Preparing for pregnancy

If you’ve noticed a lot of baby announcements recently, there may be a reason. The Centers for Disease Control and Prevention (CDC) reports July through October tend to be the most popular birth months, meaning many babies are conceived around the holidays.

As any parent will tell you, pregnancy requires some planning. Good pre-pregnancy health can improve your chances of conceiving, as well as prevent complications down the road.

“Annual visits with an OB/GYN and a primary care physician are extremely important for all women of reproductive age, even those who don't plan to conceive anytime soon,” said Anita Patel, MD, an OB/GYN who delivers at Baptist Medical Center Beaches. “It can take several months up to a year to work on improving medical conditions that could affect a future pregnancy. Having the guidance of a physician during this process is the most important thing a woman can do for the health of her future baby.”

Factors that affect fertility

If starting a family has been top of mind, it’s crucial to make an appointment to consult your OB/GYN to make sure your body is ready for pregnancy.

Medical conditions, lifestyle choices, family history and genetics may all affect your fertility. Some specific factors include:

• Age
• Amenorrhea (absence of menstruation)
• Autoimmune disorders
• Diabetes
• Endometriosis
• High blood pressure
• Obesity
• Polycystic ovarian syndrome (PCOS)
• Sexually transmitted diseases
• Smoking and/or heavy alcohol consumption
• Thyroid disease

What to expect after stopping birth control

The most important thing to know about stopping oral birth control or long-acting reversible contraceptives (LARCs), such as an intrauterine device (IUD) or Nexplanon® (a small rod inserted under the skin of a woman’s arm), is that ovulation (the release of an egg) can return immediately. That means it’s entirely possible to get pregnant immediately after ditching your birth control pills or having your IUD removed, sometimes without ever getting your period. On the other hand, it could take months for your cycle to return to normal.

“Studies have found no evidence that hormonal birth control or LARCs affect fertility over the long term,” said Dr. Patel. “About half of women will conceive within the first three months of stopping contraception.”

The only exception, Dr. Patel mentioned, is injectable contraception, which may slightly delay the return to fertility.

“If you're using this type of birth control, you may have to wait a little longer to get pregnant, but don’t be discouraged,” said Dr. Patel. “More than 80% of women are successful in conceiving after trying for one year, regardless of the method of birth control they previously used.”

Track ovulation to maximize your chances of conception

If you're thinking about getting pregnant, it's time to put your calendar to good use.

“During pre-pregnancy visits, I often recommend patients track their ovulation, either with an app on their phone or an over-the-counter ovulation kit,” said Dr. Patel.

Ovulation charting helps identify the most fertile days in your cycle. If you know when you ovulate, which is typically around two weeks before your expected period, you can try to conceive four days before or on the day of your expected ovulation to maximize your chances of becoming pregnant.

However, this can be difficult for women whose menstrual cycles fall outside of a normal range. A "normal" cycle lasts between 21 and 35 days.

“Women with irregular periods are also more likely to be anovulatory, meaning they often have cycles where they fail to release an egg,” said Dr. Patel. “They may not ovulate every month, or they may ovulate at different times from month to month. Anovulation can be diagnosed by a variety of tests or an ultrasound ordered by your doctor.”

Preparing for pregnancy after 35

Your peak reproductive years are between your late teens and late 20s. By age 30, fertility begins to decline.

It’s normal for women under the age of 35 to actively try to conceive for up to a year before becoming pregnant. Women under 35 who have been trying for more than a year without success should make an appointment to undergo an evaluation.

“It's a great idea to keep track of your cycles with an app, and use an over-the-counter ovulation kit from the start,” said Dr. Patel. “If you are having trouble conceiving, your OB/GYN will want to know how your cycles have been mapping and if you’ve had any confirmed ovulations using the kits. This information may influence what he or she does next to evaluate and treat your infertility.”

Women who are over 35 should consult a doctor if they’ve been actively trying to conceive for six months. Advanced fertility options such as assisted reproductive technologies (ART) and in vitro fertilization (IVF) can help.

“While there is no such thing as ‘too old’ to get pregnant if a woman is still having menstrual cycles, I do counsel my patients over the age of 40,” said Dr. Patel. “Should they conceive, they are at a much higher risk of complications such as miscarriage, genetic conditions, preterm delivery and preeclampsia.”

Lifestyle changes to improve fertility and pregnancy health

It's never too early to start preparing for pregnancy.

“You should begin taking a prenatal vitamin at least three months before attempting to conceive,” said Dr. Patel. “Taking a daily supplement with 400 micrograms of folic acid can help reduce the risks of certain birth defects involving the baby’s brain and spine.”

Additional lifestyle changes and behaviors that can boost your chances of conceiving and having a healthy baby include:

• Cutting out substances such as alcohol, tobacco and tetrahydrocannabinol (THC)
• Limiting caffeine to less than 200 milligrams per day, which is equivalent to around 1-2 cups of coffee or 2-4 cups of brewed tea
• Discussing your current medications and herbal supplements with your doctor and making sure your vaccinations are up-to-date