Many of us spend years trying not to fall pregnant. Then one day we’re ready to start a family, and we expect it to just… happen.
The reality for most couples, is that trying to conceive is usually a longer game — and the earlier you understand the timeline, the better.
GP and women’s health expert Dr. Michela Sorensen has this conversation with patients every day. Here’s the (realistic) fertility timeline she wishes more couples knew.
3–6 months before you start trying to conceive: see your GP
This is the sweet spot, according to Dr. Sorensen.
A lot can change in six months, so she recommends not testing any earlier; on the flip side, testing less than three months before falling pregnant doesn’t give you much runway.
“Three to six months is usually a good chunk of time to be able to do a deep dive into those things we need to look into, but also to give us time to rectify them,” she says.
Preconception health checks may include checking your iron levels, thyroid function, immunity to rubella and varicella, reviewing any medications, and getting a clear picture of your overall health including your lifestyle and any family history.[1]
3 months before you start trying to conceive: start folic acid
This step is important.
“We recommend starting a pregnancy supplement or folic acid supplement three months before you try to conceive, that's the ideal time,” Dr Sorensen shares.
Australian guidelines recommend starting a pregnancy supplement containing 400 micrograms of folic acid at least one month before you begin trying to conceive. But, Dr Sorensen recommends starting three months before trying to conceive, to make sure you’re well and truly covered.
Once pregnant, that folic acid requirement jumps up to 600 micrograms – and while breastfeeding, you’ll still need at least 500 micrograms of folic acid.
It’s true that you can get more folate by eating green leafy vegetables, legumes, citrus fruits, bananas, strawberries, avocado, tofu and eggs - but pregnant women (or those planning a pregnancy) will still need a supplement.
In fact, taking folic acid before conception is one of the most evidence-backed steps you can take to support a healthy pregnancy and reduce the risk of certain birth defects.[2]
Once you start trying: recalibrate your expectations
One of the most common questions couples ask is: How long does it take to get pregnant?
The answer is, it often takes longer to conceive than most people think.
Guidelines suggest allowing up to 12 months of trying to conceive naturally before investigating further. But in practice, Dr. Sorensen says she’ll usually have the “what’s next” conversation with patients who have been trying to fall pregnant for around six-months, to look at whether more investigation may be needed.
“A lot of people think they will fall pregnant in one, two, maybe three months max,” she says. “But the average timeframe it takes for people to conceive is actually six months.”
If you’re struggling to fall pregnant, know you’re not alone.
Infertility affects about 1 in 6 Australian couples, which can feel stressful and frustrating. Rest assured, many couples will still go on to get pregnant, with or without fertility treatment. [3]
"I wish there was one test I could do on everyone to tell them whether they're going to be fertile or not," Dr Sorensen says.
"Unfortunately it's not that simple, it's a really, really complex thing and there's so many factors at play. But there are lots of different steps that happen between seeing me as a GP and going and seeing a fertility specialist and going down the path of IVF."
Remember too, that fertility isn’t solely a women’s health issue. Male factor infertility accounts for up to 30% of cases [4] — a significant figure that often gets overlooked. Some simple tests including a semen analysis is a good starting point, and your GP can organise it.
The fertility reality we don’t talk about enough: miscarriage
Up to 1 in 4 pregnancies are estimated to end in miscarriage in Australia.[5] That’s around 285 a day — one every five minutes. Dr. Sorensen makes a point of raising this possibility with her patients early.
"If and when it does happen, the emotions are so thick and so strong, it's really hard to start talking through it at that point,” she explains. “Whereas at least having planted the seed, I find that conversation just a little bit easier."
The bottom line: Fertility and pregnancy planning shouldn’t be a last-minute conversation
The earlier you loop in your GP — ideally three to six months before you want to start trying — the more time you have to address anything that needs attention.
And if you’re already pregnant and haven’t done any of this? “Don’t panic,” says Dr. Sorensen. “Most of these checks can be done in early pregnancy too.”[6]
References
1. HealthDirect | Planning for your pregnancy
2. HealthDirect | Folate
3. HealthDirect | About infertility
4. Better Health Channel Vic | Infertility in men
5. Miscarriage Australia | What is miscarriage
6. HIF Health Hub | Pregnancy Planning - The Simple Things to do Before Trying to Have a Baby