Getting Pregnant
Guide

• 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.

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.

• 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.

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.