When to start trying to get pregnant
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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