There’s tons of guidance out there about the many things people who are pregnant should and should not do, from reducing caffeine intake to avoiding soft cheeses to not handling kitty litter. But what should you do — or not do — if you’re trying to get pregnant?
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Reproductive endocrinologist Stephen B. Mooney, MD, talks about the ways you can best ready your body and mind when you’re trying to conceive.
When to start prepping for pregnancy
If you know you want to try to conceive, there’s no one best time to start preparing your body and mind. In a perfect world, we’d all prioritize our physical and emotional health all the time — but in a busy, sometimes-stressful world, it’s not unusual to put our individual health on the back burner.
“If someone is really being conscious about preparing their body and mind for pregnancy, ideally, they should start as much as a year or six months before,” Dr. Mooney says, “But in reality, even three months or 90 days of preparation goes a long way.”
Where to start if you want to get pregnant
If “Have a baby” is at the top of your to-do list, there are some things you can do to put yourself in the best possible position to conceive and carry. Dr. Mooney shares some of the steps to consider.
1. Catalog your family history
Your family’s health issues can become your health issues — or at least play a part in the way your doctor addresses your questions about fertility.
Certain hereditary cancers, like breast cancer, ovarian cancer, cervical cancer and uterine cancer, can impact fertility. “If you know you have a family history in your mother, sister, aunt or grandmother, this information is critical to share with your physician,” Dr. Mooney says.
Other health issues may have an impact on your fertility care, too, so tell your doctor if you have a family history of heritable conditions such as:
- Blood clotting disorders.
“Having this information will help your doctor make more informed decisions about certain screenings, diagnostic tests and other procedures to help mitigate or minimize complications in getting or being pregnant,” Dr. Mooney advises.
2. Go off of your birth control
Heads up: You can, in theory, get pregnant within days of stopping your birth control, so don’t do it until you’re good and ready.
“There’s a common misconception that you should be off birth control for a while before trying to get pregnant — so that you can get your cycle back,” Dr. Mooney says. “But in reality, unless your birth control is masking an underlying ovulation disorder, many people can achieve pregnancy relatively quickly after going off contraceptives.”
3. Start tracking your ovulation
You might not yet know much about your fertile window — the time of the month when you can get pregnant. Enter ovulation tracking, which can be done through various methods.
- Phone apps: Some apps predict when you’ll ovulate based on data you provide about your menstrual cycle. “This is more accurate than guessing, but not as accurate as other methods,” Dr. Mooney says.
- Ovulation predictor strips: These over-the-counter strips test your urine to tell you whether you’re ovulating. They’re one of the most reliable at-home ways to identify your fertile window.
- Basal body temperature charting: Using a specialized thermometer each morning, you can monitor your body temperature to identify when you’ve ovulated. “This confirms that ovulation occurred, but only after the fact,” Dr. Mooney notes. “It’s not necessarily best when trying to achieve pregnancy, but it can help you better understand your cycle.”
4. Start taking prenatal vitamins
The best time to get in the habit of taking a prenatal vitamin is before you’re pregnant. One of their most important ingredients is folate, or folic acid, which helps your fetus’ spinal column to close properly, and prevents spina bifida.
The other vitamins and nutrients in prenatals help sustain and nourish both you and, eventually, the little life growing inside of you. “When you’re pregnant, nutrients are shifted from you to the fetus, so it’s important to have a continuous supply of important nutrients for fetal growth,” Dr. Mooney says.
5. Get a handle on your stress
Stress reduction isn’t directly correlated to improved rates of pregnancy, but there’s a lot of value in it that can impact your overall wellbeing, which can affect your fertility.
“Reducing stress can help you think more clearly, make life decisions with confidence, be able to weigh options rationally and improve your relationships at work, at home and beyond,” Dr. Mooney says.
High stress levels can also have a direct impact on your menstrual cycle, causing you to stop having a period or even to have your period too often, which can affect your ability to get pregnant.
6. Exercise regularly
Get moving! Dr. Mooney recommends 30 minutes of exercise a day, at least five times a week.
“Exercise improves cardiovascular health, helps with weight management and relieves stress,” he says — all of which are positives in general, but especially when you’re trying to get pregnant.
