So you have decided to become pregnant! Congratulations! At the Carl von Linné Clinic, we get a lot of questions from couples trying to conceive. The vast majority are successful on their own without our help. On the internet, there are a lot of people who give advice that is not scientifically substantiated. At the Carl von Linné Clinic, one of the cornerstones of our practice is that advice and counseling should be based on research or proven clinical experience. Below, we have put together some information that could be helpful for couples trying to conceive.
Stopping contraceptives - time to pregnancy
Most contraceptives, such as the combined pill, the mini-pill, p-patches, p-rings, p-implants, IUDs, etc., do not affect fertility once they are discontinued. Fertility after P-injections (Depo-Provera) can be affected for the first six months after the last injection. However, keep in mind that there are also women who become pregnant three months after the last injection. About 62 % of couples become pregnant within 6 months, 80 % within the first year and about 90 % within two years.
Quitting smoking will make it easier to become pregnant, shorten the time to pregnancy, reduce the risk for needing IVF, reduce the risk for miscarriages and increase the chance of having a healthy pregnancy and child. Children whose parents do not smoke are healthier.
Smoking affects the quality of both eggs and sperm. Even transportation of an embryo (fertilized egg) to the uterus is decreased as is the chance for the embryo to implant (grow) in the uterus. Women who smoke have a risk for extra-uterine pregnancies and miscarriages. Additionally, smokers have an increased risk for lower egg reserve and early menopause. However, quitting can increase your chances of conceiving and having a healthy pregnancy and child. There are too few studies of chewing tobacco (snus) to draw any clear conclusions. However, keep in mind, all tobacco contains toxic substances and it might be wise to consider quitting.
Read more here: www.slutarokalinjen.se/andra-sprak-2/
Under and overweight can affect the chance of becoming pregnant. Women with low weight or overweight have an increased risk for irregular menstrual cycles and also for cycles without an ovulation (release of a mature egg). It also takes longer time to pregnancy. Men with overweight have often poorer sperm quality. Overweight women have an increased risk for miscarriage, birth defects, pregnancy complications, difficult deliveries and poorer health of the babies. Even 5 – 10% weight reduction can increase the chance of pregnancy and increase the chance of a healthy pregnancy and child.
To determine if your weight is normal, BMI is calculated by weight (kg)/height (m) x height (m). BMI 18.5 – 24.5 kg/m2 is normal, 24.6 – 29.9 kg/m2 is overweight and over 30.0 kg/m2 is obese. All who are over BMI 30 kg/m2 should try to reduce their weight.
It can be hard to lose weight. Here are a few links that can be helpful: www.itrim.se; www.weightwatchers.com
According to the National Food Agency, Sweden (Livmedelsverket), all women who are trying to conceive should increase their intake of folic acid. The recommended dose of folic acid is 400ug/d. See Livmedelsverket.se for information about which foods are naturally high in folic acid. Additionally, this webpage contains recommendations about healthy eating habits and which food to eat when you become pregnant.
Read more here:www.livmedelsverket.se
Women who exercise on an elite level have a 10 – 20 % risk of not ovulating so if you exercise excessively, it can be good to lower your frequency and/or level of training. Exercise can help you lose weight if you are overweight.
It is always good to reduce the stress in your life. A lot of people believe that stress can affect your chance of getting pregnant and if you just “relax and take it easy” you’ll have an easier time getting pregnant. However, this really isn’t substantiated. Stress as most people mean, won’t make it harder to get pregnant. Extreme stress can sometimes lead to irregular menstrual periods and infrequent ovulations, which can make it take longer to get pregnant. However, studies done on women undergoing IVF treatment have not been able to show a correlation between pregnancy chance and stress.
Menstrual cycle and ovulation
When you are trying to conceive, it can be good to note if your periods are regular. It is not uncommon that the cycles can vary by several days. Ovulation, the release of a mature egg to the fallopian tubes, occurs usually about 14 days before the next menstrual cycle. Many women use ovulations kits that can be bought at a pharmacy to help time intercourse around ovulation. Afterwards, many describe that it is stressful checking for ovulation daily and then having sex just because “it’s the right time”. If your cycle (from the first day of one period to the first day of the next cycle) is 30 days, ovulation should occur on day 16. Sperm are viable for several days in a woman’s fallopian tubes. Intercourse a week ahead of an ovulation may result in a pregnancy, but the chance is higher higher the closer you are to ovulation. Couples who have sex infrequently often use ovulation kits that can be bought at a pharmacy in order to time intercourse at the time of ovulation. The body temperature rises at ovulation, so a different way to test for ovulation is by taking your temperature each morning before getting out of bed throughout the cycle. Continue several days after you see that it rises to be certain it remains higher.
Smart phone apps
Learn about your body and how it works! Many women use apps via a smart phone to register their menstrual cycle and/or ovulation and/or intercourse occasions. Apps can be a great help in learning how your menstrual cycle is and about your ovulation
There are many apps that work well. Find one you like. One app that we feel is exceptional and easy to use is Natural Cycles. It combines research in the field of fertility with an advanced mathematical computer model. It’s a lot more than just a calendar to keep track of your period. Natural Cycles can be used both as a natural contraceptive method as well as a method to help become pregnant. Read more at: www.naturalcycles.com
Of course, sexual intercourse is an important act needed to get pregnant! Many couples trying to conceive often note that, after a few months, sex becomes mechanical or a “must do” act. There is a lot of advice on what to do or not do, much of which is just traditional ideas or opinions without scientific proof. If you have relatively regular menstrual cycles and have sex about twice a week, you don’t need to worry about when you ovulate. However, if you have sexual problems, it is important to seek help as there are treatments available.
Miscarriages are relatively common. About 15 % of pregnancies end in a miscarriage. In women just a few years older than 40, the risk is at least 50 %. Most often, there are problems, such as genetic or chromosomal abnormalities with the fetus.
If you have had one or two miscarriages, you don’t have an increased risk for miscarriage in the next pregnancy. It isn’t until after the third consecutive miscarriage (in couples who don’t have a healthy child), that we start to consider doing a diagnostic evaluation. Even so, it is very rare that we find a problem. If you have had a positive pregnancy test at the time of an expected period but your period comes within a week, we usually don’t count these pregnancies as a miscarriage, even though it is often as disappointing as a miscarriage.
When to seek help
• >1 year - If it’s gone longer than 12 months of trying
• Age – if you are older than 38 years and you have been trying for 6 months
• Irregular menstrual cycles - if you have menstrual cycles longer than 40 days or shorter than 23 days.
• Infertility in a previous relationship or pregnancy - if you have a known problem with infertility from a previous relationship or longer than 1 year to conception with a previous pregnancy.
• Extra-uterine pregnancy or salpingitis (tubal infection) - if you have been trying for 6 months.
• Previous operations in the scrotum - you have been trying for 6 months.
• Sexual problems – contact either us or a sexological clinic directly.
• Previous illnesses - if you take medication for a previous condition, please contact your doctor who has prescribed the medication. It is important when you are trying to conceive that you are taking medication that is fine to have during a pregnancy.
• Anxious? - if you are worried that you will have problems, sometimes it can be good to get an objective opinion.