About Supported Conception
If you are a person with ovaries under the age of 35 and have not been able to achieve a pregnancy after 12 months of trying, you should consult a fertility specialist. If you are over 35, we recommend talking to a fertility specialist after only six months of trying.
The age of the person with ovaries is the most important predictor of pregnancy. Fertility starts to decline at around age 32 and your chances of pregnancy decline rapidly after 35 years of age. This is not the case for the sperm provider, who can continue to produce new sperm late into life. A fertility clinic can support a couple on their fertility journey by performing comprehensive testing and providing a holistic and evidence-based plan to enhance their attempts at conceiving naturally.
Natural or supported conception should be considered when a couple has concerns regarding the regularity of ovulation or difficulty predicting the fertile window and the person with ovaries is younger (below age 35) and has a good egg reserve.
Depending on what we find during the investigation stage, there are a number of strategies we can employ to support your efforts to conceive naturally (i.e. through intercourse). These include:
Monitoring your cycle so that we can improve timing of intercourse
Performing surgery to optimize the uterine environment, such as hysteroscopy for removal of polyps or uterine septums
Nutrition and diet counseling
Your age (and more specifically, the age of your ovaries) is a key consideration when considering whether natural conception is your best approach.
Your Supported Conception Journey Begins Here
While our supported conception program considers a wide range of options including surgery, lifestyle changes, and timed intercourse, the following journey presents a typical pathway for someone doing a medicated cycle. This cycle can be repeated as many times as needed in order to achieve a pregnancy, or until your fertility specialist recommends a more advanced approach, such as IUI or IVF.
You and your physician will review your medical history, menstrual and pregnancy history. They will also discuss your goals and expectations. They will discuss different testing options that are available.
Your care team will guide you through diagnostic tests that may include blood work for you and your partner, a semen analysis, or ultrasounds to assess the ovaries and the egg reserve. You may also have a sonohysterogram to assess the uterine cavity and the Fallopian tubes.
Reviewing with your Care Team
You and your physician will review your test results prior to discussing treatment options. If supported conception is identified as the preferred approach, your doctor will prepare a treatment plan so that you can start your cycle whenever you are ready.
Your dedicated care team will provide you with appropriate and timely instructions. Our goal is to make you feel in control. You will complete consent forms and participate in an education session where you will learn how to administer medications, if applicable. You will have multiple opportunities to ask questions.
Ovarian Follicle Maturation (10-12 days)
If you are taking an oral medication such as letrozole, you will take it daily for five days (typically cycle days 2 to 6). If you are using injectable medications you will take them daily leading up to ovulation. It typically takes 10-12 days for the eggs in the ovary to mature and be ready for ovulation. During this time you will have two to four in-person morning appointments at the clinic where we will monitor your hormones and measure ovarian follicles using an ultrasound exam. Your physician will closely monitor your stimulation to ensure the optimal uterine lining as well as the number and maturity of eggs.
The results of our monitoring over the last 10 days will determine when is the best time to conceive. We ask the sperm provider to abstain for two days prior to intercourse as this helps ensure optimal sperm quality.
Approximately two weeks after your ovulation, we will ask you to come into the clinic to check your beta-hCG, or pregnancy hormone, level. If you have the test done before 11:30 am on a weekday, we will have your results ready the same day.