How To Get Pregnant

 

Millions do it every month.  Almost half of all pregnancies are not even planned. Should be easy, shouldn’t it ? All you do is have sex and , err, that’s it.  It happens!?

The reality , however, is somewhat different.

On average , from starting to actually plan a baby, to conception, takes about six months.  So for some , it takes only two and a half minutes, and for others it may take several years.  Even under optimum circumstances, with a fertile woman and a fertile man, having regular intercourse, there is only approximately, a one in three chance of a successful pregnancy.

The reasons for this are uncertain , but it appears that some couples may be achieving successful conception, but implantation may not occur, because of subtle immunological features in the lining of the womb, that prevent anything but a perfect embryo from implanting.

Others may ” conceive ” relatively easily , and even have an early positive test but then go on to miscarry, with what may appear to the woman as a late and heavy period.

The time taken to conceive will vary according to age and opportunity.  Fertility is at its maximum between 15 and 35 years of age, and then there is a slow and gradual decline until 45 , when the chances of conception fall to low single figures.  Sadly, there is a corresponding increase of miscarriage from approximately 20% in younger women , to more like 50 % in the mid forties.

I want to get pregnant, what should I be doing?

Well , first and foremost, it’s best to plan ahead.

  • Get fit, look at your weight, and look at your life style.
  • Avoid drugs, take folic acid, and don’t binge drink when you are in the second half of your cycle.
  • Think about your general health, and the health of your immediate family.  If you have any significant past or current health problems , then do seek advice from your GP.  The same applies , if you have had previous complicated pregnancies or if there are any possible genetic problems in your families.
  • Ideally, your body mass index (BMI) should be between 19 and 25.  This is important, as fertility is often reduced in women who are underweight or overweight.
  • Taking folic acid is important, not only in early pregnancy, but also for the 3 months before conception, as it will reduce the incidence of spina bifida and other  abnormalities.  There are several “over the counter ” folic acid preparations that are easy and safe to take.  You can take a simple folic acid pill or a Pregnancy multi-vitamin containing folic acid.
  • Special diets are not needed, unless you have a proven deficiency or a recognised absorption problem.  There is no substitute for a good balanced diet. And the same goes for during pregnancy.

 

What about sex?

Let’s spell it out, because we have come across a couple where the man was putting his penis in the girls’ belly button.  It means penetrating vaginal intercourse with ejaculation into the vagina.  Sadly, not every couple can manage that.  Some men have erectile problems and some have premature ejaculation , or other more complicated problems that make successful vaginal sex difficult or impossible.  Also some women are unable to have vaginal sex for either physical of psychological reasons.  Approximately 1 in 20 couples may experience significant problems with intercourse, and early and sensitive help can be expected from your GP.

 

How often and when?

For most women, ovulation takes place approximately half way through the menstrual cycle.  So, if you menstruate every 28 days, then you can expect to ovulate approximately, on or around day 14 (assuming first day of period is day 1).  If you have a 5 week or 35 day cycle then you will ovulate a week later ( ie. day 21 approx).  If you have a 21 day cycle you will be most fertile on day 7 , very soon after your period.

Many, but not all women, are aware of ovulation.  The most reliable sign is that of extra clear and stretchy vaginal mucous or discharge.  “Like the white of an egg “, is a good description.  Some women notice a dull discomfort low down in the tummy on one side or another for a day or two.  And , no , the two ovaries do not take it in turns to perform.  It is totally random.

Other ways of detecting ovulation , which are very accurate, are urine testing kits , which you can buy from most chemists. Taking your temperature is not so reliable . A word of warning! There is a risk that getting obsessed about timing will upset and interfere with your sex life and take away some of the fun and spontaneity .

The evidence suggests that, with a normal couple, there is no need to have sex every night during the possible fertile period.  Healthy sperm, with good quality mucous may survive for 24-  48 hrs, so all that is required for most couples is “a normal sex life”, whatever that is!  Maybe 3 times a week for most young couples.  Very often, pregnancy occurs when you are least expecting it, and when you were just having sex because you felt like it, rather than, because it was on the calendar, or in the diary .  So girls , do be a little subtle.  It’s no good ” booking”  him for next Tuesday.  He might have a headache!

However , it does help to be in the same country and preferably the same town.  A facetious comment perhaps, but some high flying couples have difficulty in conceiving as they simply cannot find the time for sex.

And yes, you can get pregnant standing up.  And you do not have to lie down for half an hour with your knees behind your ears!

If nothing has happened after a year of trying, then do seek advice.  Maybe a little earlier  if you are older or if there are known possible medical problems. But sometimes it just takes a little longer than you expected , so try to be patient.

 

Some “Do Nots”

Here are some things that we think you should try and avoid doing whilst you are trying to get pregnant.  We are very aware that many of these may be easier said than done, but we hope that they help.

  • Do not panic if it doesn’t happen in the first three months.  Most couples expect success very quickly, especially if they have been carefully using contraception for months or years.  But good things take time.
  • Do not get obsessed with the plan.  Menstrual calendars with key dates circled are generally not a good idea.  
  • Try and avoid stress.  It may actually delay things happening.  Easy to say, but hard to achieve.
  • Do not tell the whole world about your plans, or this will just add to your stress.  Family, friends and work colleagues simply do not need to know.
  • Do not go over the top with the sex thing.  Sex every day can , in some couples, be counterproductive, as sometimes sperm counts are better after a days abstinence!
  • Do not despair if nothing has happened after a year.  Expert help is available, with a large variety of often simple and safe techniques to assist conception.  The science and success rates with assisted conception are improving all the time.  In many cases, IVF success rates are astonishingly high and may be similar, or sometimes even better than those occurring naturally.
  • However, IVF  techniques are not without some extra risk to both mother and baby (compared with natural conceptions).  Interestingly, approximately one in ten couples get pregnant naturally while waiting for treatment. Further evidence that stress can often play a negative role when trying for a baby.
  • Do not experiment with extreme diets or unusual vitamin and trace elements. There is no evidence that lots of extra vitamins, zinc and selenium will assist conception.
  • Do not get suckered into any new and ” revolutionary ” technique ,” guaranteed” to get you  pregnant.  If it sounds unlikely, it almost definitely is.  Please remember that you may be particularly receptive to ideas that previously might have sounded outrageous but now may seem worth trying. There are literally hundreds of people out there ready to take advantage of couples desperate to try any trick that might work.

NHS guidelines