You and your partner have decided to become pregnant, or maybe you are going at it alone (kudos to you!). Where do you begin? I have summarized 10 steps to help you get pregnant below. I believe that it is important to be adequately prepared to optimize your fertility before you begin trying to increase your chances of getting pregnant.
It’s best to start trying to conceive by following these steps rather than discovering this information after a few months of difficulty getting pregnant. And don’t worry, I will delve into each of these steps in much greater detail in future posts.
Step 1: Deciding to become pregnant.
This decision alone is not easy to make, so congratulate yourself on taking the leap. But now what?
Step 2: Define your plan and goals with the shareholders.
Just like a business venture you want to know what you are getting into. What are your goals? What are your parenting roles? Make sure you are ready to become parents.
Look at your financials–babies are expensive. Babysit a relative or friend’s baby so there are no unexpected surprises. Think about who will care for your future child. Are you going back to work and considering childcare or do you plan to stay home? Inquire into your options for maternity and/ or paternity leave.
Having these conversations from the start is important in easing the stress of pregnancy and not rushing into a pregnancy you and/or your partner are not prepared for. For more information about deciding if you are ready to have a baby, read my post Are We Ready to Have a Baby?
Step 3: Consider your recent travel.
Although media attention has been diverted from Zika, the CDC still considers it a risk to the fetus. The CDC recommends waiting to become pregnant for 6 months after returning from a Zika affected country.
Step 4: Stop your Contraception.
As you probably know, the first step is getting off birth control. You definitely want to get off the pill (or other method) atleast 3 months before TTC, but I recommend stopping your birth control as soon as possible!
Different types of birth control can linger for varying amounts of time. Women who have used Depo-Provera can take up to a year for normal fertility to return and other forms of contraception can take 3-6 months. This means if you discontinued Depo-Provera and started trying to get pregnant right away, you could be considered “infertile” when really the progesterone hormone left over from the Depo-Provera was actually preventing you from becoming pregnant. Therefore knowing when to stop contraception is important in your quest to conceive. To find out more check out my article: When is it time to Quit?
Step 5: Getting to your ideal body weight.
I am not referring to your bikini body, but carrying extra body fat can actually affect your fertility. Research has shown that obese women experience higher rates of infertility and higher rates of miscarriage. Although I hate to use BMI as a metric- you can use BMI as a loose guideline. Your goal BMI is 18.5 to 25. Women with a BMI >27 have been found to have more difficulty becoming pregnant. BMI can be calculated using the formula:
Additionally, women with a low BMI also experience subfertility. If your BMI is below 17 this could make it very difficult for you to become pregnant. Some women are concerned that when they become pregnant they will gain weight, so they hit the gym while trying to become pregnant. Research shows that frequent, strenuous exercise in normal and underweight women has a negative impact on ability to conceive. Therefore, I encourage exercise, but don’t overdo it. I will expand upon body weight and fertility in future posts, but for now just focus on a healthy lifestyle.
Step 6: Setup-up a preconception visit with your provider.
This can be with your primary care doctor, your nurse practitioner, gynecologist, obstetrician or midwife. Don’t worry if you haven’t decided yet who you want to see for your entire pregnancy. The person you see for your preconception visit doesn’t have be the same person you go to for your pregnancy.
The preconception visit is an opportunity to review your medical history, review safety of medications, do baseline blood work, address any medical conditions, consider genetic carrier testing and obtain any recommended vaccinations. And as an added benefit- if you have a provider in mind for your pregnancy, this visit can also be a way to test out the practice.
Step 7: Start a prenatal vitamin.
You can take a prescription prenatal vitamin or purchase one over the counter from any local pharmacy or online. To find out more about choosing between prescription and over the counter, checkout my article Prescription vs Over the Counter Prenatal Vitamins. I’ve also published a guide to help you choose which prenatal vitamin to take. It is important to know what to look for when selecting your prenatal vitamin!
Step 8: Consider toxins in your beauty products, environment and household items.
Quit smoking; this should probably be step 1, but if you told me you smoked I would have told you to quit 10 years ago. Smoking is associated with many adverse fetal and maternal outcomes including preterm birth and miscarriage among many others.
Even if you don’t smoke, there are many other toxins in our environment. The information out there on toxins in beauty and household products is overwhelming. That is why I have sorted through it all, tested products, and came up with a list of products I personally use and recommend to patients. I will share this list and my personal reviews in subsequent posts.
Step 9: Begin charting your fertility.
I am talking about basal body temperature and cervical fluid consistency. This makes up the fertility awareness method (FAM). It is amazing the misconceptions about ovulation and our bodies.
Once you begin to understand how to chart when you ovulate, you can time your baby-making when there is an egg to fertilize. Fertility charting is empowering and can help you feel in control. This method helps you identify when you are fertile and when you are ovulating. To find out more about fertility charting, check out my article How to Start Fertility Charting
Step 10: Start trying to get pregnant.
This is the most exciting part and should not be stressful. By following all the steps above you will begin trying with the optimal probability of becoming pregnant and staying pregnant. Once you begin trying to become pregnant, check out my article “10 Early Signs of Pregnancy“.
Source: Hornstein, M. D., Gibbons, W. E., Barbieri, R. L., & Barss, B. A. (2010). Optimizing natural fertility in couples planning pregnancy. Up To Date. Rose, BD (Ed), Up To Date, Waltham, MA. link