So you’ve decided it is time to start or grow your family. It may seem odd to need a “how to” when we all learned at a very young age how babies are made! What they didn’t tell us back then is that it can be harder than you think to become pregnant. While some women will conceive very easily, others of us will take longer and could use a little (or a lot of) help. If you are in this group, or are not sure yet but want to expedite the process, there are some things that you can do to take the guesswork out of getting pregnant. Yes, women have been getting pregnant for ages, but now we have the knowledge to make the process healthier and more efficient. We’ll start with the basics.
Quit the Contraceptives
You have probably spent most of your adult sexually active life actively trying NOT to get pregnant. Now that you are trying, the first thing you will do is stop whatever method of birth control you are using.
If you have an implanted device like an IUD, you will need to have it removed by a physician. Normal ovulation can return as soon as it is removed, and assuming no other fertility issues, you could conceive immediately. The same is true with oral contraceptives. You can resume normal ovulation the first month after going off the pill. Some women will take longer, but it is a myth that it takes a certain amount of time….everyone is different.
If you have been tracking your ovulation as a means of birth control, you are well on your way. Just use the information to know when to have sex, instead of when NOT to!
Understand Your Cycle
You are not alone if you are an adult woman who has no idea when you are ovulating (or whether you do at all or even what that means!). If you have been on the pill, which regulates your cycle to the normal number of 28 days, you may have rarely paid attention to the calendar. Moreover, you do not know how your body will regulate itself once it is on its own. There are a few methods to become in tune with what your body is doing and when.
Ovulation is the releasing of an egg from the ovary. One egg is released each month in an attempt to meet with sperm and be fertilized. If this occurs, the fertilized egg will travel to the uterus where it will implant in the uterine wall and early pregnancy begins. If fertilization does not occur, the egg will join the shedded uterine lining in the menstrual period.
Do the Math
A normal menstrual cycle is 28 days. If you mark the first day of your period as day one, ovulation will typically occur on day 14. Your most fertile days are days 12-16 of the cycle, so a couple of days before and after ovulation. Sperm can live in the female body for 48 hours so having sex before ovulation occurs is a good way to maximize this fertile time.
Ovulation Predictor Kits
Ovulation predictor kits (OPK’s) offer another way to determine when you are able to conceive. OPK’s work by detecting hormone levels in the urine and are at-home friendly. The most common hormone to test for is the luteinizing hormone (LH). LH is always present in your urine but surges 24-28 hours before ovulation. This is the optimal time to have sex since the sperm will stick around through ovulation.
Fertility Monitors are used to track fertility throughout the month by testing urine for LH. Some monitors are also able to test estrogen levels. It is recommended that you test your urine every day for a month to get a clear picture of a complete cycle. This will help you determine when you are ovulating and conception odds are high!
There are fertility monitors on the market that claim they can test fertility using saliva, but these are generally not recommended by medical professionals.
Cervical Mucus (CM) is secreted from the cervix when stimulated by estrogen. Tracking the consistency of the CM can help you identify when ovulation occurs. In the beginning of your cycle as you approach ovulation, estrogen levels rise and the cervix responds to the call to duty by secreting more CM. The CM protects and nourishes the sperm as it makes its way to the egg. At this point, the CM has what is described as an “egg white quality”. It is clear and viscous.
The best way to track the changes in CM is to evaluate a sample daily and get to know what you are dealing with. With clean, dry hands, insert a finger into your vagina and remove, taking with it some CM. Feel the consistency by rolling between thumb and forefinger and pulling them apart to see the viscosity. Throughout your cycle you should be able to tell the difference between samples. Here is what you are likely to find:
- After Menstrual Period: Directly after your period you will find the least CM. Many women experience vaginal dryness at this time. During this time, it will gradually be building back up, and it will go from dry to a thick, often yellow or white and cloudy, consistency. Biologically, its work is done for now. It is not needed to move sperm to the egg so it is in its rebuilding phase.
- Approaching Ovulation: The CM will increase in moisture and volume.
- Ovulation: At this time, the CM will reach its highest volume and most fertile-quality state. This is the egg-white phase. It will be very moist and a clear, stretchy consistency. When you detect this, you know it is the right time to try to conceive.
- After Ovulation: The volume once again decreases and the CM becomes thicker as your period approaches.
Becoming familiar with your cycle of cervical mucus production is a great way to understand your ovulation cycle and fertility chances. If you have trouble detecting any changes in the CM, you should talk to your doctor.
Basal Body Temperature
Another way to track your ovulation cycle is your Basal Body Temperature (BBT). This is the lowest temperature attained by your body during rest. It is most accurately taken at the moment of waking from a night’s sleep, before even sitting up or talking.
