Trying to conceive (TTC) is one of the most emotionally loaded experiences a couple can go through. For some it happens quickly. For others it takes months or years. What separates the two groups is rarely luck — it is usually knowledge. Understanding how your body works, what helps conception, and what silently works against it makes a measurable difference.
This guide covers 12 evidence-based steps that fertility specialists recommend to women trying to get pregnant, including the specific issues that affect Nigerian and African women at higher rates. No false promises, no miracle cures — just what the research actually supports.
1. Track Your Ovulation — Not Your Period
Most women track their menstrual cycle. Fewer track their actual ovulation window. These are not the same thing, and confusing them is the single most common reason couples try for months without success.
Ovulation is when a mature egg is released from the ovary. The egg survives for 12 to 24 hours. Sperm can survive in the female reproductive tract for up to 5 days. This means your fertile window — the days when sex can result in pregnancy — is approximately 5 to 6 days long, ending on the day of ovulation.
In a textbook 28-day cycle, ovulation occurs around day 14. But most women do not have a textbook cycle. Cycles of 25 to 35 days are normal. If your cycle is 32 days, you likely ovulate around day 18, not day 14. Having sex on day 14 in a 32-day cycle means you are 4 days too early.
How to track ovulation accurately: Ovulation predictor kits (OPKs) detect the LH hormone surge that occurs 24 to 36 hours before ovulation. They are inexpensive, widely available in Nigerian pharmacies, and significantly more reliable than calendar counting. Basal body temperature (BBT) tracking — taking your temperature every morning before getting out of bed — also works but requires consistency and a digital thermometer.
2. Have Sex During the Fertile Window — Not Just When You Feel Ready
Frequency and timing both matter. Research consistently shows that having sex every one to two days during the fertile window (the five days before ovulation and the day of ovulation itself) maximises the chance of conception each cycle.
Having sex only on the predicted day of ovulation is slightly less effective than having sex in the days leading up to it, because sperm needs time to travel to the fallopian tubes and await the egg. Aim for sex every other day from approximately five days before your expected ovulation date through ovulation day itself.
3. Get a Preconception Health Check for Both Partners
Fertility is a two-person equation. Male factor infertility accounts for approximately 40 to 50 percent of all infertility cases — yet most couples focus exclusively on the woman’s health when conception is delayed.
Before months of trying pass, both partners should have a preconception health assessment. For women this includes a pelvic scan (to check for fibroids, ovarian cysts, or polycystic ovary syndrome), hormone profile (FSH, LH, AMH, prolactin, thyroid function), and a review of any existing medical conditions. For men this includes a semen analysis covering sperm count, motility, and morphology.
In Nigeria, semen analysis is available at most teaching hospitals and fertility clinics for approximately ₦5,000 to ₦15,000. It takes one visit and 24 to 48 hours for results. It is the single most valuable test a couple trying to conceive can do.
4. Understand How PCOS Affects Your Fertility
Polycystic ovary syndrome (PCOS) is the most common hormonal disorder affecting women of reproductive age worldwide, and it is prevalent in Nigeria. Studies suggest it affects between 10 and 15 percent of Nigerian women of childbearing age.
PCOS disrupts ovulation — in some women, ovulation becomes irregular or stops altogether. This means the fertile window is unpredictable and conception without intervention becomes difficult. Women with PCOS often have longer, irregular cycles, excess body hair, acne, and difficulty maintaining a healthy weight.
If you have been trying to conceive for 6 to 12 months without success and have any of these symptoms, ask your doctor specifically about PCOS. A pelvic ultrasound and hormone blood tests will usually confirm or rule it out. PCOS is treatable — ovulation induction with clomifene citrate or letrozole is often highly effective.
5. Maintain a Healthy Weight
Body weight directly affects fertility through its influence on hormone levels. Both underweight and overweight conditions disrupt the hormonal balance required for regular ovulation. Excess body fat increases estrogen production, which can suppress ovulation. Even modest weight loss — 5 to 10 percent of body weight in overweight women — has been shown in multiple studies to restore regular ovulation and significantly improve pregnancy rates.
