Research on how climate affects conceptions is limited and often constrained by data limitations. Additionally, scientific knowledge is typically based on research focused on very poor or wealthy settings. Here, we examine two middle-income and climate-sensitive contexts, Armenia and Tajikistan, and use finely detailed data on local weather conditions and all conceptions, including those not ending in a live birth. We fit fixed-effects linear probability models of the time until each conception using data from the Demographic and Health Surveys, stratified by educational level and urban/rural residence. No relationship appears between heat and conceptions in Armenia or between rainfall and conceptions in either context. In contrast, exposures to higher-than-usual temperatures and hot days are associated with a lower probability of conception in rural Tajikistan. This finding persists when examining all conceptions and only those resulting in a live birth. Further, the results do not vary by women’s educational attainment nor by being childless or not. As such, we do not find evidence that specific groups of women are more vulnerable to climate variability beyond those living in rural (versus urban) areas. Given the broad impact of heat on conceptions in rural Tajikistan, differences in how individuals engage with the urban and rural environments may be important in the short-term relationship between climate and conceptions.