Dr Georgina Leslie, Clinical Lead at Bloomful
06 Feb 2023
The road to pregnancy can be a journey. With multiple factors influencing the moment of conception, it can be difficult to know where to start. Here are nine things to know as you prepare yourself for pregnancy. If you have PCOS or suspect you may have it, make sure you read our in-depth guide on PCOS and fertility.
1. Check your gynae health
Maybe you’ve never had an issue with your periods or maybe you have a condition such as PCOS. Whatever your situation, checking your gynae health can save you time further down the line by addressing issues early on.
Do that smear test you’ve been hiding the reminder letters for.
Get that strange discharge checked out.
If you have a diagnosed gynaecological condition, make an appointment with your GP to make sure everything is OK. Also ask for personalised fertility advice and check when you should return if you’re struggling to conceive.
If you have a menstrual cycle that’s irregular (varying by more than 7 days each cycle), periods that come less often than every 35 days or bleeds that last longer than 7 days, then get this investigated as it’s important to rule out conditions that can affect fertility.
2. Track your cycle
Unless you’re one of those lucky couples who has sex 2-3 times a week, you’ll want to work out the best time to optimise your chances of conception.
Keeping a record in a diary or app of when your period starts, how long you bleed for and how regularly your period comes will help you determine roughly when you should be ovulating (and therefore having sex).
Usually, if you have a regular monthly cycle that lasts 28 days, ovulation will occur 14 days before your period starts. We generally advise having unprotected sex every 2 days from day 10 to day 16 of your cycle, to cover that ovulation window. Statistically, 24 hours before you ovulate is the best time to have sex for conception (once an egg has been released from an ovary, it can survive for 12-24 hours, while sperm can last up to five days). If you’re trying to work out your cycle length, take the first day of your period (day 1 of your cycle) and count up until the day before your next period starts (the last day of your cycle). This number is your cycle length and it may vary slightly from one month to the next.
Additional ovulation signs can be helpful to track such as measuring your basal body temperature or checking for egg white discharge (a fluid that has an egg white tint to it). Some people prefer to use ovulation sticks. These check your urine for LH surge (luteinising hormone surges 24-48 hours prior to ovulation) and will indicate the peak time to have sex. For best results, use it during your first pee of the day.
3. Take your vitamins
Pre-pregnancy vitamins are a must if you’re trying to conceive.
Doctors recommend taking a 400mcg supplement of folic acid. It’s important to start this before trying to conceive as a folate deficiency is linked to spine and brain defects in babies. If you have diabetes, are on anti-epilepsy or anti-retroviral treatment, or have neural tube conditions in the family, then you may need to take a higher dose. Folate is also found in green leafy vegetables.
Lack of sun in the winter months can lead to vitamin D deficiency, which can affect our bone and muscle health and that of developing babies. The recommended dose is 10mcg per day. Red meat, eggs and oily fish are good natural sources of vitamin D.
There are other vitamins that are marketed as helpful for fertility and conception and it can be easy to fall down a rabbit hole of expensive supplements. The ones fertility specialists recommend include omega-3, vitamin C and co-enzyme Q10 (especially in women over 37).
Remember - there is no replacement for a healthy balanced diet!
4. Avoid cigarettes and alcohol
Not only does smoking mess with long-term health, but it’s proven to reduce fertility in both women and men. It can also affect a baby during pregnancy. If either partner smokes, your chance of getting pregnant decreases by 50% (1). Smoking can also affect a baby during pregnancy. The good news is you can increase your fertility by quitting before trying to conceive (meaning past smoking won’t affect your chances).
The jury is out on alcohol, but most fertility specialists will recommend cutting down. Excessive alcohol consumption in both men and women has been shown to be detrimental to fertility and the same goes for recreational drug use.
5. Nourish yourself
While a fertility-friendly diet won’t unblock your fallopian tubes (if that’s the issue) having a well-balanced diet will allow your body’s systems to function well, which will have a knock-on effect and help increase your fertility.
Avoid: junk foods, high sugar and processed foods.
Lean into: complex carbs, fruits, veggies, legumes, omega-3 and ‘good’ fats (eg olive oil, nuts, seeds, and fish).
If you’re struggling to conceive and have a high BMI, this will be the first thing your doctor or fertility specialist recommends addressing.
6. Exercise (but don’t overdo it)
We all know regular exercise is important for the body and the mind. Our advice is to keep going with your normal exercise regimen but avoid impact sports.
Women have run marathons while pregnant, but when you’re trying to conceive, it’s best to put off training for a big event. This is because high levels of stress (including prolonged exercise-induced stress on the body) can affect your hormones and lead to irregular periods.
7. Get intimate
There’s nothing like marking ‘must have sex today’ in the calendar to kill the romance. Instead, try scheduling a date night or a cosy night in to connect with your partner. Many couples find trying to conceive stressful and isolating. Getting closer to your partner can help you both ride through this period.
While we’re on the subject of sex, it’s a myth that you need to lie with your legs in the air after ejaculation (sperm can be found in the cervical canal seconds after ejaculation, regardless of coital position). It’s also untrue that your partner should abstain from ejaculation to ‘store up’ the sperm. Sperm should be ‘flushed’ out at least every 5 days for better quality sperm to be present in semen. Finally, some vaginal lubricants may decrease fertility so use a fertility-friendly lube if needed.
8. Keep calm and carry on
After months of trying to conceive, some people experience stress, anxiety and even depression. Your mental health is important during this time, especially because, once you’re pregnant, hormonal changes can exacerbate issues.
Whether it’s talking to a friend who had a similar experience, relaxation and breathing techniques, self-care, exercise or finding a supportive community, make your mental health a priority. If you’ve used a therapist in the past or have been putting off seeing one, now is the time to connect and have that extra support. If you’re taking medication for your mental health, make sure you review any changes with your doctor.
9. It takes two
Male fertility issues are present in 50% of cases where couples are struggling to conceive (2). Has your partner had an injury, infection or surgery to his testicles or inguinal region? If so, highlight this to your GP. Cutting out smoking and alcohol are proven to help sperm quality and the same goes for a healthy diet and exercise.
If you’ve been unable to get to the bottom of a gynaecological symptom or you have a known condition, speak to a doctor about how this could impact your fertility and what you can do to address it (read our guide on how to approach these conversations with your GP).
Work out when your menstrual cycle starts and begins so that you can make the most of your fertile window.
If you’re trying to conceive with a male partner, make sure they take measures to improve their fertility too.
(1). How smoking affects female and male fertility. (Published: 2018)
(2). A unique view on male infertility around the globe. (Published: 2015. Authors: Ashok Agarwal, Aditi Mulgund, Alaa Hamada, Michelle Renee Chyatte).
Knowledge is power
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