How to Get Pregnant
How to increase your chances of pregnancy
If you are having difficulty getting pregnant, before you see an infertility specialist you want to make sure you are maximizing your chances of pregnancy. A number of things, from how and when you have sex to lifestyle practices you should or shouldn’t do, can affect pregnancy success. Keep in mind that trouble conceiving can be due to factors affecting both women and men.
How often should you have sexual intercourse?
- Studies have shown that intercourse at least twice a week increases the probability of pregnancy.
- Intercourse prior to ovulation is more likely to result in pregnancy than intercourse after ovulation. Try to anticipate when you think ovulation will occur and have intercourse before ovulation happens. See “Are You Ovulating?” below.
- Intercourse every one to two days at midcycle is ideal.
- Trying to have sex on a timetable can be stressful, so remember to still have sex for fun, not just to make a baby!
How should you have sex to get pregnant?
Having vaginal intercourse with male ejaculation is required for pregnancy. There are a lot of old wife’s tales about sexual position or actions after intercourse which may increase pregnancy rate, however, there is no evidence to this effect.
- Even though a woman’s orgasm can help transport the sperm, there is no evidence that an orgasm is linked to better chances of pregnancy.
- Some vaginal lubricants can negatively affect fertility because of their effect on sperm survival as studied in a lab:
o K-Y Brand Jelly, K-Y Brand Touch, Astroglide, olive oil and diluted saliva inhibit sperm motility.
o The American Society of Reproductive Medicine (ASRM) recommends using mineral oil, canola oil or hydroxyethylcellulose-based lubricants (Kama Sutra Premium, Astroglide Natural), if a lubricant is needed.
Are you ovulating?
For a woman to conceive she must ovulate (release an egg). A woman who has regular cycles occurring between 25 and 35 days on a regular basis is very likely ovulatory. Ovulation typically occurs about 2 weeks before the expected menstrual period. So for a typical 28-day cycle, ovulation is anticipated on days 13-15.
If cycles are irregular it is likely that you are not ovulating; further evaluation and treatment to help assure that ovulation occurs is indicated.
While methods of ovulation monitoring have become increasingly popular, there is NO EVIDENCE that ovulation monitoring during a cycle increases the chance of achieving pregnancy. Daily monitoring of the cycle can increase the stress associated with infertility.
Couples that have difficulty timing intercourse due to travel or other constraints may find monitoring ovulation to be of benefit.
Methods of ovulation monitoring include:
Luteinizing hormone (LH) level monitoring
These urine-analysis kits that are available over the counter show changes in LH levels. When these levels surge, ovulation usually happens within 12-36 hours.
• Testing should begin a few days prior to expected ovulation.
• Ovulation predictor kits are accurate over 80 percent of the time if done correctly.
• Ovulation predictor kits do not work for everyone and may be less reliable when using medication for ovulation, such as clomiphene citrate.
• While more expensive, there is no evidence that computerized devices are more accurate.
These apps monitor cycle length and calculate anticipated day of ovulation.
• Very convenient way to monitor cycle and calculate ovulation.
• They are no more accurate than counting out days on the calendar yourself.
Monitoring cervical mucus is an inexpensive way to track ovulation. However, this method has limited accuracy and is often difficult to interpret.
Basal body temperature (BBT) chart
BBT charting is a tool to track a woman’s body temperature, which may rise by 0.5 degrees after ovulation. This may help determine when ovulation has occurred.
However, many factors can effect a woman’s temperature, so BBT charting does not work well for all women. Because it detects ovulation after it has happened, it can only tell you if your timing of intercourse was appropriate after the fact. Therefore, for most practical purposes BBT charting is of limited benefit and can increase the level of stress associated with infertility.
What lifestyle practices affect fertility?
A healthy well-balanced diet, for men and women, is overall beneficial. There is little evidence that specific types of diets (vegetarian, low-fat, antioxidant) increase fertility for the general population. Patients with polycystic ovarian syndrome may benefit from a relatively low carbohydrate diet.
Take a folate-containing vitamin (0.4mg per day) when you are planning to start trying for a baby. This practice will reduce certain types of birth defects.
Maintain a healthy weight: Obese, overweight or underweight women definitely experience a decrease in fertility; obesity also negatively affects men’s sperm count and quality.
Reduce stress, which can interfere with ovulation.
Exercise moderately, as women who exercise too much may have suppressed ovulation. What constitutes moderate exercise can vary considerably according to the individual, but a good rule of thumb is to limit exercise to intensive cardio workouts no longer than 45 minutes, five times per week. Moderate levels of exercise may help with stress reduction.
Immunizations should be up to date prior to trying for pregnancy.
Smoking has a negative impact on fertility in women, altering estrogen levels and impairing ovulation; tobacco use in males (either chewing or smoking) may have a negative impact on sperm function.
Alcohol’s effect on female fertility has not been clearly determined. Alcohol intake is associated with birth defects, so should be avoided if there is any chance of pregnancy.
Caffeine consumption at high levels (more than four cups of coffee daily) may negatively impact female fertility and increase the risk of miscarriage. This association has not been seen with lower levels of caffeine.
Medications often are associated with increased risk of birth defects. Always check the safety of all of your medications, including over the counter medications, if you are trying to conceive.