The Getting Pregnant Guide
Whether you’re actively trying or planning for the future, we’re here to help and guide you at every step. Our team are women’s health experts and will optimise your chances of conceiving. Below are some tips for preparing for pregnancy, help to find the optimal days to try, and a rundown of fertility tests to give you information and support on your journey.
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Getting Prepared: Pre-Pregnancy Checklist
Pregnancy is a very exciting and physically demanding time. In the time leading up to it, it’s important to prepare so you give yourself the best chance of conceiving and that you feel healthy and ready. Improving your nutrition and lifestyle will take time as you form new habits: stick with it!
Your Pre-Pregnancy Prep:
- Have a chat with your GP: Meet with your GP to discuss your plans and get some pre-conception advice. They can review any medications you are taking as some are not safe to take during pregnancy. They can evaluate any medical issues you have that might affect conception and pregnancy.
- Start taking pregnancy-focused vitamins: Look for a formulation with at least 400 micrograms of folic acid, and this should be taken daily for a minimum of three months before conception. Key developments occur for your baby in the first few weeks of pregnancy so these nutrients need to be available in the body. Depending on your doctor’s advice, you might also want to supplement with CoQ10, vitamin D, omega-3 fatty acids, and iron.
- Track your Cycle: Understanding your menstrual cycle is hugely important. Track your cycles and look at them over time. Do you always get periods? Are they predictable? Have they changed in the last six months and created a shorter or longer pattern? Do you have any irregular bleeding? If you notice any of these changes, it’s best to discuss them with your doctor.
- Stop Your Birth Control: This may seem a strange instruction if you’re not quite ready to become pregnant yet, but if you are using hormonal birth control (like the pill), it can take a while for your cycle to regulate. There is a chance you could conceive quickly after stopping, so if you are not ready to become pregnant, do use an alternative form of birth control in the meantime.
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- Nutrition: Review your diet and see if there are ways to add more nutrition. Use the Mediterranean diet as a guide and base your diet on whole foods. Include lean proteins, oily fish, plant foods, healthy fats, and lots of fruit and vegetables. Replacing processed foods with home-cooked alternatives will be very beneficial.
- Limit Caffeine: While you don’t have to give it up completely, try to limit your caffeine intake to 200mg per day as that is associated with better fertility outcomes. Be aware that it’s not only tea and coffee that have caffeine; other drinks such as soft drinks, energy drinks, herbal teas, matcha have caffeine, and even some foods such as chocolate and protein bars have much more than you’d expect. Caffeine can have an impact on your reproductive hormones, so reducing and limiting it where possible is sensible.
- Quit Smoking and Vaping: It is important to quit smoking and vaping before you start trying for a pregnancy, as they have been shown to impact fertility and pregnancy rates negatively.
- Take Time To Prepare Mentally: If you don’t already have relaxing routines, start creating them. These can take the form of whatever works for you. Practice activities like medication, yoga, walking with friends, journaling, crafting, whatever will help you manage your stress.
- Exercise: It is important to be physically active, but you don’t need to overdo it. Moving your body will help with your energy levels, reduce stress, and keep you healthy.
- Rest well: Maximise rest and sleep in both quality and quantity. Waterstone Clinic offers free meditation programmes that can help you destress and sleep well.
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When Should We Try?
Timing is everything in fertility, and when you try is incredibly important. During a regular cycle, an egg is released from the ovary. It will then be available in the fallopian tube to be fertilised by sperm. The amount of time the egg is available is very short, but sperm can survive in the female body for up to 5 days, so ideally, it should be there waiting when the egg is released.
If you have a monthly cycle and are ovulating, then you ovulate 12 times a year: just 12 opportunities to get pregnant in a year. It is easy to miss these opportunities if you are unaware of when you ovulate or if you try at the wrong times. So when should you try?
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The Fertile Window: The Time To Try
Although it goes against what you might think, if you wait until you have ovulated to try, you’ll be past your fertile window and will have missed the opportunity. Once released from the ovary, an egg only survives in the body for about 12 hours, and after this, the possibility of conceiving in that cycle falls to zero. Trying in the days before ovulation is when you have the best chance to conceive.
The fertile window begins 4 days before ovulation, and ovulation occurs 14 days before your period is due. To find out your fertile window, subtract 18 days from your cycle length; this will give you the starting day, and subtracting 14 days from your cycle length will give you your Ovulation Day, the last day of your fertile window.