BBT charting is a commonly used method of tracking fertility metrics and ovulation, as the pre-ovulation BBT is typically one half to one degree lower than during or post-ovulation. Your most fertile days are the 2-3 days before your temperature goes up. Tracking for a least a full menstrual cycle will give you the best data about when or if ovulation occurs. A basal body thermometer can be used to determine the BBT, but a standard thermometer, as long as it gives you a reading to at least 1/10th degree, is acceptable.
BBT charting is a much more accurate way to determine whether you are ovulating normally than simply looking at the menstrual cycle. Plenty of women with regular periods do not ovulate correctly or at all, and normal ovulation can occur with an irregular cycle. BBT tracking is one of the more accurate methods there is to predict ovulation.
Get Your Body Ready
One of the best things you can do to help your body along in the quest to pregnancy is to get healthy. This means putting the right things into your body, taking the wrong things out, and getting yourself in the best shape you can for the major physical undertaking that is pregnancy and childbirth.
Maintain a Healthy Weight
This is the most important thing you can do to help your chances of conception. Being over or underweight will greatly affect your fertility. Both conditions are linked to anovulation, or the absence of ovulation. The ovaries and fat cells regulate estrogen, and too many or too few of these cells will affect the hormone levels in your body. The Body Mass Index (BMI) is a calculation based on weight and height. “Normal weight” is generally defined as a BMI of 19-24. 25-29 is considered overweight, and 30+ is obese. Fertility chances are greatly improved by being in the normal range of 19-24. Having a BMI under 19 can actually affect your fertility more that being slightly overweight. If you are trying to conceive, check out your BMI. There are many online calculators, but a visit to your doctor to discuss your weight and possible nutrition plans is the best option.
Eat the Right Things
A healthy diet full of fruits, vegetables, and whole grains is important for all people. This is especially true for you as you are starting to try to conceive. You are probably aware of the ways your diet needs to change once you are pregnant. But did you know that improving your diet while trying to conceive (and even before then!) will greatly improve your chances? Here are a few of the things to make a part of your diet to get your body prepared for pregnancy:
- Whole Grains – Slowly digested carbohydrates that are rich in fiber help fertility by controlling blood sugar and insulin levels in your body. They are also a good source of Vitamin B & E. Replace your white rice and white bread with brown rice and whole grain bread.
- Plant Protein – Protein from beans, peas, nuts, soy and tofu are shown to improve fertility. Try replacing a serving a day of red meat or poultry with these zinc & iron-rich plant protein sources.
- Full-Fat Dairy – Whole milk is an excellent source of protein and calcium and is shown to have positive effects on fertility, whereas skim or low fat milk can have the opposite effect. Now is not the time to cut calories on your dairy products! Drink a glass of whole milk a day, or have a bowl of ice cream or full-fat yogurt.
- Fresh Fruit & Vegetables – There are endless benefits to a diet full of fruits and vegetables when it comes to promoting general and reproductive health. A big one is the abundance of antioxidants. These are a family of vitamins & minerals that act as the body’s natural cleansing and defense mechanism. Fruits and veggies are also excellent sources of Vitamins A, B, C & E, all of which are needed for reproductive health.
- Good Fats – Monounsaturated, Polyunsaturated, and Omega-3 are all good fats that you want to start looking for and adding to your diet. They reduce inflammation and increase insulin sensitivity- both good for fertility. Once pregnant, Omega-3’s help with the baby’s brain and nervous system development and reduce the risk of premature birth. They are found naturally in avocados, nuts, pumpkin & other edible seeds, salmon, and sardines. You can also take fish oil supplements for Omega-3.
Don’t Eat the Wrong Things
- Trans Fats – These saturated fats are strongly linked to heart disease and poor metabolism. it was recently discovered that in addition to these known effects, they are especially bad for women trying to conceive. If you are trying or planning to try, these should be eliminated from your diet and replaced with healthier mono- or polyunsaturated fats.
- Caffeine – Research is divided on the issue of caffeine before and during pregnancy. Most sources say to limit caffeine intake to no more than two 5 oz servings a day, while some advocate eliminating it altogether. Some studies have linked high amounts of caffeine in the body to poor egg maturation. Once you are pregnant, caffeine you ingest can cross the placenta and affect the fetus. At the very least follow the advice to limit your intake, and starting before you are pregnant can only help the process.
- Alcohol – Everyone should know to avoid alcohol when you are pregnant, as there is no medically-recognized safe consumable level. Recent studies have shown that even light to moderate consumption while trying to conceive can have negative effects on fertility. Alcohol can affect your menstrual cycle and ovulatory function. Start preparing your body for a healthy pregnancy by eliminating or lowering your alcohol intake now.
- Some Herbal Teas & Supplements – While some botanicals offer health benefits to the body, there are some that should be avoided when trying to conceive or pregnant. These are licorice, sassafras, ginseng, and St. John’s Wort, to name a few. Ask your doctor about the inclusion on herbal supplements in your diet.
