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5 Things Your Gynecologist Wants You To Know: Getting Pregnant

hey guys welcome back mama dr. Jones

OBGYN and mom - for today we're going

through optimizing your natural

fertility this is meant to be an

evidence-based getting started guide for

anyone who is considering or in the

early stages of trying to get pregnant

we're going through what to expect some

diet and lifestyle considerations

including alcohol tobacco caffeine

specific sex practices physicians and

lubricants and also touching very

briefly on when in your cycle you're

actually able to get pregnant if you

follow me on instagram you know that my

eye on this side looks crazy because I

had an incident with hydrogen peroxide

contact disinfectant hot lava melting my

eyeball out of the socket public service

announcement don't accidentally put

hydrogen peroxide into your eyeball as

always this is meant to be

evidence-based information for you but

it is not meant to be specific medical

advice for you before trying to get

pregnant I would highly encourage all of

you to make a preconception visit with

your doctor and talk to them about your

health history and

underlying health conditions as well as

any advice that they have on trying to

conceive it can be normal to try for up

to 12 months before pregnancy happens

but about 80% of people will be pregnant

in the first six months so when do you

make an appointment and come in and see

me as long as you are young healthy and

relatively normal cycles and you can try

for about a year and that should be fine

if those things don't apply it then come

in sooner if you're not having regular

cycles if you're over the age of 35 or

if you have any underlying health

conditions that make us think that you

may have trouble getting pregnant

I also encourage patients to use the

first six months to try rather

spontaneously

don't get too wrapped up and cycle

charting and ovulation prediction and

things like this and the first six

months if you've been trying for six

months and it hasn't happened and you

want to make an appointment and come in

talked about how to track your cycles

how to identify ovulation when your

fertile window is things like that great

I just know I probably am going to tell

you we should hold off on extensive work

up until you're about a year into trying

unless there are one of those other

things going on let's talk about before

you're actively trying to get pregnant

what should you do the first thing I

always encourage people is if you think

you may

try to get pregnant sometime in the near

future you should go ahead and start

taking a prenatal vitamin the most

common question I get when I tell people

that is which one I'm not really brand

loyal to any type of vitamin the most

important thing with a prenatal vitamin

is that it needs to contain fully what

is fully folate or folic acid those are

sometimes used interchangeably is

vitamin b9 and this is an important

supplement because supplementing this in

your diet prior to conceiving decreases

the risk of a neural tube defect like

spina bifida or anencephaly late

supplementation in foods and prenatal

vitamins has decreased the risk of

neural tube defects in the United States

by about 35 percent that's huge

while the bran doesn't matter I do want

you to look at the back of the bottle

and make sure that it has at least 400

micrograms of L methyl Foley and the

reason is because some prenatal vitamins

contain synthetic folic acid and

although a lot of people can break that

down into the type that your body needs

maybe up to 60% of people have trouble

breaking that down I want you to get the

one that has L methyl Foley

another great ingredient I believe is

DHA which helps with the brain

development of fetus most vitamins other

than those two ingredients are pretty

similar some people get really nauseous

taking prenatal vitamins if you're one

of those people sometimes taking the

iron out of that will help if you get a

prenatal vitamin that doesn't have iron

in it which is usually the gummy

prenatal vitamins that's fine unless we

find on your prenatal labs that you're

anemic and then we'll have to add the

iron back in if you can tolerate a

prenatal vitamin that has iron in it

that's great too

second thing that's really good if you

are thinking about trying to get

pregnant but you're not quite ready to

start trying yet is to optimize your

weight and diet this doesn't mean you

have to be at a perfect weight before

you're allowed to start trying to get

pregnant we do know that people who are

underweight and people who are obese

both have trouble conceiving at higher

rates so if you have time before you're

ready to actively start trying to

conceive to optimize your weight that's

a great time to do it the more you can

do to get into a healthy routine for

diet exercise and weight prior to

getting pregnant the better off you're

going to be both for trying to conceive

and for having a healthy pregnancy I

want to reiterate this does not mean

you're not allowed to try to get

pregnant until

you're at the perfect weight I don't

think that that's the case but if you

have time before you're trying to

conceive it is a great time to really

think about weight loss or weight gain

if that's something that you need to

focus on so let's talk a little bit

about how you know when you can even get

pregnant what point in your cycle are

you actually fertile this is going to

vary for everybody but in general we

consider the day of ovulation and the

five days preceding it to be the Fertile

window or the maximum fertility time in

a cycle why an OSI or the egg once it

all eights has a very short life span

they only live about 12 hours maybe even

less if they don't get fertilized but

sperm are like cockroaches they don't

die they can just live in the fallopian

tubes for days the five days before is

because the sperm can live in the

fallopian tubes for that long and then