The fertile window will move if your cycle is shorter or longer – see the below examples.
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Having sex every second day within your fertile window will give you a good chance of success. If you’re unsure when you might be ovulating or want additional reassurance, ovulation predictor kits can be useful. Once the kit turns positive, intercourse on that day and the following day should give you the best chance.
How long does it take to get pregnant?
While everyone’s journey is individual, averages can sometimes help us understand what’s “normal” in fertility. For example, it is normal for it to take a year to become pregnant. The chance of a person falling pregnant in one month is between 15-25%. The younger you are, the higher the odds within that range.
If one hundred couples with normal fertility began trying for a baby, about 20% would be pregnant within the first month. Only half of the couples would be pregnant within 6 months of trying, and it would take a year for 90% of the couples to be pregnant. That is still normal fertility.
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When Should You See A Specialist?
- If you are under 35, then it is recommended you see a specialist after trying for one year.
- If you are over 35, you should see a specialist after trying for six months.
- If you are 40 or over, you should see a specialist when you start trying.
Of course, you can see a specialist at any point, even if you’re just curious about your fertility. Early assessment can reassure you and make you aware of any issues impacting your chance of conceiving earlier, so less intervention may be needed.
Remember that it is also completely normal to need some assistance. 1 in 6 couples struggle with fertility, meaning over 25 million people across Europe have fertility issues. Having fertility assessments does not mean you’ll need fertility treatment, and if you do, we will be here to support you.
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What Fertility Tests Do I Need?
It is very important to be tested as a couple to get a true picture of your fertility potential together. While it is a very pervasive myth that fertility issues are female issues, the reality is that as many fertility issues stem from men as they do from women.
For men, a semen analysis will check the different parameters of the sperm sample that can impact conception. The test will examine the number of sperm in the sample (this is the “sperm count”), if the sperm are moving normally in the sample (the “motility”) and if the sperm cells are correctly shaped (the “morphology”). The sperm sample needs to have enough sperm in the sample to travel to the egg; they must be able to swim towards the egg, and the cells must be the right shape to fertilise the egg.
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What is Ovarian Reserve?
If you are unsuccessfully trying during your most fertile periods, your period regularity and ovarian reserve are typically the first areas we will look into. Some women have irregular cycles and cannot predict when they will ovulate, making it very difficult to plan a pregnancy (although they often do fall pregnant spontaneously). Finding out the reasons for this, whether it is because you have many antral follicles and polycystic type ovaries or if it’s because of diminishing ovarian reserve, will help you understand what is happening and get the assistance you need to become pregnant.
For women, the initial tests are blood tests to explore fertility hormones and ovarian reserve and an ultrasound scan to examine the health of the ovaries, uterus, and pelvis. The fertility specialist may also suggest further testing to investigate whether the fallopian tubes are open.
Your ovarian reserve is the number of eggs housed in your ovaries. Women are born with all the eggs we will ever have, and they decline as we age. While your age can indicate an expected ovarian reserve, fertility is individual. Examining our reproductive hormones will give an insight into whether you have an average, higher or lower number of eggs than would be expected for your age.
The number of eggs we have drops dramatically from birth to our twenties and falls considerably after 35. By the time you reach 37, approximately 90% of your reserve is gone. The only way to determine your own personal ovarian reserve is to have an AMH test interpreted alongside an ultrasound scan.
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The AMH blood test checks the level of Anti-Mullerian Hormone, which is produced by the follicles in your ovaries that contain an immature egg. This level is a good indicator of how many eggs you have and whether there are any issues you need to be aware of that could impact your chances of conceiving, such as PCOS or premature ovarian failure. A fertility-focused ultrasound scan will interpret the results of the AMH test more closely, with an antral follicle count and assessment.
From here, the fertility specialist can advise you and help you plan for your fertility future.
A Note from the Team
Trying to conceive isn’t always as easy as we’d like it to be. Sometimes, it can take longer than we expect or require some planning and help. If you are thinking of or about embarking on your fertility journey, we wish you the most heartfelt luck. We hope you can approach your fertility journey without any apprehension, safe in the care of the experts.
We hope this guide has helped you understand the process in more detail. More information and guides to fertility are available on our podcast, and you can book a free introductory call with our advisors for more information on testing and treatment options.