Improving Your Chances

There are many myths circulating about family planning. One of the most persistent: After intercourse, a woman should lie down with her pelvis elevated for thirty minutes. Such advice is unsubstantiated and unnecessarily strains your love life. We’ve summarized for you what the evidence really says—and what you can safely ignore. 

Understanding the Fertile Window

The most fertile period is the six days leading up to ovulation. Fertility peaks about two days before ovulation—the day of ovulation itself is already less likely to result in conception.

What’s more: Even with a regular 28-day cycle, ovulation can occur on day 12 one time and on day 16 the next. There is no reliable method for determining the most fertile time in advance—except for measuring the follicle via ultrasound. 

The best advice: Consistency over stress

Working couples, in particular, are best off following a simple recommendation: be intimate about two to three times a week, regardless of the phase of the cycle. This way, you’ll reliably hit the fertile window—and avoid the trap of only having sex when it’s “worth it.” 

Age—the most important factor

As uncomfortable as it may be, a woman’s age remains the most significant factor in reproductive medicine. As a woman ages, the number of available eggs decreases, and the remaining eggs are more prone to fertilization failures. Egg quality does not decline linearly, but rather decreases at an increasingly rapid rate toward the end of a woman’s thirties (Sujino et al. 2025). Even modern methods such as IVF and ICSI cannot always compensate for this. 

The practical implication is this: you shouldn’t put off family planning without a good reason. If your life circumstances allow it, sooner is better than later. Read more about this in our article “Age and Fertility.” 

Lifestyle: What Really Matters

Smoking is the best-documented modifiable factor, and it affects both partners. In women, it prolongs the time it takes to conceive and increases the risk of remaining childless against one’s wishes (He & Wan 2023). In men, it measurably impairs sperm quality (Fan et al. 2024), although these values recover after quitting smoking. Smoking also increases the risk of miscarriage (Yuan et al. 2021). Secondhand smoke is not harmless either. 

Incidentally, family planning is a good reason to quit smoking together—a benefit that extends far beyond fertility. 

Body weight plays a role—as one factor among many—and you shouldn’t put pressure on yourself. Both being significantly overweight and underweight can prolong the time it takes to conceive, for both women and men (Boxem et al. 2024). A moderate approach to achieving a healthy weight can be beneficial. Important: This isn’t about strict diets or grueling exercise regimens—those tend to be counterproductive. If this is an issue for you, we’d be happy to support and advise you. 

Alcohol in large quantities has a negative effect: starting at about eight glasses per week, the chances of conception decrease measurably for both partners (Rao et al. 2022). With moderate consumption, the evidence is less clear-cut. So you don’t have to explain why you’re passing on the glass of wine every time you’re invited out—an occasional glass is no cause for concern. However, we recommend being more mindful of your intake both before and during treatment. 

Based on current knowledge, you do not need to strictly avoid caffeine when trying to conceive: typical amounts of coffee or tea do not demonstrably impair fertility (Purdue-Smithe et al. 2022). However, once you are pregnant, moderation is advisable, as higher amounts are associated with an increased risk of miscarriage (Jafari et al. 2022). The standard recommendation is then a maximum of about 200 mg per day, which corresponds to roughly two cups of coffee (ACOG 2010). 

Folic acid is the one supplement we strongly recommend to all women engaged in family planning: It significantly reduces the risk of certain birth defects in the child—especially when taken before pregnancy, since the neural tube closes during the first few weeks. So don’t wait until you get a positive pregnancy test to start taking it; begin as soon as you’re actively trying to conceive. 

Moderate exercise is beneficial. Only extreme and professional sports can have adverse effects. 

When no cause is found

One of the most frustrating situations: Initial investigations reveal no identifiable cause—neither in the man nor in the woman. And yet, pregnancy does not occur. This is not uncommon: In about one in ten couples, no clear cause can be found despite thorough investigation (Carson & Kallen 2021). 

Here’s an important point to keep in mind: With regular intercourse, about 85% of couples conceive within the first year, and about 92% by the end of the second year (NICE 2013). Such a couple is therefore by no means “infertile.” Experts today deliberately avoid using the term “infertility” and instead speak of reduced fertility—the chance of conception per month is lower, partly for unknown reasons, but it is still there. 

Practical Tip: Stop Using Birth Control in a Timely Manner

After using hormonal birth control such as the pill or a hormonal IUD, it can take up to three months for the menstrual cycle to stabilize—regardless of how long birth control was used beforehand. If you’re planning family planning in the foreseeable future, you should stop taking the pill in good time; barrier methods are suitable for the interim period. 

When You Should Contact Us

Almost all couples ask themselves the same question: At what point is it taking too long? As a rule of thumb: If pregnancy does not occur after one year of regular, unprotected intercourse, it’s worth getting checked out. If the woman is 35 or older, we recommend doing so after just six months—not to cause alarm, but because time becomes a more significant factor at that point.