Ask a Yoetzet
Golda Koschitzky Hotline
Expanding one’s family can be exciting as well as daunting. Often, the numerous personal and medical factors involved in preparing for pregnancy fall into place naturally, without any special effort. Sometimes, however, the process can be intimidating and stressful, especially when there are delays or medical complications.
Whether it happens easily or requires more effort, conception (as well as pregnancy, childbirth, and postpartum care) involves close attention to one’s body and health, together with recognition that each step is very much b’ydei shamayim, in God’s hands. Accepting the lack of ultimate control over one’s body can inspire faith and connection. It can also feel uncomfortable or anxiety-provoking, and even lead to spiritual questions. The process requires balancing patience and faith with awareness of when proactive efforts can make a difference.
For women who are conceiving after pregnancy loss, these issues can be particularly complex. Please see here for more information regarding pregnancy loss and conception after loss.
Planning to Become Pregnant
Ideally, the process of trying to conceive begins with a woman and her husband each taking care of their own health . This includes practicing balanced nutrition, engaging in physical activity, getting sufficient rest, and managing any underlying medical conditions. Factors such as stress, exhaustion, smoking or alcohol use can all decrease a woman’s chances of conceiving and carrying a healthy pregnancy.
It is recommended for a woman to meet with her medical provider for a pre-pregnancy check-up to discuss any health considerations or concerns in advance of becoming pregnant.
It is particularly important to begin taking a prenatal vitamin containing folic acid at least 1-3 months before attempting to conceive, or any time when there is a possibility of becoming pregnant. Folic acid plays a key role in preventing neural tube defects in babies, and high levels are required early in pregnancy, often before a woman even realizes she is pregnant.
Many Jewish couples undergo genetic testing before conception, if they haven’t done so prior to marriage (learn more here).
Expectations Regarding Conception
Most couples trying to conceive are successful within the first year of trying, just by having regular sexual intercourse, and without any additional intervention. Over half of couples conceive within the first six months of trying, and about 85% within one year. Nonetheless, conception can take patience. Even for a healthy young woman, the chance of becoming pregnant is about 20% each cycle. Thus, there is no cause for alarm if a woman does not become pregnant quickly.
Sometimes, however, various factors can reduce a couple’s chance of conceiving. Factors affecting female fertility include general health , weight, anatomic abnormalities, and menstrual cycle irregularities. For many women, maintaining a veset calendar provides sufficient period tracking to identify irregularities.
A woman’s health is not the only thing that can affect her ability to get pregnant – the male reproductive system plays an equally significant role in conception. Therefore, when considering potential factors affecting fertility, disorders of the male reproductive system must be considered alongside any female factors.
Age also plays a role in fertility and conception. As women and men move into their mid-30s and 40s, fertility declines (less predictably for men), and therefore the chance of becoming pregnant in a given cycle decreases. Most women over the age of 45 have difficulty conceiving naturally.
If there is a specific reason for concern, or if a couple has not conceived either within a year of trying or within six months if the woman is over 35, it is medically recommended to speak with a doctor about further evaluation and management. A Nishmat Yoetzet Halacha Fertility Counselor can help guide couples through this process as well.
Fertilization and Conception
Fertilization occurs when a sperm cell joins with a mature egg cell in the fallopian tube following ovulation.
A woman typically ovulates once each cycle. With ovulation, an egg is released from the ovary and travels to the fallopian tube, where it remains, ready for fertilization, for about 12-24 hours.
In natural fertilization and conception, sperm cells are ejaculated from the penis into the vagina during sexual intercourse. The sperm cells then travel to the fallopian tubes. Sperm cells usually live in the female body for about 72 hours, although with optimal nutrition from cervical fluid sperm may live as much as five days.
Fertility Window and Timing
A woman’s “fertility window,” during which she can potentially conceive, is generally from 3-5 days before ovulation until 1-2 days after ovulation. Within this window, fertilization statistically is most likely to occur if marital relations take place a day or two before ovulation.
Mikveh night often falls out around the time of ovulation, so intercourse every day or two, starting on mikveh night until a day or so after a woman thinks she’s ovulated, can give a couple a good chance of having intercourse during the woman’s fertility window. Pressure to “time it right” can generate stress, and it is best for couples to focus instead on the enjoyment and connection of marital relations.
Women with longer or irregular cycles may not be ovulating the first week after mikveh, and may want to track ovulation and time intercourse accordingly. Couples who have been trying for six months to a year (see above) may also want to track ovulation more precisely. Learn more about ovulation before mikveh here.
There are various tools, apps, and trackers available to assist in tracking menstruation, and some women find having this information, and the precise planning it can enable, to be empowering. However, for a woman with a regular monthly cycle, these types of tools are typically not necessary in order to identify the fertility window for conception. Furthermore, for some women, period trackers can create an unnecessary sense of anxiety or urgency about timing intercourse with ovulation. These tools are also imperfect, and women should be mindful not to become too reliant on the data, which may contain errors.
Intercourse
Many couples find lubricant to be helpful in ensuring that intercourse is comfortable and pleasurable. Some lubricants may interfere with sperm motility and effectiveness, although there has not been conclusive evidence that this affects conception. Nonetheless, the FDA approves some lubricants (e.g., hydroxyethylcellulose-based lubricants) as “fertility-friendly,” and it may be advisable for a couple who use lubricant to choose this type when trying to conceive.
There is no evidence that certain coital positions are better for conceiving than others, nor that lying on one’s back for a period of time after intercourse helps. Couples should do what is best for them to support enjoyable intimacy while trying to conceive.
After Stopping Contraception
Women who stop using contraception can generally become pregnant as soon as they ovulate.
Barrier devices (e.g., diaphragms), spermicides, and the copper IUD do not interfere with ovulation, so a woman can become pregnant immediately after stopping these methods.
Hormonal birth control methods, including combined hormonal contraceptives (pill, patch, or ring), the progesterone implant, the hormonal IUD, and, in many cases, the progestin-only minipill, function by preventing ovulation. When a woman stops this type of birth control method, she may ovulate within a few days or weeks, and therefore it is possible to become pregnant within one cycle, even before her next period. However, for some women, ovulation may not resume until about 1-3 months after stopping the method, which can delay the ability to conceive.
Women who do not return to ovulatory cycles after stopping contraception may have an underlying reason why their bodies are not ovulating at regular intervals, unrelated to birth control use. Any woman concerned about irregular cycles and ovulation should speak with her health care provider about additional evaluation.
Taharat Hamishpacha
Taharat hamishpacha is a halachic obligation that is central to Jewish marriage. However, the merit of observing this mitzva does not guarantee that a couple will have children, nor do lapses or omissions in its observance mean that a couple will face difficulties in conception or pregnancy. Still, couples may find their observance of taharat hamishipacha to be especially significant for their connection with each other and with God as they begin to pursue practical efforts to conceive.
For some women, ovulation before mikveh can present challenges in conceiving. Learn more here.
Traditional Jewish sources occasionally refer to the concept of a “ben niddah,” a child conceived while a woman is in niddah. While teshuvah (repentance) is a mitzva for parents in this situation, the child is not held accountable for the parents’ actions, and it is otherwise unclear what “ben niddah” means. There are no halachic ramifications for the child, nor does this limit the child’s spiritual potential.
To learn more about pregnancy, see here.
For more one-on-one advice regarding preparing for pregnancy, please reach out to us through this website, call our hotline, or contact a Yoetzet Halacha in your community.