when you ovulate they can be there the

highest fertility time is going to be

about two days before ovulation if

you're not cycle tracking and you don't

know exactly when you ovulate where can

you kind of best guess this to be for

most people who have average cycle

length so 28 to 35 days between your

periods that's from the first day of

your period to the next first day of

your period is about 28 to 35 days

starting to have sex every day or every

other day and we'll talk about that in a

minute as well a day your period ends

and continuing that for about 10 to 12

days usually will land you somewhere in

that fertile window that's not specific

but for most people who are kind of at

the beginning stages of trying to get

pregnant that's kind of a good timeline

to follow what is the best position to

optimize your chances of getting

pregnant there's not one as long as

you're having consensual intercourse

that involves penis in vagina your

chances of pregnancy are the same

regardless of position should you lay

with your legs in the air after sex to

increase the chances that the sperm gets

the egg no sperm can be found in the

cervical canal within seconds of

ejaculation and can be found in the

fallopian tubes within minutes position

of you or your legs after intercourse

doesn't change that at all how often

should you be having sex this is one of

the most common things I hear told to

people incorrectly that's that you have

to do every other day or the sperm

counts decrease that's not really

science-based

and actually we see increasing chances

of conception with increasing frequency

of intercourse

up-to-date it's not significantly

different between daily and every other

day I'm more spaced out it is after that

the lower your chances each month of

getting pregnant that doesn't mean you

guys need to be having sex every day or

every other day it just means it should

be up to you whatever feels right

especially in those first six months

don't take all the fun out of trying to

make a baby by trying to make a baby

let's talk about lubricant some of the

over-the-counter lubricants that people

frequently use which are great to use

when you're not trying to get pregnant

like a sure glide and KY jelly because

they don't interfere with condom

effectiveness can potentially interfere

with how efficiently sperm can move in

the lab using this types of lubricant on

sperm decreases their motility and makes

them die faster I do generally encourage

people to switch to a different type of

lubricant so which ones are okay

anything that is hydroxy ethyl

cellulose-based is going to be okay so

that would be marketed as like precede

and also things like canola oil or

mineral oil are just fine

these lubricants are not fine if you're

trying to avoid pregnancy because they

do decrease effectiveness of condoms so

don't use canola oil or mineral or oil

with your condom but if you're trying to

get pregnant those are probably better

than things like Astroglide and KY jelly

their sperm friendly let's move on to

diet and lifestyle there are no specific

diets that are more or less likely to

help you get pregnant so just a healthy

varied diet everything in moderation is

probably the best way you can go if

you're vegetarian that's fine if you're

already on a certain type of diet it's

probably fine to continue as long as

your nutritional status is optimized

there's also no evidence that herbal

supplements or antioxidants things like

that improve your chances of conceiving

what we do know though is that people

who eat a lot of seafood enough that

their blood mercury levels are higher do

have a harder time getting pregnant just

a limited amount of time mercury fish is

probably a good idea and is something

that we would encourage you to continue

doing through the pregnancy as well

smoking we definitely know that there is

an association with trouble getting

pregnant and miscarriage and people who

smoke tobacco this includes vaping and a

cigarettes we think that the method is

something to do with oxidative stress to

the oocytes which are the eggs in the

ovary and to gammy as well as

potentially damage to the fallopian

tubes or maybe even cervical mucus we

definitely see an association between

people who smoke and how much they smoke

and their risk of infertility and their

risk of miscarriage if you're currently

smoking I would highly encourage you to

cut back and work on quitting prior to

trying to get pregnant alcohol this is a

confusing one because you always hear

people say that it's bad when you're

trying to get pregnant to drink alcohol

studies aren't really there to strongly

support that it seems like alcohol and

moderation meaning one or two drinks a

day or less is not associated with an

increased risk of difficulty getting

pregnant after that Ms period after that

positive pregnancy test it definitely

shouldn't continue to drink but before

you're pregnant when you're just trying

to conceive it's probably not overtly

harmful to continue having an occasional

drink during that time what about

caffeine we know that caffeine in high

amounts is associated with trouble

getting pregnant high amounts would be

like over five cups of coffee a day we

also know that caffeine over 250

milligrams a day is associated with an

increased risk of miscarriage but I

encourage all of my patients if you're

trying to get pregnant and especially if

you're already pregnant to cut back to

only a moderate amount of caffeine one

or two cups of coffee a day should be

totally fine but try not to do a lot

more than that I hope this was helpful

guys if you have any questions leave

them down below if you haven't watched

last week's video about PCOS you can

watch it right over here and don't

forget to come back next Monday for a

new video the kinds it's yourself to

each other to me in the comments be kind

and I will see you next time

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