So you’ve decided you want to try for a baby? Now what?
Here are 9 things to think about before you get pregnant.
We’re going to assume you have just started trying or are preparing to conceive. Despite many couples these days having troubles trying to conceive (1 in 6), there are also many couples (or singles) that don’t have these challenges. Regardless, there are several things you can do to not only help your chances of getting pregnant, but also to be in your best shape possible to maintain and enjoy a healthy pregnancy.
In later blogs, we will talk about more complicated issues around conception and how we can support this (endometriosis, PCOS, irregular cycles, amenorrhea, sperm issues, donor sperm or eggs, going it alone, IVF, home insemination….). There’s so much to talk about in terms of the different ways that people can become pregnant and obstacles they may need to overcome. But for now, let’s start with the basics, if you are a woman wanting to prepare your body for pregnancy, what are our top tips?
In a perfect world, you are allowing 3 months of preconception care, but it’s never too late to start! Here are 9 things we think you should know:
1. Get to know your menstrual cycle!
There are many ways to do this. The best place to start is using a fertility app to track your cycle.
We are looking to confirm the regularity of your cycle, details of the period bleed itself (colour, consistency level of flow) and any cyclical signs and symptoms. These may include irritability, breast distention or tenderness, bloating, bowel changes, mild (or severe!) cramping before or during your period. Part of our focus with fertility treatments is to regulate your cycle and reduce these uncomfortable signs and symptoms that can come with your period.
2. Avoid alcohol, smoking and recreational drugs.
Hopefully it goes without saying that recreational drugs and smoking are likely to have an adverse effect on your chances of conceiving, but the impact of alcohol can be a little more unclear.
There is significant evidence to show that heavy alcohol use should be avoided when trying to conceive , however, the evidence around light to moderate is less black and white. Studies have found negative impacts of alcohol but also some studies report a neutral impact [2,3]. Important to note, there is definitely not a positive impact! Our advice is to abstain and reduce where you can.
3. Reduce your exposure to chemicals
Avoid toxicants such as BPA and BPS, typically found in plastics. These chemicals are endocrine disrupters, affecting our hormone function and therefore fertility . This is why we will talk to you about ways you can reduce your exposure to these plastics. Simple things like swapping to a glass water bottle, glass tupperware, avoiding canned items not labelled BPA free, avoiding thermal paper (such as receipts which we can always email to you) and taking care when using plastics with your food and drinks (ie not heating in plastic where possible).
4. Increase your antioxidants
Antioxidants play an important role in egg quality by protecting against oxidative stress. For younger women without fertility concerns, supplementation may not be required. The focus can simply be on ensuring you take your prenatal vitamin and embracing a diet rich in antioxidants – fresh fruit and vegetables, whole grains and lean protein sources.
However, for those with unexplained fertility, PCOS or age related infertility, then your prenatal vitamin and a healthy diet may not be enough. If you fall into this latter category, we will speak to you about possible supplements to consider such as Vitamin E, Vitamin C, N-acetyl cysteine (NAC) and Ubiquinol (CoQ10). Your Fertility Specialist may also speak to you about these options.
5. Reduce your refined sugar intake
As a society, we are becoming more and more aware of the negative health impacts of sugar, in particular refined sugars. This doesn’t exclude fertility impacts and studies have found sugar impacting ovulation  and egg quality . For both your fertility and overall health, reduce refined sugars wherever you can.
6. Reduce your caffeine intake
Sorry, yes another thing to cut out, or reduce at least. Our recommendation is to give up coffee completely if you can and particularly if you are experiencing fertility concerns. However, if you are struggling to give up and don’t have any known fertility challenges (such as recurrent miscarriage, poor response rate to egg retrieval), then we suggest that you keep your daily intake to 1 cup a day (200mg) . Don’t forget that caffeine isn’t just in your coffee, but also teas (including green), energy drinks and even chocolate.
7. Take a good quality prenatal vitamin
Most of us know by now the importance of taking a prenatal vitamin, but how do you choose a good one? We will do a separate blog on what to look for in your pre natal vitamin, but for now our recommendation is to choose a prenatal with folate in the methyl-folate form (rather than folic acid) and one that includes B6, B12, iodine, zinc, selenium and choline. We stock a product that we feel ticks these boxes, however, are also happy to advise of suitable products in other brands.
8. Reduce your stress
Even though we may not think of ourselves as ‘stressed”, it’s often the case that our bodies think otherwise. In our modern world, many of us lead busy lives and our body can easily sit in a ‘fight or flight’ mode, rather than moving to it’s ‘rest and digest’ state. It’s this parasympathetic (rest and digest) state we need to be in to maximise on our reproductive hormones. For example, the LH surge needed for ovulation can be delayed when stressed .
We love to use acupuncture as a way of helping to reduce stress , however, we will also discuss other ways that you can assist with this. Examples include guided meditation, yoga (or gentle exercise), getting out in nature, doing things you love and find fun (excluding those on the reduce or avoid list above!).
9. See your GP
You may want to consider some testing with your GP before trying to get pregnant. Common tests include a full STI check to include infections that affect fertility such as HIV, Hep B and syphilis. You may also want to consider a Hep C test, assessing the currency of your rubella immunity and looking at your iron and Vitamin D levels. In recent times, GP’s will also recommend Covid 19 vaccinations.
Other tests more specific to fertility include AMH (looking at your egg reserve), progesterone level test (7 days post ovulation to check you’ve ovulated), a hystero-salpingo contrast sonography (HyCoSy), commonly referred to as the dye test (to ensure tubal latency) and a semen analysis for your partner or known donor. There are many ways to improve the health of your sperm if this is required (actually even if it technically not, why not aim to improve it anyway!).
1. Hawkins Bressler L, Bernardi LA, De Chavez PJD, Baird DD, Carnethon MR, Marsh ee. “Alcohol, cigarette smoking, and ovarian reserve in reproductive-age African-American women”. Am J Obstet gynecol. 2016;215:758.e1–758. e9. doi: 10.1016/j.ajog.2016.07.012
2. Van Heertum K, Rossi B. “Alcohol and fertility: how much is too much?”. Fertil Res Pract. 2017;3:10. Published 2017 Jul 10. doi:10.1186/s40738-017-0037-x
3. Eggert J, Theobald H, engfeldt P. “effects of alcohol consumption on female fertility during an 18-year period”. Fertil Steril. 2004;81:379–383. doi: 10.1016/j.fertnstert.2003.06.
4. Pivonello, C., Muscogiuri, g., Nardone, A. et al. Bisphenol A: an emerging threat to female fertility. Reprod Biol endocrinol 18, 22 (2020). https://doi.org/10.1186/
5. Chavarro, J., Rich-edwards, J., Rosner, B. et al. A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. eur J Clin Nutr 63, 78–86 (2009). https://doi.org/10.1038/sj.
6. Chaffin CL, Latham Ke, Mtango NR, Midic U, VandeVoort CA. Dietary sugar in healthy female primates perturbs oocyte maturation and in vitro preimplantation embryo development. endocrinology. 2014;155(7):2688-2695. doi:10.1210/en.2014-1104
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9. Smith, CA, de Lacey, S, Chapman, M, et al. The effects of acupuncture on the secondary outcomes of anxiety and quality of life for women undergoing IVF: A randomized controlled trial. Acta Obstet Gynecol Scand. 2019; 98: 460- 469.