in women where weight is a contributing factor. This is not about aesthetics, it is about hormonal signalling.
9. Reduce Alcohol Completely When Actively Trying
Both partners should reduce or eliminate alcohol when trying to conceive. For women: no safe level of alcohol in pregnancy has been established, and some alcohol consumed before a confirmed pregnancy will be consumed before you know you are pregnant. For men: alcohol consumption above 14 units per week is associated with reduced testosterone, lower sperm count, and higher rates of sperm abnormality. A 2023 meta-analysis found that even moderate drinking (5+ drinks per week) reduced male fertility outcomes.
10. Manage Stress, It Is Not "Just" Psychological
Stress is not a soft factor in fertility. Elevated cortisol directly suppresses GnRH production, reducing LH and FSH and interfering with ovulation timing. Chronic stress is associated with longer time to conception, higher miscarriage rates, and reduced IVF success rates in multiple large studies. Effective stress management for fertility includes: evidence-based mind-body programs (MBSR has the strongest data), moderate exercise, adequate sleep, acupuncture (which has evidence for HPA axis regulation), and psychological support. Telling someone to "just relax" is medically unhelpful, but actively managing the stress response is not.
11. Switch to Fertility-Friendly Lubricant
Standard lubricants, including saliva, KY Jelly, and most off-the-shelf products, are toxic to sperm. Studies show they reduce sperm motility by 60–100% at clinically relevant concentrations. If lubrication is needed during the fertile window, use Pre-Seed, Conceive Plus, or any lubricant specifically formulated to be sperm-compatible and isotonic (matching the pH and osmolality of semen). Fertility-friendly lubricants are widely available in pharmacies without prescription.
12. Know When to Seek Help, Do Not Wait Too Long
Current guidelines recommend seeking a fertility specialist assessment after 12 months of regular unprotected intercourse for women under 35, and after 6 months for women 35 or older. However, seek earlier assessment if: you have irregular or absent periods; you have a diagnosed condition known to affect fertility (endometriosis, PCOS, previous STIs, uterine fibroids); you have had previous fertility treatment or pregnancy loss; your partner has a known sperm issue; or you are 38 or older. Earlier assessment does not mean rushing into treatment, it means having accurate information to make informed decisions. Time spent hoping things will work out on their own can be time lost that matters significantly for treatment outcomes.
Medical Disclaimer
This article is written for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making health decisions.
Dr. Nina Patel
Reproductive Endocrinologist
All TryHerCare articles are written and reviewed by qualified medical professionals. Our content is clinician-reviewed to ensure accuracy and clinical relevance.