7. Reach a healthy weight
Your weight can impact your ability to conceive, so talk to your doctor or dietitian to learn about proper calorie intake, exercise and other healthy habits as you try to conceive.
If you’re underweight…
Some people who are underweight, especially those with eating disorders, like anorexia or bulimia, may not ovulate or may have irregular periods.
“Even those who are underweight without eating disorders can have issues that relate to ovulation, cycle management, implantation of pregnancy and preterm delivery once they do become pregnant,” Dr. Mooney says.
If you’re overweight…
Obesity, too, can affect your menstrual cycle, including the quality of your eggs. And people who are who are overweight are at higher risk for:
- Chronic hypertension.
- Gestational diabetes.
“I encourage patients with obesity to first try to maintain their weight, and then we can get a plan in place to begin to lose weight,” Dr. Mooney recommends. “Start slow, with just five pounds, then 10 or 12, and we’ll go from there.”
8. Optimize your diet
If you’ve been meaning to up your eating habits, now’s the time to revamp them. Try embracing a diet that trends toward:
- Lower carbohydrate intake.
- Increased intake of protein and healthy fats.
- Lots of fruits and vegetables.
“We typically recommend a low-carb, Mediterranean-style diet, with lots of leafy green vegetables,” Dr. Mooney says. “Essentially, anything brightly colored in the produce aisle is likely to have a lot of good nutrients in it.”
There are also a variety of foods you shouldn’t eat when you’re pregnant. If you’re currently consuming a lot of them, you may want to try to cut them out before you get pregnant, just to make things easier on yourself when the time comes. In particular, scale back on predator fish, such as tuna, which can expose you to increased levels of heavy metals, including mercury and cadmium.
9. Quit smoking
Smoking is a known risk factor for infertility.
“Our lung cells are separated from the blood vessels in the lungs by just one cell layer, so anything we take in, such as cigarettes or marijuana, goes into the bloodstream and transits throughout the body,” Dr. Mooney explains.
“All of the compounds in cigarette smoke end up deposited throughout the body — including the ovaries. And so cigarette smoking can have a profound, detrimental impact on ovarian function, egg quality and egg number.”
It’s better never to start smoking at all. But if you’re currently in the habit of lighting up, try quitting smoking to boost your chances of a healthy pregnancy.
10. Scale back on caffeine
You don’t have to give up your a.m. coffee when you’re trying to get pregnant. But if you typically have a few morning mugs, you might want to cut down.
“Having 500 milligrams or more of caffeine per day — the equivalent of five or six cups of coffee — has been shown to have an impact on fertility and miscarriage,” Dr. Mooney says.
Try limiting yourself to no more than two caffeinated beverages (including coffee, tea and soda) per day when you’re trying to conceive.
11. Talk to your doctor about your medications
A range of medications can affect your ability to conceive and can have an impact on your fetus once you become pregnant.
“If you’re trying for pregnancy, review your prescription medication list with your physician and ask: ‘Do any these have any impact on pregnancy?’” Dr. Mooney advises.
Some common medications that may affect fetal development include:
- Methotrexate, which is used to treat arthritis.
- Isotretinoin, which is used to treat acne.
- Valproic acid, which is used to treat seizures.
- Warfarin and other blood-thinning medications.
- ACE inhibitors, which are used to lower blood pressure and treat other cardiac conditions.
- Some antibiotics, including doxycycline and tetracycline.
- Some antidepressants and anti-anxiety medications, including alprazolam, diazepam, lithium and paroxetine.
Before you panic about stopping a medicine that’s integral to your own wellness, there’s good news: Dr. Mooney says that in many cases, your doctor can guide you toward a safer swap.
If no alternative is available, though, your doctor will work closely with you to discuss the risks of being pregnant while on the medication and determine the best and safest course of action for you and your fetus.
When to start discussing infertility
It can be frustrating — and even devastating — to try to conceive and continue seeing just one line on repeated pregnancy tests. If you’ve been trying for six months to a year with no success, it may be time to see a doctor.
Infertility is defined as one year of unprotected intercourse without achieving pregnancy. If you’re age 35 or older, though, that timeframe is shortened to six months.
“Start having the dialogue with your partner and your healthcare provider sooner rather than later,” Dr. Mooney says, “So you can feel prepared and assertive in starting to get the care you require.”