So, you’ve made the decision to try for a child.
You’re excited. You’re nervous. You’re hopeful.
And odds are, you also might have a few questions about the journey you’re about to embark on.
Pregnancy planning 101
Annie Liljegren is an advanced practice registered nurse and a certified nurse-midwife at Sanford Health in Alexandria, Minnesota.
She said first and foremost, male and female presenting couples should attempt pregnancy during ovulation.
Liljegren said the highest probability of conception appears to be with intercourse within one to two days before ovulation, due to sperm being able to survive in the body for several days after intercourse.
She outlined various ways to track ovulation:
- Charting menstrual cycle: Recording the day of onset of a period for several months, to gauge the typical length of the menstrual cycle. Ovulation often occurs halfway through a woman’s cycle. Mobile apps can be a helpful way to keep track of your period cycle.
- Tracking symptoms: Increased volume of clear, stretchy and slippery vaginal discharge due to a rise in estrogen.
- Tracking basal body temperature: A woman puts a basal body temperature thermometer under her tongue every morning while still in a basal state (having ingested no food for 12 hours). During ovulation, there can be a half degree increase in body temperature due to the release of progesterone from the corpus luteum.
- Ovulation test strips: At home test kits where a woman urinates on the test strips to indicate likelihood of fertility.
- Lab tests: Drawing serum progesterone seven days prior to a period is a reliable indicator of ovulation.
She said timing ovulation is often regarded as the most effective way to conceive.
How conception occurs, and when to seek help
When pregnancy happens through intercourse, the following steps must happen:
- An egg is released from the ovary (ovulation).
- A partner’s sperm swims up the vagina, into the uterus, and up the fallopian tubes.
- When the sperm reaches the egg, at least one sperm must get through the outer casing of the egg and make it inside (fertilization).
- The new, fertilized egg travels down into the uterus, securing itself to the wall of the uterus (implantation).
How long it takes to conceive can vary greatly from couple to couple. And if a couple is having a hard time getting pregnant, it doesn’t mean they’ve done anything wrong.
Scientifically, a lot of things have to go right for conception to happen.
Liljegren said after stopping birth control, “the typical rule for women under 35 is to be assessed for possible infertility if they’re unable to spontaneously conceive after one full year of having timed intercourse – and that’s for women who have never been pregnant before.
“If it’s for women who have been pregnant before, or if it’s for women over the age of 35, the rule is six months of unprotected intercourse,” she added.
Learn more: Fertility care at Sanford
What can complicate conception?
Liljegren said irregular menstrual cycles can often cause irregular ovulation timing, which makes it difficult to track ovulation.
“If cycles are every 30 to 60 (or more) days, it can be really hard to know when to try and conceive if you don’t have a routine day, or window of time, that you typically ovulate,” she said.
She said long or short menstrual cycles can be related to anovulation, which is the absence of ovulating.
“If that’s the case, the next steps would be to speak with a provider about next steps and how to change that,” she said.
Liljegren said some causes of anovulation can be:
- Polycystic ovarian syndrome (PCOS)
- Thyroid disorders
- Congenital adrenal hyperplasia (CAH)
- Birth control
- Antidepressants
- Chemotherapy
- Corticosteroids
- Eating disorders
- Intense exercise
- Stress
- Low sperm count
- Low sperm motility
Not timing intercourse correctly can also prevent conception.
“It’s ideal to start having intercourse at two days prior to when you’re supposed to ovulate. I think a lot of people assume you’re supposed to start having unprotected intercourse the day you get a positive ovulation test result, and that sometimes can be too late,” said Liljegren.
There’s help at Sanford
Liljegren said she and other providers at Sanford Health can help couples navigate the entire pregnancy process.
“The biggest thing is patient education,” she said. “There’s a lot of information we can provide on infertility, conceiving, and preconception counseling. We have providers who do preconception visits, in addition to infertility visits too. We also have infertility specialists as well.”
She said preconception visits are often overlooked but are very useful for couples.
“I don’t think people fully understand the benefit of a preconception visit. I highly recommend them if you are considering pregnancy in the near future. It’s very important to be seen by your provider to ensure you have all the information you need, and that your medical history is all up to date.”
This allows your provider to flag any potential risks to your pregnancy before it even occurs.
“There have been a lot of times where we see women who are now pregnant, and they’ve been taking a medication or several medications that are not safe in pregnancy. This could have been avoided if we could’ve seen them prior to conceiving and assisting them in changing these medications to something that is safe and just as effective,” Liljegren said.
Learn more
- Reasons you may not be enjoying sex
- What happens during a preconception appointment
- Preconception planning for high-risk pregnancy
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Posted In Health Information, Pregnancy, Women's