6. Start Folic Acid Before You Are Pregnant
Folic acid (vitamin B9) is the one supplement with the strongest evidence base in preconception care. It significantly reduces the risk of neural tube defects in the developing foetus during the first few weeks of pregnancy, often before a woman even knows she is pregnant. The recommended dose is 400 micrograms per day for all women actively trying to conceive. Begin at least one month before you plan to start trying.
7. Stop Smoking and Significantly Reduce Alcohol
Smoking reduces fertility in women by damaging eggs and disrupting hormone levels. In men, smoking significantly reduces sperm count and motility. Even moderate alcohol consumption — 3 to 6 units per week — has been associated with reduced fertility rates in women in prospective studies. Heavy alcohol use in men reduces testosterone levels and sperm quality. Both partners should stop smoking and reduce alcohol when actively trying to conceive.
8. Manage Stress — There Is a Real Hormonal Reason
Chronic stress elevates cortisol, which suppresses GnRH — the hormone that drives the entire reproductive cycle. High cortisol can disrupt or delay ovulation. This is not imagined or psychological. It is a real hormonal mechanism. Practical stress management for TTC includes regular physical activity, adequate sleep (7 to 9 hours), and deliberate separation from the mental loop of symptom-tracking and test-watching that intense TTC can create.
9. Check Your Thyroid
Thyroid disorders are significantly underdiagnosed in Nigerian women and have a direct, well-documented impact on fertility. Both hypothyroidism and hyperthyroidism disrupt menstrual regularity, ovulation, and the hormonal environment necessary for implantation. A TSH blood test is all that is needed to screen for thyroid disorders and costs ₦2,000 to ₦5,000 at most diagnostic centres. If you have been trying to conceive for more than 3 months, add TSH to your preconception bloodwork.
10. Understand What Fibroids Do — and Do Not — Mean for Fertility
Uterine fibroids affect approximately 30 to 40 percent of Nigerian women by age 40. The impact on fertility depends almost entirely on their location and size. Submucosal fibroids (protruding into the uterine cavity) have the most significant impact and are the type most likely to need treatment before conception. If you have been diagnosed with fibroids, ask your doctor: what type, what size, and what is the location relative to the uterine cavity?
11. Do Not Ignore Recurrent Miscarriage
One miscarriage affects approximately 10 to 15 percent of known pregnancies and is most often caused by a chromosomal abnormality in that specific embryo. Two or more miscarriages — recurrent pregnancy loss — warrants full investigation. Causes include chromosomal abnormalities, uterine structural abnormalities, antiphospholipid syndrome, thyroid problems, and uncontrolled diabetes — many of which are treatable. If you have experienced two or more miscarriages, insist on a recurrent miscarriage workup with a gynaecologist.
12. Know When to See a Fertility Specialist
Women under 35 who have been trying for 12 months should see a fertility specialist. Women 35 to 40 who have been trying for 6 months should seek evaluation. Women over 40 should seek evaluation after 3 months. Anyone with known PCOS, fibroids, endometriosis, previous STIs, or irregular periods should seek evaluation after 6 months regardless of age. Seeking help early does not mean you have a serious problem — it means you have access to information that most people wish they had sooner.
Frequently Asked Questions About Trying to Conceive
How long does it usually take to get pregnant? In couples where both partners are fertile and timing is correct, approximately 85 percent conceive within 12 months and 92 percent within 24 months.
Can you get pregnant with irregular periods? Yes, but it is more difficult because ovulation is harder to predict. Ovulation predictor kits are especially useful for women with irregular cycles.
Does age matter for fertility? Yes. Female fertility begins declining gradually after 32, more significantly after 35, and sharply after 40 due to the age-related decline in egg quantity and quality.
What vitamins should I take when trying to conceive? Folic acid (400mcg daily) is essential and evidence-based. Vitamin D supplementation if deficient is reasonable. Prenatal multivitamins provide a useful nutritional baseline.