Mucus observations in the fertile window: a better predictor of conception than timing of intercourse

BACKGROUND: Intercourse results in a pregnancy essentially only if it occurs during the 6‐day fertile interval ending on the day of ovulation. The strong association between timing of intercourse within this interval and the probability of conception typically is attributed to limited sperm and egg life times. METHODS: A total of 782 women recruited from natural family planning centres in Europe contributed prospective data on 7288 menstrual cycles. Daily records of intercourse, basal body temperature and vaginal discharge of cervical mucus were collected. Probabilities of conception were estimated according to the timing of intercourse relative to ovulation and a 1–4 score of mucus quality. RESULTS: There was a strong increasing trend in the day‐specific probabilities of pregnancy with increases in the mucus score. Adjusting for the mucus score, the day‐specific probabilities had limited variability across the fertile interval. CONCLUSIONS: Changes in mucus quality across the fertile interval predict the observed pattern in the day‐specific probabilities of conception. To maximize the likelihood of conception, intercourse should occur on days with optimal mucus quality, as observed in vaginal discharge, regardless of the exact timing relative to ovulation.