Here are some more fertility food facts…
Folate is one of the B vitamins and helps the body make new cells. It is needed by all people, but is especially crucial for a woman who is trying to conceive or is pregnant. Women who are able to get pregnant should get 400-800 mcg/day. This is the same amount recommended for women throughout pregnancy. The reason to start this dosage before you have confirmed that you are pregnant, is that the earliest days after conception are critical and folic acid is required for normal cell development. The neural tube – from which the baby’s brain and spinal cord will develop – begins to form about 3 weeks after conception. Most women do not know they are pregnant this early. The presence of folic acid at this point in the pregnancy can prevent serious birth defects of the brain and spinal cord.
Folic acid is found in leafy, dark greens such as spinach and kale, lentils, and citrus fruits and juices. However, the body actually absorbs synthetic folic acid better than the natural kind, so it is recommended that you supplement your diet. Many breakfast cereals are supplemented with folic acid, some with the full 400 mcg. It is also recommended that you take a multivitamin containing at least 400 mcg of folic acid all the time, whether you are trying to get pregnant or not. Once you are pregnant, the requirement to mantain throughout your pregnancy is 600-800 mcg.
This is an often overlooked essential nutrient that your body can only synthesize in small amounts. Research shows that it, like folic acid, is associated with a lower risk of neural tube defects. It is also the precursor to the neurotransmitter responsible for muscle control and memory. Adding choline to your pre-pregnancy and pregnancy diet make have long-term benefits to both you and your child.
Daily recommendation for choline intake during pregnancy is 450 mg, increasing to 550 mg when breastfeeding. The highest amount of choline is found in beef and chicken livers, followed by wheat germ and then eggs (yolk). None of these offer the full required amount, and should be supplemented with a vitamin. Be aware though… not all prenatal vitamins contain choline. Make sure you find one that does.
Yet another reason to drink plenty of water! Staying hydrated is important for general health and all people are encouraged to drink water throughout the day. There are benefits to fertility too! Drinking water increases and improves the quality of cervical mucus. This will help to facilitate better sperm movement when you are trying to get pregnant. Your follicles will be plump and healthy, and your body will be overall cleaner and more free of toxins. If you are like many and have trouble drinking plain water all day, add some lemon or lime. It tastes great and has the added benefit of vitamin C and other helpful antioxidants!
So what have we learned? When you maintain a healthy weight and make smart food choices you will be healthier, and will get the nutrients and lifestyle choices you need to keep your body, and your reproductive system, functioning properly.
After you’ve done everything you can to prepare your body and improve your fertility, now comes the fun part. You have to have sex.
DO have sex 3-5 days before ovulation. Sperm can live in the body for up to 48 hours, so you can maximize your chances of conception by covering the whole window of fertility each month.DO NOT use lubricants or chemical stimuli. Some contain spermacides which is a definite no no. Even some non-spermacide, water-based lubricants can negatively affect the sperm’s motility to the egg. Your natural lubricant is best, but if you need to use something to assist in intercourse, use a fertility-friendly lubricant such as Pre-Seed. This product has been found to best mimic your own cervical mucus to facilitate proper sperm motility.
DO enjoy yourself! Having sex with your partner on a schedule with your eye on the baby prize can be a stressful, and less than romantic, endeavor. Don’t let all of the pressure of trying to conceive get in the way of enjoying the process. Stress is harmful to your health and well-being. Relax and have fun!
Know When to Seek Help
All of the things we’ve talked about here will prepare you for getting pregnant and help your chances. However, some of us will need a little more help. Actually, a lot of us will!
Assuming you are doing everything right and your partner’s sperm is in tip top shape as well, you have about a 15-25% chance of getting pregnant in each ovulatory cycle. About 40% of couples will conceive within 3 months of focused, active trying, and 70% will conceive in 6 months.
And if you don’t fit into these categories? You are not alone. An estimated 15% of women, or 1 in 8 couples, experience some form of infertility.
Infertility is defined as the inability to conceive a child after one year of frequent, unprotected sex. If you are over 35, the time is reduced to 6 months. This is the time at which you and your partner should seek the help of a fertility specialist called a Reproductive Endocrinologist, or RE for short. Your OB/GYN may have to refer you so start there first.
They will asses your reproductive health, and that of your partner, and work out the best treatment plan for you. It may consist of vitamins, hormone supplements, or more in-depth testing and procedures to diagnose and fix a problem. In more complicated cases (about 3%), there are assisted reproductive technologies (ART), like intrauterine insemination (IUI) or in vitro fertilization (IVF).
But you are not there yet so don’t panic! Start by following the tips we’ve talked about to maximize your chances of getting pregnant. And know that there many options and so much help and support for you out there.