Getting Ready for Pregnancy

Dr Sue Smith, based at IMC Camden, gives us the low down on getting ready for pregnancy.

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How do I know if I am fertile?

If you have regular periods this is a good indication that you are ovulating monthly. Ovulation usually happens between 10 and 16 days before the start of your period, so if your periods are regular you can predict when you will be ovulating by working out the start of your next period and counting backwards. There are helpful apps which can do this too!

There are quite a few physical signs that you are currently ovulating though not everybody will experience them all. Cervical mucus is one of the most common indicators of ovulation as around this time you may notice a thinner, clearer discharge, sometimes likened to egg white. There is a small rise in body temperature after ovulation which may be detectable with a thermometer. It is also possible to detect ovulation using a urine stick that measures changes in hormone levels at the time of ovulation.

Some but not all women experience additional signs, such as breast tenderness, lower tummy pain and bloating.

How many months on average does it take to get pregnant? Is it age dependent?

The time to get pregnant does vary with age.  In couples where the woman is under the age of 40, having regular unprotected sex (every 2 to 3 days) 80% should become pregnant in the first year and half of the remaining 20% will become pregnant the following year. So, 90% in total will become pregnant within 2 years.

Women over the age of 35 have an increased risk of complications, miscarriage and chromosomal abnormalities than younger women.

Should I get a check-up before I start trying to get pregnant? What tests are done at a pre-pregnancy check up?

There are a few factors that can alter your chance of becoming pregnant, age is one, but other factors are your general health and reproductive health as well as how often you have sex.

It is definitely worth having a check-up before trying to get pregnant to talk through your general health with a GP and review your reproductive health. This is not a “one size fits all” consultation as we are all different.

Some of the things that may be discussed at a pre-pregnancy check-up are age, pregnancy plans, coming off contraception, previous pregnancies, exposure to hazards, vaccine history and updates, as well as any current chronic health issues, such as diabetes, thyroid or mental health conditions. Your GP will also want to know if you have any risk of genetic conditions. Smoking, alcohol intake, diet and body mass index (BMI) would usually form part of this discussion as well.

Any tests needed will depend on the patient. Some may need blood tests, and cervical screening will be recommended if not up to date.

I’m overweight. Will this affect my chances of getting pregnant?

Being overweight, obese or morbidly obese does affect the chances of becoming pregnant.

Obesity (BMI >30kg/m2) reduces the chance of pregnancy and also increases the rate of miscarriage.  Women who are obese during pregnancy have a higher chance of gestational diabetes, high blood pressure and pre-eclampsia as well as complications at time of delivery.

Being underweight also reduces fertility and increases the chance of early miscarriage.

Does smoking affect fertility? Why are pregnant women told to stop smoking? What does it actually do to the baby?

Smoking affects both male and female fertility as the chemicals in cigarettes cause damage to eggs and sperm.  Passive smoking also has this effect.  In addition to a reduction in fertility, smoking is linked to miscarriage, small babies, birth defects, stillbirth and sudden infant death syndrome (SIDS). If you or your partner need help to stop smoking, talk to your GP.

What does folic acid do? Should I take it if I am planning on getting pregnant?

Folic acid is known to reduce the likelihood of neural tube defects such as spina bifida and it is recommended for all women who are pregnant. It makes sense to start this when trying to conceive as you may not initially know when you become pregnant.  A dose of 400 micrograms every day is recommended for the majority of women.

Patients who are obese, have diabetes, certain types of anemia, take anti-epilepsy medication or have a history of neural tube defects should take a higher dose of 5mg a day.

In both cases, this should be taken until the 12th week of pregnancy.

How can I increase my chances of getting pregnant?

Living a healthy lifestyle with a balanced diet, exercise and no smoking or alcohol should increase your chances of getting pregnant and result in a healthier pregnancy. Caffeine should also be limited. Start taking folic acid early. If you need help with weight loss, to quit smoking or advice on your diet, or any pre-pregnancy advice, see your GP.

Any last comments?

Whilst the vast majority of couples do get pregnant in the timescales given above, some couples can find it difficult.  If this is something you are experiencing, we are happy to help.

Dr Sue Smith is a UK trained GP and based in IMC Camden. Contact: 6733 4440 or visit www.imc-healthcare.com to make an appointment.