TIPS TO GET PREGNANT

TIPS TO GET PREGNANT

Pregnancy is a state of ‘carrying a baby or fetus’ in a women’s body. If anyone is considering having a baby, they may have several questions like how long it will take to get pregnant, when to consummate.

The primary question anyone may as is how long will it take to get pregnant – it is suggested that every month the chances of a woman getting pregnant is about 15% – 25%.

The most common things that affect pregnancy are:

  • Age – after you reach age 30 every month the chances of you getting pregnant is decreased and steeps too low after 40 years of age
  • History of irregular menstrual cycles – while having an irregular menstrual cycle it is hard to calculate ovulation which helps determine the duration of sexual interaction
  • Frequency of having sex – the lesser number of times you have sex the lesser chance you get pregnant
  • Any other medical illness like diabetes, thyroid disorder

 

OVULATION AND FERTILE WINDOW –

The best time to get pregnant is when a woman is having a ‘fertile window’. Ovulation is the duration when ovaries will release a mature egg which travels to the fallopian tube where it stays still awaiting fertilization for 12 – 24 hrs. During this phase, LH surges 24 – 36 hrs before ovulation which triggers egg release. If copulation occurs, sperm travels up to the egg and fertilizes. An added advantage to copulation is that sperm can live up to 3 – 5 days within the female reproductive tract thus it is possible to get pregnant 5 days before the estimated duration of ovulation. The chances of getting pregnant are highest within 24 hours of ovulation and one day before ovulation. If the egg doesn’t get fertilized, the unfertilized egg gets resorbed within the uterine lining and sheds out while menstruating.

Changes that occur during ovulation may be:

  • Cervical mucus is thinner and slippery during ovulation
  • Spotting
  • Breast tenderness
  • Increased libido
  • High sense of smell
  • Mild pelvic pain

 

It is important to know that not everyone experiences symptoms of ovulation.

To determine fertile window and ovulation it is important to create a menstrual diary that contains information on day 1 of the menstrual cycle which is the first day of the menstrual period and ovulation takes place 14 days before the next period is due. In normal women, the menstrual cycle may take 21 – 35 days. For example, if the interval between periods is 30 days, ovulation occurs on day 16 and if the cycle is 28 days, ovulation occurs on day 14. Since the fertile window is on the day of ovulation and the five days before ovulation, thus based on this example fertile window is days 11 – 16 and 9-14 respectively. 

           

Calculating Fertile Window is done by -

  • Ovulation Predictor Kits – it uses a urine test to identify the fertile window which monitors luteinizing hormone which surges at 36 hours before ovulation. It is best to copulate immediately having LH surge for better results.
  • Monitor Cervical Mucus - Cervical mucus increases in volume, clear and slippery like egg white means you are ovulating.
  • Charting Basal Body Temperature - Your resting basal body temperature rises during ovulation by at least 2/10th of a degree best observed in the morning but it only detects ovulation after it has occurred thus can be used to sense the day of ovulation only thus not advised by most physicians
  • Fertility Monitors - it monitors LH and estrogen levels to determine a person’s most fertile days. They are the most effective tool in determining fertile windows.

 

HOW LONG DOES IT TAKE TO CONCEIVE -?

Though having regular sexual intercourse may increase the chances of getting pregnant it is not absolute even after identifying ovulation days and have intercourse during the fertile window. Sometimes, ovulation days and length of the menstrual cycle may vary from month to month. In most women with irregular periods, ovulation occurs between 11 - 21 days of the menstrual cycle. It may take 6 months to 1-year duration, if it increases more than 1 year it is best to consult your physician as the lack of conception may be a result of any underlying infertility-related conditions.

 

SEXUAL INTERCOURSE AND CONCEPTION RATIO –

In general, people may think that decreasing the number of sexual attempts or having sexual intercourse only during ovulation may increase the volume of sperm and increase your chances to get pregnant. But abstaining too much from sexual intercourse will decrease your chances to get pregnant even when the volume and number of sperm increase by decreasing the motility of sperm. Also, most women misinterpret ovulation and fertility window thus having sexual intercourse only during these days will decrease the chance of getting pregnant.

Also having too many sexual encounters like having several times a day or over every day may also cause burnout issues that may result in a missed opportunity.

