Priming for Pregnancy

You’ve started your folic acid and are eating a healthy diet and exercising regularly. Your body is ready for pregnancy.

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Q: How does my age affect my fertility?
A: As you get older, your fertility and chance of achieving a pregnancy worsens. This is particularly true in women over age 35 and men over age 50.

Q: When should I seek further advice and assistance with my fertility, beyond this website?
A: If you are under age 35: after 12 months of having unprotected sexual intercourse without a pregnancy. If you are over age 35: after 6 months of having unprotected sexual intercourse without a pregnancy.

Q: How often should I be having sexual intercourse to maximize my chances of achieving a pregnancy?
A: You can maximize your chances by having “stress-free” intercourse as often as every 1 to 2 days. In other words, don’t follow a strict or limiting schedule that makes sexual intercourse less enjoyable. Find the right balance between having intercourse as frequently as every day, while still enjoying the act.

Q: Are there certain days in my menstrual cycle when having intercourse will maximize my chances of achieving a pregnancy?
A: Yes! You have the highest chance of achieving a pregnancy when having sexual intercourse in the 3 days leading up to ovulation.

Q: How do I know when I am ovulating?
A: There are a number of methods that may help you predict the day that you ovulate. These include:

1. Cervical mucus: This involves assessing the secretions at the entrance to your vagina. When these secretions are at their highest, when they are slippery and clear, the probability of achieving a pregnancy is highest.

2. Basal Body Temperature: Ovulation causes the body’s temperature to rise by about 0.5°F within 1-2 days. This tool can be used to assess if and when ovulation occurred in your cycle. Note: ovulation will have already happened with this increase in temperature. It can only help predict the day of ovulation in upcoming cycles.

3. Urinary LH monitoring kits: These ‘ovulation detectors’ come in a number of different kits and forms. Each has its own instructions. They all measure the same pre-ovulatory “LH surge”. Ovulation may occur any time within the 2 days following a positive “LH surge” test.

4. Menstrual cycle monitoring: This involves recording the day of onset of your menses in several consecutive months. “Day #1” of the cycle is the first day of your menstruation. Assuming you have regular menstrual cycles that vary in between 25 and 35 days, this method can help predict your day of ovulation.

The number of days in between one “Day 1” and the next “Day 1” is your ‘menstrual cycle length’. Subtract 14 from your ‘menstrual cycle length’. This number corresponds to the most likely day of ovulation in your cycle.

For example:

    If your cycle length is 28 days, you will most likely ovulate on day 14.
    If your cycle length is 32 days, you will most likely ovulate on day 18.
    If your cycle length varies from 28 to 32 days, you will most likely ovulate between day #14 and day #18 of your next cycle.

Q: Are any of these methods a sure indication that I’m ovulating?
A: Unfortunately, none of them are 100%.

Q: Do I have to use any of these methods to get pregnant?
A: No. You can still achieve pregnancy with regular intercourse, without using any of these methods.

Q: Do I need to stay lying down after intercourse to prevent the sperm from ‘leaking out’?
A: No. This does not help ‘transport’ sperm and does not improve your chance of pregnancy.

Q: Should I avoid using lubricants when having intercourse?
A: Some lubricants decrease semen quality. These include commercially available water-based lubricants, saliva and olive oil. Other lubricants have no effect on semen quality and should be used if needed. These include: mineral oil, canola oil, or hydroxyethylcellulose-based lubricants (Pre-Seed®).

Q: Can my diet affect my chances of achieving pregnancy?
A: It is important to eat a well-balanced diet - being too underweight or too overweight may make it more difficult to achieve a pregnancy. Heavy seafood consumption should be avoided. Specific dietary variations are otherwise less important.

Q: Are there any other supplements I should take while trying to get pregnant?
A: Folic Acid supplementation is important for all women to take prior to becoming pregnant. This reduces the risk of “neural tube defects” in your baby.

Q: Is there any way to increase the chance of having a girl or boy baby?
A: No. Don’t believe what you read about position during intercourse, whether you have an orgasm or not or when it relates to ovulation to increase the chances of having a male or female baby….none of it is true. There is a 50:50 chance you will have a boy or girl and it’s all dependent on which sperm gets into the egg first.

Q: I smoke cigarettes. Will this be a problem for my fertility?
A: Smoking will decrease your chance of becoming pregnant and may also shorten the number of years you are fertile. If you do achieve a pregnancy, smoking will also increase your chances of miscarriage and pregnancy complications.

Q: I use recreational drugs. Will this be a problem for my fertility?
A: There is limited information on the effect of recreational drugs on fertility. These do have harmful effects in pregnancy though and should therefore be avoided, even when attempting to become pregnant.

Q: Can I drink alcohol while trying to achieve a pregnancy?
A: Moderate alcohol consumption (up to 2 drinks/day) is acceptable. Higher levels should be avoided and alcohol intake should be limited altogether in pregnancy or if pregnancy is suspected.

Q: How much coffee can I drink while trying to achieve a pregnancy?
A: You can drink 1-2 cups of coffee/day (or the equivalent in caffeine) without any affect on decreasing your fertility. High levels of caffeine intake (over 5 cups of coffee/day) may decrease your chances of achieving pregnancy.

Written by: Dr. Ruth Ronn and Dr. Robert Reid, Division of Reproductive Endocrinology and Infertility, Kingston General Hospital

References:
ASRM article: Optimizing Natural fertility
Hornstein M.D., Gibbons, W.E. Optimizing Natural Fertility in couples planning pregnancy. UpToDate. 2001
Welt C.K. Evaluation of the menstrual cycle and timing of ovulation. UpToDate. 2001



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