Fertile after your pregnancy

Approximately 6 weeks after giving birth you can have sex again because your womb has recovered and the blood loss has stopped. You can then start again for the first time and so you are fertile again. 4 weeks after delivery you can get pregnant again. After 6 weeks you are not yet pregnant. Here you do about 9 months. If you do not want to run the risk of becoming pregnant immediately, consider how you want to prevent this.

Fruitful without you knowing it

The first menstruation can start again from 6 weeks. It can also stay away for months. About 2 weeks before your period, the ovulation takes place. This allows you to be fruitful without knowing it. If you do not breastfeed, you can be fertile again from 3 weeks after delivery. Therefore think about reliable contraception for post-delivery during your pregnancy. If you do not want to become pregnant again immediately, make sure you use a contraceptive if you have sex. Providing full breastfeeding (including night food) can significantly reduce the chance of a new pregnancy, but does not exclude it. Get more details on pregnant on ovulation day

Information from your midwife

In the pregnancy or in the maternity period, you provide obstetric information about different methods of contraception. This topic is discussed again during follow-up and six weeks after delivery. If you want to know more about the different contraceptives, ask for advice from your midwife. She can prescribe all hormonal contraceptives and possibly place an IUD.

Become pregnant

If you want to become pregnant, you can ensure that your child gets a healthy start. The midwife helps you with that. If you live healthy, you increase the chance of a pregnancy. You also lay a good foundation for the health of your child.

Difficult to get pregnant

You want to get pregnant as soon as possible. If this is not successful after a year, you and your partner can have the cause investigated. Then make an appointment with a midwife or with your doctor. They can refer you to a gynecologist if necessary.

Fertility treatment

If it turns out that you can not become pregnant in the normal way, then you may be eligible for fertility treatment. Unfortunately, a fertility treatment does not guarantee pregnancy.

If you are older

The ideal age to become pregnant is between 25 and 35 years. Women in the Netherlands are on average slightly older than 29 when they have their first child. The ideal age to become pregnant is between 25 and 35 years. Women in the Netherlands are on average slightly older than 29 when they have their first child. On average you have 20% chance per month to become pregnant. If you are over 35 years of age, it may take longer to become pregnant. After your 35th the chance is still 10%. You are also more likely to have a miscarriage and problems during pregnancy. As you get older, the chance of a child with a chromosomal abnormality, such as Down syndrome, also increases.

What if you do not succeed in getting pregnant?

What you can expect after you have been referred for further research, The information in this brochure is general and therefore does not always have to apply to your situation. The chance of a pregnancy in a woman who regularly has sex, does not use contraceptives and has a regular menstruation, is on average 15%. On average 80 to 90% of women become pregnant in the first year. When a couple seriously tries to conceive and this is not successful after a year, subfertility is mentioned. This is the medical term for reduced fertility.

Symptoms when pregnant are not successful

A fertility disorder exists in about 25% of women. In 13% of women this becomes clear when they want to become pregnant for the first time. There is then talk of a primary fertility disorder. With the other women, the disorder only becomes clear when they want to become pregnant again.

How is it that pregnancy does not work?

In about 30% of the couples with a fertility disorder, the cause lies with the man; 20% for men and women and 50% for women. It is also possible that no clear cause is found. Causes with the man A reduced fertility of the man almost always has to do with the sperm. The cause of sperm abnormalities can be congenital or acquired later and can not always be traced. It may have to do with factors such as smoking, alcohol use, a congenital disorder in the production of sperm, a venereal disease or testicular inflammation (mumps), injuries or operations on the testicles, use of medication, exposure to harmful substances, irradiation and chemotherapy. Sperm abnormalities can be divided into three groups:

 Not enough sperm cells Normally, ejaculate contains an average of 100 to 200 million sperm cells. This corresponds to 20 to 50 million sperm per milliliter of ejaculate. If there are fewer than 20 million sperm per m33illiliter ejaculate, there is talk of reduced fertility (subfertility). It usually takes longer for the woman to become pregnant. If there are less than ten million sperm per ml of ejaculate (oligozoospermia), the chance of pregnancy is even lower. It is only at less than five million sperm per milliliter that the risk of childlessness is clearly increased. It is also possible that there are no sperm cells in the ejaculate at all (azoospermia).

