So, you and your partner have decided to take the plunge and start trying for a baby soon? Congratulations! This is an exciting time of your life, but also one that can involve quite a bit of planning as well as waiting. Not only can taking a "proactive" approach to trying to conceive make you feel more in control, it can also increase your chances of getting pregnant sooner and having a healthy pregnancy.
While getting pregnant is something that just happens for some people, this isn't true for everyone by any stretch of the imagination, so we'll also look at signs it's time to see your doctor about fertility struggles.
Here's an overview of everything you may be curious about if you're planning to start trying for a baby. Ready? Here goes!
Health and lifestyle changes you should make before you try to get pregnant
About half all all wanted pregnancies in the US were planned pregnancies, and planning a pregnancy does offer you some advantages over being surprised — you can take care of your preconception health to maximize your chances of a healthy pregnancy, as well as get mentally ready to be expecting a baby.
The preconception checkup
Did you know that even the CDC recommends a preconception checkup with your doctor? Before you and your partner try to get pregnant, it's ideal to talk the following issues through with your healthcare provider:
- Do you have any medical issues that could affect the outcome of a pregnancy? If so, they need to be managed as well as possible before you try to conceive. This could refer to conditions you already know you have, like hypothyroid, diabetes, hypertension, and so on, but also ask your doctor to conduct testing for sexually transmitted diseases.
- Are you currently relying on prescription or over the counter medications of any kind? If so, take the opportunity to ask your doctor if they are compatible with pregnancy or need to be switched up.
- Are you up to date on your vaccines? Women who are trying to conceive need an annual flu shot, but may also require several booster vaccines. These will protect not just you, but will also your baby when once are born but still too young to have received a full dose of all vaccines.
Put the bad stuff away — stop smoking and drinking
Smoking and drinking alcohol can't just affect your own health in a bad way, they're also — of course — bad for a fetus. When you're trying to conceive, treat your body as though it could be pregnant at any time. We know that smoking, drinking, and of course also illegal street drugs, can be harmful. If you and your partner smoke, now is the time to quit. While it's, perhaps unfairly, OK for dads to consume some alcohol while trying to conceive, binge drinking in the early stages of pregnancy is associated with birth defects such as cleft lips and palates, and any woman who is trying to get pregnant is ultimately taking the safest course of action by abstaining from alcohol altogether.
Start with folic acid supplements
Taking 400 mg of folic acid, a B vitamin and the synthetic version of the naturally-occuring folate, a day helps prevent neural tube defects such as spina bifida during early pregnancy. Women who are hoping to have a baby should ideally start taking folic acid a month before they being trying to conceive to "get their stores up".
Eat well and aim for a healthy weight
Being at a healthy weight — neither overweight or obese, nor underweight — helps promote a healthy pregnancy. Eating a healthy and balanced diet that contains plenty of whole grains, fruits, and vegetables while shunning the processed junk foods we all know don't offer optimal nutritional benefits goes a long way toward maintaining a healthy weight, but it also means offering yourself and your baby the best chance at health. Regular exercise should always be part of a healthy lifestyle, as well.
What you need to know about your fertile window when trying to conceive
By now, most of us will have internalized certain commonly-accepted views regarding the so-called fertile window, the period of time during which it is possible to conceive:
- While men can produce what amounts to almost literally countless sperm cells throughout the month, women typically only release one mature egg from one of their ovaries during each menstrual cycle, during the process known as ovulation. Sperm cells need to be present when the egg is, or you won't be able to get pregnant.
- Sperm can live in the female reproductive tract for around five days, so having intercourse in the days before ovulation may give you a very good shot at conceiving that cycle. However, the fertile window closes as soon as 12 to 24 hours after ovulation, because the egg is no longer there. You have about six days of the month during which you may be able to conceive.
- Couples who know when the female partner ovulates are more likely to be able to get pregnant faster, because they are hitting that "fertile window".
- What's more, it's commonly accepted that the fertile window tends to take place around cycle days 10 through 17.
Are those ingrained ideas all facts? One piece of research regarding the fertile window actually showed that only 30 percent — slightly less than a third — of women had fertile windows that fell within the clinical guidelines, that is, between days 10 and 17. On cycle days six through 21, meanwhile, women had a 10 percent chance of being fertile on any given day. What's more, up to six percent of women were sometimes fertile during the fifth weeks of their cycles, meaning they ovulated very late.
The "old" view — that you can only get pregnant a few days of the month — is still true. It's just that you don't necessarily know which days they are.
Should you try to find out when you ovulate?
What can you do with this information? Two things, really — have intercourse every other day regardless of whether you may be ovulating, and you'll be almost guaranteed to hit that fertile window. Or rely on one or more methods to find out when the female partner is ovulating.
Research found that:
- So-called "ovulation tests", which detect a surge in luteinizing hormone associated with ovulation, are indeed effective at identifying the start of the luteal phase of the menstrual cycle, as opposed to ovulation itself. Ovulation tests do not take those crucial five or so days before ovulation during which you can also get pregnant into account, however, potentially causing couples to miss chances to conceive.
- "Natural family planning" methods do assist couples as they try to figure out when they're most likely to be fertile. Looking at your cervical mucus, by inserting a few fingers into the vagina and then removing them, is one such method. The kind of cervical mucus associated with the fertile window is clear, stretchy, transparent, and a bit watery, as opposed to the whiter, thicker, "hostile" mucus that comes during the luteal phase. Examining your cervical mucus is a low-tech, easy, way to help determine fertile days.
