Ready, Set, Go: The Race to Have a Baby

The decision to start trying to get pregnant is exciting, but can often raise several questions about what you can and should be doing to maximize your chances of a healthy conception. Women often are concerned about nutrition, lifestyle, frequency and timing of intercourse, and how long it should take to conceive. Here is some information that will help you on your journey to pregnancy.

Nutrition and Lifestyle

Exercise: Starting a new and vigorous exercise program should be discussed with your doctor, but continuing your regular exercise routine while trying to conceive is an excellent way to stay healthy.

Diet and Weight: Fertility can be decreased for patients that are excessively thin or overweight, so it is important to optimize your weight in the normal range. Women attempting to conceive should take folic acid – at least 400 mcg daily – as a supplement or in a prenatal vitamin to reduce the risk of certain birth defects.

Alcohol, Caffeine and Tobacco: Smoking decreases pregnancy rates while also increasing the risk of many pregnancy complications including miscarriage. Speak with your doctor if you need assistance to quit tobacco products.

Some research supports that high amounts of alcohol – more than 2 drinks per day – decreases fertility, but moderate alcohol use does not appear to be detrimental. Once pregnant, alcohol use should be discontinued.

Moderate caffeine consumption – one or two cups of coffee per day or its equivalent – also does not appear to decrease fertility and is fine in moderation until pregnancy occurs.

Ovulation Optimization

Pregnancy is most likely to occur when intercourse occurs within the three days leading up to ovulation. Sperm have the ability to fertilize an egg for several days once inside the woman, but an egg has only up to approximately 24 hours to be fertilized once it has ovulated.

Some women report that they can feel when they ovulate, or may notice changes in cervical mucus. The chances of conceiving are highest when mucus becomes clear and slippery. You can also track your cycles with basal body temperature charting to determine approximately when you ovulate.

Many women find urinary ovulation predictor kits helpful to determine the most fertile time to conceive. Ovulation predictor kits detect the hormonal signal that triggers ovulation. To optimize your chances, it is best to have intercourse the day the test is positive and the following day or two.

If you are not using ovulation predictor testing, having intercourse every one to two days the week you are expected to ovulate is optimal. Although many women may believe that laying flat for a while after intercourse or specific coital positions may increase chances for pregnancy, there is not evidence that this is the case.

When to Seek Assistance

Most doctors recommend trying to get pregnant for at least one year before seeking an evaluation with your physician or a reproductive endocrinologist. Earlier evaluation is warranted for women over 35 years of age; for women with irregular menstrual cycles or known uterine, pelvic or fallopian tube abnormalities; or if their partner has any known fertility concerns. Testing is tailored to the patient or couple depending on their age, duration of infertility, the patient’s wishes and any known medical or gynecologic conditions.

Top 3 Therapy Options

Fertility Therapies
Several treatment options are available to help patients have a healthy conception depending on the underlying fertility factors.

Ovulation Induction
Oral and/or injectable medications may be recommended to improve the likelihood of pregnancy by enhancing ovulation. Intrauterine insemination, or IUI (placement of sperm into the uterus), is often incorporated to improve pregnancy chances.

In Vitro Fertilization
IVF involves the retrieval of eggs from the ovary, fertilization with sperm in the laboratory, and then transfer of the fertilized eggs back to the uterus. It is commonly used for a variety of infertility causes or if other treatments do not result in pregnancy.

Surgical Options
Surgery may be recommended for evaluation and treatment of some causes of infertility. A small telescope can be placed in different areas of the pelvis to assess fertility: Laparoscopy involves placement in the pelvis; hysteroscopy is inside the uterine cavity; and fertiloscopy is near the fallopian tubes. Other surgeries to remove uterine fibroids, polyps or endometriosis also may be recommended as these can decrease fertility.

Dr. Michelle Matthews is associate director of reproductive endocrinology and infertility at Carolinas Medical Center’s Center for Reproductive Medicine at CMC Women’s Institute.