The best time to have sexual activity is mornings or after men have had a good night’s rest. Sleep will increase the loss of sperm that occurred earlier. It is best to avoid hot tubs, bike rides, etc.

 

GENERAL PRACTICES AFTER SEXUAL INTERCOURSE -

In general, during sexual intercourse after ejaculation of sperm, the ejaculated sperm swims through the cervical mucus and reaches the fallopian tubes which may take only a few minutes regardless of the position during intercourse. Some people think that laying on their backs and raising their legs and hips for 30 minutes and more after ejaculation will increase their chances of getting pregnant. This belief has no scientific foundation. It is beneficial to lie on your back for approximately 10 – 15 mins after conception but do not have to raise your feet.

 

THE PROCESS OF PREGNANCY or EMBRYO FORMATION -

It is important to know what happens during your menstruation. The first day of menstruation is day 1 of your menstruation cycle.

  • The first step is the maturation of ovaries that occurs once a month, the lining of the uterus gets thicker to prepare for fertilization of eggs.
  • After maturation of the egg occurs it is released from the ovaries and this process is called ovulation.
  • During ovulation cervical mucus becomes thinner which supports the transportation of sperm to the egg.
  • While having sex, millions of sperm swim towards the cervix and into the uterus and fallopian tubes and reach the fallopian tube and meet the mature egg
  • If sperm is found at the time of ovulation it results in fertilization
  • Fertilized egg reaches uterus where it divides into 2 cells and then 4 cells followed by 8 cells and 16 cells and 32 cells and so on.
  • After fertilized egg reaches uterus and multiplication has occurred at morula stage implantation occurs which is determined as the start of the pregnancy that occurs from 6 – 12th day
  • Some women may have slight spotting or pain while implantation occurs which is not to be worried about.
  • Pregnancy doesn’t occur if sperm doesn’t reach the matured egg in the fallopian tube, or when fertilization occurs and implantation doesn’t occur.
  • An unfertilized egg is reabsorbed into the uterus and hormone level decreases and the lining of the uterus start shedding which results at the beginning of your next menstruation

 

WHEN TO SEE A DOCTOR OR SPECIALIST

Most people get frustrated within 2 – 3 months of trying to get pregnant but even under ideal conditions with no underlying conditions may take several months to a year to get pregnant. Thus,

  • If you have been trying to conceive for more than a year

or

  • At the age of above 35 with regular menstruation
  • If you are younger than 35 years of age
      • Irregular menstruation
      • History of sexually transmitted infections
      • History of ectopic pregnancy
      • History of pelvic inflammatory disease
      • History of polycystic ovarian disease
      • History of fibroids
      • History of endometriosis
      • History of endocrine disorders
      • History of missed abortions

The couple must know that infertility issues and causes may be due to men and women, according to studies infertility is more commonly male-oriented in 50% of cases, and 40% is female-oriented cases, and 10% of cases both male and female infertility is the cause of infertility.

 