- Some women also track their basal body temperature when trying to conceive, the idea being that hormones slightly affect your temperature. During the first portion of your cycle, your "BBT" will be around 98.6 °F, dropping by 0.36 to 0.54 °F as you ovulate (because of luteinizing hormone), and then rising again as you enter your non-fertile window, to around 98.6 °F. Doing this does give you a statistically significant chance of correctly identifying ovulation, but it's also a lot of work.
- Research also, interestingly, indicates that women tend to feel more "frisky" around the time of ovulation — your body may do all the hard work for you even if you don't rely on natural family planning or ovulation tests!
The bottom line, here, is something like this. If you don't have intercourse all that much just because you want to, trying to determine when you ovulate may help you out on the path to getting pregnant. If you regularly get intimate, and especially if you stick to that doctor-recommended "once every other day" guideline, you may gain nothing by trying to determine when you ovulate. Relying on ovulation tests to tell you when you are fertile may make you miss out on those crucial days before ovulation which are also counted as part of the fertile window, so do not wait until you get that "smiley face" back on a kit!
How long does it usually take to get pregnant?
The majority of couples who are trying to conceive — having sex regularly, meaning every two to three days, and not using any form of birth control — will get pregnant within 12 months. This does depend on the age of both partners, though the effect age has on female fertility is much more studied and clear than the effect of the male partner's age. We know, for instance:
- That 92 percent of couples between the ages of 19 and 26 will get pregnant within a year, while 82 percent of those aged 35 to 39 will. Even more couples will be pregnant within two years of beginning to try.
- That women in their twenties and early thirties have a very respectable 25 to 30 percent chance of conceiving every single cycle, while these odds decline to less than 10 percent when a woman reaches 40.
The actual probability of getting pregnant each cycle involves complex mathematics. One study compared it to rolling dice until you get a six; not having thrown any sixes recently doesn't mean you will now definitely get one on the next go, but neither does a first throw mean you have less of a chance.
When to see your doctor about possible infertility
The American College of Gynecologists and Obstetricians recommends that you consult a doctor for an infertility evaluation if:
- You're under 35 and not pregnant after a year of trying — meaning regular intercourse without contraceptives.
- You're over 35 and not pregnant after six months of trying to conceive.
- You have an irregular menstrual cycle.
- Either partner has an already known cause of infertility, whether or not you've been trying to conceive.
These guidelines encourage you to seek medical attention a bit earlier than some would; you may also have heard to see a doctor if you haven't conceived after two years under the age of 35 or one year after that age.
Causes of infertility
Male infertility causes (which research suggests are solely behind a couple's inability to get pregnant in around 30 percent of cases) include:
- Abnormal sperm production — this can be caused by many things, from infections to chronic health conditions and physical problems in the testicles, such as undescended testicles or a varicocele (an enlarged vein in the testicles). Some men have lower sperm counts because of these issues, while up to 15 percent of infertile men do not make any sperm at all.
- Abnormal sperm delivery — the man makes sperm, but it can't get to its destination. This can be caused by physical abnormalities as a result of injury or illness. Erectile dysfunction can also fall into this category.
- Poor sperm health as a result of factors such as the use of alcohol, drugs, and prescription medications.
Female infertility, which is likewise responsible for around 30 percent of cases of infertility, can be caused by numerous things:
- Not ovulating is the most common cause of female infertility, and this can in turn be due to many things, including polycystic ovary syndrome, primary ovarian insufficiency, hormonal imbalances, and age.
- Abnormalities within the cervix or uterus — such as fibroids or uterine malformations — may mean that while you ovulate and eggs can be fertilized, it becomes impossible for a fertilized egg to implant.
- Menstrual cycle irregularities can interfere with fertility.
- Endometriosis, a condition in which tissues very much like those that line the uterus grow outside of it too, can cause infertility.
- Blocked fallopian tubes, which mean eggs cannot find their way to the uterus from the ovaries, can also be caused by sexually and non-sexually transmitted diseases.
- Autoimmune conditions such as lupus and certain kinds of thyroid diseases can again interfere with the ability to get pregnant.
A combination of male and female infertility is also possible, of course, and this accounts for a further third of cases of infertility.
To figure the cause of your fertility struggles out, your doctor may suggest a myriad of tests, ranging from a physical examination and imaging tests to sperm count, tests for progesterone, prolactin, ovarian reserves, and thyroid function.
Once tests have been conducted to find out why you and your partner aren't getting pregnant, you and your medical team can work together to decide how to move forward. This may include assisted reproductive techniques and other fertility treatments, such as:
- Surgery to correct or alleviate underlying problems such as blocked tubes, a varicocele, or endometriosis lesions. The success rates of such surgeries depend on the individual operation being carried out, something you'll want to discuss with your doctor.
- Medications to induce ovulation in women who aren't ovulating — these include Clomid and letrozole.
- Intrauterine insemination, an assisted reproductive technique in which sperm is placed directly into the uterus (mostly in combination with drugs to induce ovulation). IUI works best for couples in which the male partner has a low sperm count or produces sperm but cannot ejaculate it, or in which the female partner has cervical scarring. Where necessary, a sperm donor can also be considered.
- Invitro fertilization (IVF) is a more complex medical procedure during which sperm and egg cells are collected and embryos are then incubated in a lab setting and placed back into the uterus at a certain stage of development. It requires a regime of medications to stimulate the production of multiple eggs at once, and is invasive as well as expensive. IVF offers many couples the chance to become parents, however.
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We hope this overview of the basics of trying to conceive was useful to you, but there is, of course, much more to explore. If you're interested in finding out more about any of the aspects of trying to get pregnant in more depth, SteadyHealth contains a wealth of articles about just about everything you want to know.