Time to Pregnancy (TTP)

Time to pregnancy (TTP) is the number of months from the start of unprotected intercourse attempting conception to the achievement of a confirmed pregnancy, and it is the primary population-level measure of couple fecundability. In couples with normal fertility using fertility-aware, timed intercourse, studies estimate that approximately 81% conceive within 6 cycles and 92% within 12 cycles.1 These probabilities decline with advancing age. When a couple has not conceived after 12 months of appropriately timed attempts, or 6 months at age 35 or older, infertility evaluation is indicated.2

TTP depends substantially on whether intercourse is timed to the fertile window. Couples who cannot identify the peak day of their cycle, or who are not using fertility-focused intercourse, may show extended TTP for behavioral rather than pathological reasons. Accurate TTP reporting requires that couples know when they began attempting and whether attempts were cycle-timed. This distinction matters clinically: extended TTP in the absence of cycle tracking may reflect missed fertile windows rather than underlying disease.

In restorative reproductive medicine, TTP is most meaningfully interpreted as a cumulative outcome over a defined treatment horizon rather than a per-cycle metric. Published NaProTechnology cohort data report outcomes at 24 and 36-plus months, reflecting the time required for diagnosis, treatment of underlying conditions, and physiological restoration.3 This differs from procedural approaches that report per-transfer or per-cycle success rates, a framing that does not capture couples who discontinued treatment. TTP over a full treatment horizon is the relevant comparison metric for couples evaluating care pathways at mature reproductive age.

Cited in this entry

  1. Gnoth C, Godehardt D, Godehardt E, Frank-Herrmann P, Freundl G. Time to pregnancy: results of the German prospective study and impact on the management of infertility. Hum Reprod. 2003;18(9):1959-1966. Human Reproduction. https://pubmed.ncbi.nlm.nih.gov/12923157/
  2. Optimizing natural fertility: a committee opinion. Fertility and Sterility. https://rrmacademy.org/library/optimizing-natural-fertility-a-committee-opinion-recft4hl2pkqxb8id/
  3. Natural procreative technology (NaProTechnology) for infertility: take-home baby rate and clinical outcomes in a 5-year single-center cohort of 1,310 couples. Frontiers in Reproductive Health. https://pmc.ncbi.nlm.nih.gov/articles/PMC12660242/

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.