Too little moving sperm cells In a normal ejaculate, at least 50% of the seed moves and at least 25% should swim well. If there is less than 25% sperm count (asthenozoospermia), it will take longer for the woman to be pregnant. If less than 20% of the sperm cells move well, the chance of a natural pregnancy is lower. Too little well-formed sperm cells In addition to motility, the shape of the sperm cells is also important. In every man malformed sperm cells occur in the sperm. If this is more than 70% of the seed (teratozoospermia), it takes longer for a pregnancy to come about. When more than 80% of the sperm cells do not have a good shape, the chance of a natural pregnancy is lower. Causes in women The most common causes of fertility disorders in women are cycle disorders, abnormalities of the fallopian tubes and islets of uterine lining in the abdomen (endometriosis). In addition, medication use, chemotherapy, abdominal surgery and survived venereal diseases can reduce fertility.

Cycle disorders In about 20% of women who are less fertile, the cause is a cycle disorder. Normally, ovulation occurs every month, followed by menstruation fourteen days later. Women with a cycle disorder have less frequent or no ovulation. Many cycle disorders can be treated well with hormones, which eventually leads to ovulation and thus the possibility of becoming pregnant. Sometimes the cycle disorder is caused by the so-called polycystic ovary syndrome. This benign deviation is often accompanied by excessive hair growth and weight gain. With hormones it is often possible to induce ovulation.

Abnormalities in the fallopian tubes In about 14% of women who are less fertile, the cause lies in abnormalities of the fallopian tubes. These could have been caused by inflammation that has risen from the vagina to the area around the fallopian tubes. The inflammation leads to the formation of scar tissue, as a result of which the fallopian tubes can be closed or adhered. The fallopian tubes can then no longer cope with the egg after ovulation. Many of these abnormalities can be treated surgically.

Endometriosis In women with endometriosis the uterine lining is not only located in the womb, but also in other places in the abdomen. Light forms do not seem to influence fertility and are therefore not treated. More severe forms of endometriosis can lead to adhesions of the fallopian tubes, reducing their function and thus fertility. The fallopian tubes can even be completely closed. The use of certain hormones can cause the adhesions to shrivel. During such a tablet cure no ovulation takes place and the woman is therefore infertile. This can be a problem for women who want to get pregnant quickly, for example because of their age. Unfortunately, the cure has no demonstrable beneficial effect on fertility.

Is it serious and what can you expect?

Although 25% of women have fertility dysfunction, only 3% of women do not really get pregnant. They are referred to as primary infertility (infertility). Approximately 6% of women have a secondary infertility disorder and therefore have fewer children than desired. So even if you are not pregnant within a year, chances are that you will eventually become.

When to the doctor?

If after a year you have not become pregnant, you can contact your doctor. If you are older than thirty-five years, you can consult your doctor after half a year. The optimal age for your body to get pregnant is between twenty and thirty years. The older you are, the longer it takes before you become pregnant. It is also advisable to go to your doctor if you think that you have been pregnant more than twice but lost the fruit at a very early stage (a miscarriage). If you think that medical matters from the past may play a role, you can always contact your doctor.

Maintain basic temperature curve

By tracking a basal temperature curve you gain insight into your cycle. Based on body temperature, you or your doctor can check whether ovulation occurs with you and if so, when in the cycle. After the ovulation the body temperature is somewhat higher.

Solve any problems with sexual intercourse

Although problems with lovemaking are almost never the cause of not becoming pregnant, different problems concerning sexual intercourse can occur. It is precisely because you may now experience sex as something that ‘needs’ can cause tension. It is good to talk about this openly with your partner and, if desired, with your doctor.


Impotence means that a man does not get an erection or an insufficient erection during sexual excitement, so that sexual intercourse is not possible. Impotence can occur at any age, but the chance increases with age. Of the men of sixty-five years or older, a quarter has to deal with impotence. Impotence is therefore completely separate from ‘having less sense in lovemaking’ or libido loss.