Can a female of reproductive age with a regular menstrual cycle and no underlying medical conditions conceive if she has intercourse during mid-cycle pain, which is often associated with ovulation?

Yes, Intercourse During Mid-Cycle Pain Significantly Increases the Chance of Conception

Mid-cycle pain (mittelschmerz) typically occurs around ovulation, which is precisely when you are most fertile, making this an optimal time for conception if that is your goal. 1

Understanding the Fertile Window

The fertile window is the 6-day interval ending on the day of ovulation, characterized by slippery, stretchy cervical mucus and other signs of peak fertility. 1, 2 This is when conception is most likely to occur because:

• Sperm can survive in the female reproductive tract for up to 5 days before ovulation 3
• The egg is viable for approximately 24 hours after ovulation 3
• Intercourse during this window, especially on the day of ovulation or the 1-2 days before, maximizes conception probability 1, 2

Timing and Ovulation Variability

While mid-cycle pain often coincides with ovulation, it's important to understand that ovulation timing varies considerably:

• Only 12.4% of women actually ovulate on day 14 of a 28-day cycle, despite this being the commonly cited "average" 4
• For women with 28-day cycles, there is a 10-day spread of observed ovulation days, with day 15 being most common 4
• 95% of fertile windows occur between cycle days 4 and 23, but only 25% of women have their entire fertile window between the traditionally cited days 10-17 5
• 87% of women have cycle lengths between 23-35 days, and over half experience cycle variation of 5 days or more 4

Maximizing Conception Probability

If you are trying to conceive, the CDC and American Society for Reproductive Medicine recommend: 1, 2

• Have intercourse every 1-2 days beginning soon after your menstrual period ends to ensure coverage of the fertile window regardless of when ovulation occurs 1, 2
• Use ovulation predictor kits to detect the LH surge, then have intercourse when detected and continue for 2-3 days 2
• Monitor cervical mucus for the characteristic clear, stretchy, slippery quality that indicates peak fertility 1

Important Caveats

If you are NOT trying to conceive, you should use effective contraception throughout your cycle, as:

• The fertile window is highly unpredictable, even in women with regular cycles 3
• Women have at minimum a 10% probability of being in their fertile window on every day between cycle days 6 and 21 3
• 4-6% of women may be potentially fertile even in the fifth week of their cycle due to sporadic late ovulation 3

Factors That Reduce Fertility

Regardless of timing, avoid these factors that decrease conception probability: 1, 6

• Smoking, alcohol consumption, and recreational drug use 1, 6
• Being very thin or obese 1, 6
• High caffeine intake (more than 5 cups per day) 1, 6
• Most commercially available vaginal lubricants 1, 6