There are many factors influence fertility and if you are planning a pregnancy, it is a good idea to be well prepared.
Some of the following health and lifestyle information will help you in reaching your goal of pregnancy. Also included are some preventative measures to ensure the health and safety of your baby.
General health check
First of all, you should visit your GP for a general health check including Pap smear, breast check, blood pressure, weight screening, blood tests and lifestyle advice. Book a long appointment and your GP will check these issues in detail.
Folate supplementation is recommended at least 1 month prior to pregnancy and for 3 months into the pregnancy as this reduces the chance of the baby having a defect in the neural tube, such as spina bifida. Folate can be taken alone or with other pre-pregnancy supplements.
A blood test can show if you are immune to rubella. If not, you should be immunised. You should also have a blood test to check your immunity to varicella. If you are not immune, you can be immunised to reduce the risk of infection in pregnancy.
Be sure to update your smear test if it is nearly due. It is better to have one a bit early than be due in the middle of a pregnancy and find out that you have an abnormality on your smear that needs attention.
A healthy diet includes fruit and vegetables each day and good quality protein such as in lean meat, fish, eggs and pulses (beans, lentils etc). You also need to consume complex carbohydrates, whole grains and plenty of calcium, preferably in the form of low fat dairy products. If possible, avoid excessive additives such as colours, flavours and preservatives. Try to keep to a relatively low fat diet, and to include mainly healthy fats such as olive oil. Fish oil supplements can be good for fertility and in pregnancy, and may reduce the risk of postnatal depression.
When you are pregnant, remember to avoid eating food that could contain listeria, which can cause serious problems for the unborn child. These foods include soft cheese such as feta, pate, cold meats, pre-prepared salads and raw or smoked seafood. You should also limit amounts of fish known to have high levels of mercury, such as swordfish, marlin, shark/flake, orange roughy, tuna and catfish.
Weight issues are important for both men and women when considering fertility. If you are overweight, your body mass index (BMI) will be more than 25. BMI is determined by your weight in kg divided by your (height in metres)². If your BMI is over 25, try to lower it. The closer to BMI 25 the better, and remember any weight loss in this situation will improve your fertility. See a dietician if you feel you would like expert one-on-one advice
Rapid or extreme weight loss is not good for your fertility but may be a good ‘kick-start’ before you begin trying for pregnancy.
Women who are underweight (with a BMI lower than 20) are also at risk of reduced fertility. If you are underweight and your period cycles are long or irregular, a small weight gain may be beneficial. Alternatively, you could cut back on strenuous exercise.
Smoking is hazardous to your fertility, your general health and your baby. Smoking can affect the fertility of both males and females, causing erectile dysfunction and increased DNA damage to sperm and eggs
There are no safe levels of alcohol consumption for women while trying to conceive and during pregnancy. Men should aim to keep to current safe drinking guidelines which are an average of 2 drinks per day maximum, with several alcohol free days each week and no more than 4 standard drinks in one session.
You will benefit from being fit prior to pregnancy. For women who are unfit, developing at least a moderate level of fitness is advisable – perhaps build up to 45 minutes of brisk walking 5 days per week.
If you are very unfit, start with a 10 minute walk twice a week at a moderate pace, and each week increase the time and frequency of your exercise. It is best to limit intense or high impact exercise, and no more than 4 hours of high intensity exercise per week is recommended.
Men should also try for a reasonable level of fitness.
Both men and women need to aim for less than 200mg of caffeine a day, which equals a maximum of 1 to 2 coffees or glasses of cola/energy drinks, or 2 to 3 teas – and not too much chocolate either!
If you need to cut down, do it slowly to reduce the impact of withdrawal symptoms.
Maintaining a positive state of mind also improves your health and well-being, and your chances of a successful pregnancy. A degree of stress in life is inevitable, but how you deal with it is important. At Monash IVF we provide counsellors for individuals and couples. Our counsellors have extensive therapeutic experience and have specialised skills and knowledge in the field of infertility.
It is best to avoid excessive heat from saunas, spas etc when you are trying to conceive and during pregnancy. Men should also avoid situations where their scrotal area is unable to keep cooler than the rest of the body – keep laptops on the desk and off the lap!
Fertility and phases of the menstrual cycle
A normal menstrual cycle may result in changes in your body temperature that can indicate if ovulation has occurred. But these changes are not able to accurately predict ovulation – many things affect temperature. There is a reliable progesterone blood test that can be used to confirm ovulation, and urine Ovulation Predictor Kits can be helpful if they work (not all women get enough hormone entering the urine to get a positive reading). Saliva kits are available but they can be difficult to interpret, which may make you more stressed or confused. Simple maths is often very helpful. Record your longest and shortest menstrual cycle. The potential fertile time starts 16 days before the end of your shortest cycle and ends 12 days before the end of your longest cycle.
Not getting pregnant?
If you are over 35, you should not wait too long before getting expert advice about fertility. Monash IVF suggests that you seek advice if you have not achieved a pregnancy after 6 months.
If you are under 35, you should seek advice if you have menstrual problems or are not pregnant after 12 months of trying.