CHANCES OF PREGNANCY IS INCREASED BY –

  • Weight management
      • you mustn't lie on either side of the Body Mass Index because it may result in pregnancy-related complications.
      • More commonly overweighed women do not ovulate regularly thus remain infertile. Obese women have too much fat which secretes excess estrogen thus interferes with ovulation. Studies suggest that overweight women take twice as long to become pregnant as those at normal BMI.
      • Similarly, women who are under weighed do have the necessary nutrients to provide a healthy egg for conception thus may result in misconception or abortions or fetal-related issues. Studies suggest that underweight women take four times as long as to become pregnant than those at normal BMI.
      • In men, obesity has been linked to a decrease in testosterone secretion and male endocrine function thus impacts sperm function. It also causes a decrease in the number or quantity of sperm production and has an impact on ejaculatory function.
  • Quit smoking – smoking causes the reduced blood supply to ovaries as they are vasoconstrictors thus smoking causes loss of potentially healthy eggs to rot and it results in conception may lead to pregnancy-related complications. Inhalation of smoke when others exhale also has similar effects thus avoid companies who smoke. In men, smoking has been linked to a decrease in the motility of sperm.
  • Avoid binge drinking alcohol and alcohol-containing substances – they have been linked to structural abnormalities or changes in ovaries and sperm thus post conception causes fetal developmental disorders and frequent abortions
  • Reduce caffeine intake – caffeine intake should not exceed 200 mg/d
  • Reduce intake of Soda, tea, energy drinks
  • Avoid stress – more commonly exerted by work, education, and financial conditions. Practice stress-avoiding techniques like yoga, breathing exercise.
  • Exercise regularly – most studies suggest that it is best to adapt cardiovascular exercise before and during pregnancy. Some studies suggest that high-impact workouts may prevent the process of conception because several athletes have irregular menstruation. It is best to walk fast pace for 20 – 30 mins every day to improve circulation. Thus, follow simple regular exercise.
  • Avoid certain medications that may affect conception like spermicidal condoms and lubricants or mix western and eastern medicine (modern and traditional)
  • Reduce exposure to radiation affects ovaries and sperm count and result in infertility in both men and women.
  • Do not douche – douching is a process of spraying water to clean up the vaginal region. This process washes out sperm and makes it less hospitable for sperm to stay in the vagina. It is also linked to the increase in the occurrence of vaginal infections like bacterial vaginosis, pelvic inflammatory disease, preterm delivery, and ectopic pregnancy.
  • Take prenatal vitamins – it is necessary to take multivitamins which include 400mcg of folic acid per day, and vitamin B complex to prevent birth defects related to neurological disorders like spina bifida. It is best to take them 3 months before conceiving or once you plan to get pregnant and at least 1 month after conception
  • Eat healthy foods – there is no specific diet during pregnancy but it is best to add fruits like citric fruits, vegetables like green leaves, broccoli, cereals, beans, lean proteins, whole grains, dairy and healthy fat in proper ratios. It is best to avoid fish.

 

PRE-CONCEPTION CONSULTATION:

It is more commonly indicated in women above age 35. It is best to counsel your physicians 60 – 90 days before trying to conceive.

  • Screening is done for endocrine disorders, anemia, hormonal imbalances, PAP smear, and mammogram. The slightest change in endocrine function may lead to miscarriage or difficulty in getting pregnant.
  • It is also best to contact your dental doctor to screen for dental carries as pregnancy may increase the risk of infections.
  • Discuss family history on misconceptions, cancers, tumors, or any hereditary disorders. if there is a family history of genetic illness like cystic fibrosis or Down syndrome, it is best to counsel the patients to meet and get counseling from genetic counselors.
  • Advice man to get tested for basic semen analysis where motility and sperm count is determined
  • Advice on vaccinating for conditions like:
  • German measles vaccine
  • Chickenpox vaccine
  • Influenza vaccine
  • COVID -19 vaccine

 

SPECIAL CONDITIONS -  

POLYCYSTIC OVARIAN SYNDROME -

  • Polycystic ovarian syndrome is a hormonal disorder that is the most common cause of female infertility in reproductive age. According to CDC if there are the following 3 categories then PCOS is diagnosed which includes:
      • Dysmenorrhea or amenorrhea due to lack of ovulation
      • High levels of male hormones result in excessive hair on the face and body, acne, and thinning of hair in the scalp
      • Multiple small cysts in both ovaries were observed in ultrasonography
  • It causes PCOS-related infertility and overweight which can be controlled by healthy eating and exercise.
  • Sometimes medications like letrozole and metformin can be used to induce ovulation and regulate insulin.
  • If medication is not enough then laparoscopic ovarian drilling is done which makes small holes in ovaries which in turn reduces male hormone levels

 

ENDOMETRIOSIS

  • It is another most commonly found reproductive issue seen in more than 1:10 women.
  • Endometriosis is a condition where uterine tissue is found in ovaries and fallopian tubes.
  • It causes infertility by obstruction of normal uterine anatomy more commonly causes blocks in fallopian tubes
  • Treatment depends on presenting symptoms
  • Surgery is done to excise endometrial and scar tissue to improve the rate of fertility and reduce the pain that occurs commonly in endometriosis.
  • Other treatments for fertility are IVF, ovulation induction, artificial insemination

 

OTHER OPTIONS TO CONSIDER IN PREGNANCY –

There are more ways to have a baby when natural conception fails. The commonly used methodologies are:

  • Sperm donation
  • Egg donation
  • Adoption
  • In vitro fertilization
  • Intrauterine insemination
  • Infertility support groups