Planning for pregnancy is a significant milestone in the life of any individual, often marked by anticipation, excitement, and a multitude of questions. This article aims to provide comprehensive advice and guidance for couples embarking on the journey of conception and pregnancy planning. From optimising fertility to ensuring a healthy pregnancy, careful planning and preparation can enhance the chances of a successful and fulfilling pregnancy journey.
Understanding the Menstrual Cycle: A woman’s reproductive system comprises a uterus, two fallopian tubes and two ovaries located in the pelvis. These organs are under the control of the brain and the pituitary gland. The length of one menstrual cycle is usually 28-30 days. With the hormonal stimulation from the pituitary gland, one egg ovulates every month in the mid-cycle. Once ovulated, the egg remains viable for a day, before which should be fertilised by the sperm. The fertilised egg then grows into an embryo, which gradually moves into the uterus and implants in the uterine lining after 4-5 days. Since the egg is very shortlived, couples should have intercourse in mid-cycle at the time of ovulation. This is called the fertile period. The recommended frequency of intercourse is every 2-3 days in that period. If your cycles are irregular, then it indicates either no or delayed ovulation. An earlier consultation with a fertility specialist is advisable.
Healthy Lifestyle Habits: Maintaining a healthy lifestyle can greatly enhance your fertility. Eating a balanced diet, exercising regularly, maintaining a normal weight for your height, avoiding smoking and recreational drugs and limiting alcohol intake can help a woman conceive easily and enjoy a healthy pregnancy.
Timing Intercourse: Couples are advised to time intercourse during the woman's fertile window, typically around ovulation, to increase the likelihood of conception. The recommended frequency is once every 2 to 3 days.
Tracking Ovulation: There are various methods for tracking ovulation, including basal body temperature charting, ovulation predictor kits, and monitoring cervical mucus changes. If you have a regular cycle, you are likely to ovulate 12-14 days prior to your expected period. Urine LH kits or ovulation predictor kits help track the LH surge, which usually happens one day before ovulation. This home test kit is an easy, sensitive and accurate method to predict the day of ovulation. LH is a hormone produced by the pituitary gland. Initially, in the early part of the cycle, the levels are low, but the level suddenly surges close to mid-cycle and this LH surge results in ovulation after one day. Testing must begin on day 10 of the cycle, 4 days prior to expected ovulation and be performed daily till a positive result is obtained. Once the test is positive, you are likely to ovulate the following day and can plan intercourse accordingly.
Some women experience mild cramping pain on the day of ovulation.
Change in cervical mucus is another simple way to detect ovulation. Women experience an increased quantity of egg white type of watery discharge 1 day prior to ovulation. The loosening of the cervical mucus is likely to be receptive to sperm penetration.
Basal body temperature – Post ovulation, the release of hormone progesterone results in the rise their basal body temperature by 0.5-1 deg F. Women are advised to measure their basal body temperature daily when they wake up in the morning before initiating activity. A rise in the temperature is a retrospective indicator of ovulation the previous day.
Preconception Health
Preconception health refers to your health before conception. Optimising your health before conception can enhance your chances of conception, prevent complications in pregnancy and increase the chances of a healthy baby. One should start preparation and focusing on one’s health three months before you start trying to conceive. It is essential to correct the same prior to conception as the major fetal organs develop by 8 weeks of pregnancy.
Preconception Check- up: Both partners should undergo a preconception check-up with their healthcare provider to ensure good health and that the body is ready for pregnancy. It gives an opportunity for the doctor to assess your overall health, address any underlying medical conditions, and optimise health before conception.
Prenatal Vitamins: Folic acid is an essential vitamin that is required for healthy growth and development of all body cells. A deficiency of this vital vitamin in our diet can result in birth defects, especially in the brain and spine (neural tube defects). It is recommended to initiate intake of prenatal vitamins containing folic acid at least one month before attempting to conceive to reduce the risk of birth defects. This should be continued till the end of the first trimester of pregnancy.
Vaccinations: To ensure that both partners are up-to-date on vaccinations, including rubella and varicella, as certain infections can pose risks to the fetus during pregnancy.
Managing Pre-existing Conditions
Uncontrolled pre-existing medical conditions, such as diabetes, high blood pressure, thyroid disorders, etc. can have a detrimental impact on the mother and the fetus. To ensure a safe pregnancy and a healthy baby, it is essential to control them before conception.
Chronic Medical Conditions: You must consult your physician to obtain guidance for managing pre-existing medical conditions such as diabetes, hypertension, thyroid disorders, asthma, etc. to optimise health before conception and reduce pregnancy-related complications. Many drugs are harmful to the fetus and must be avoided during pregnancy. A consultation with the physician before conception will ensure switching to pregnancy-safe medications.
Genetic Counseling: Some families have inherited genetic diseases afflicting few family members. Genetic counselling should be considered for couples with a family history of genetic disorders or chromosomal abnormalities prior to conception to assess the risk to future offspring and explore options for prenatal screening or testing. In cases of known genetic disorders, relevant mutations are identified in the couple, and fetal testing can be performed at the end of the first trimester to understand whether the fetus is affected by the index illness.
Environmental and Occupational Exposures
Environmental Toxins: Exposure to high ambient temperature, synthetic insecticides and pesticides, harmful chemicals, environmental pollutants and radiation may have an impact on the health of egg, sperm or the growing embryo; and hence impact fertility. It is useful to discuss the same with your fertility specialist prior to conception and educate yourself about protective strategies to minimise exposure.
Occupational Hazards: Assess workplace exposures to chemicals, radiation, or infectious agents that may pose risks during pregnancy and obtain advice on appropriate precautions or modifications.
Emotional and Psychological Preparation
Support Systems: Couples are encouraged to establish strong support systems, including partners, family members, friends, and healthcare providers, to navigate the emotional and psychological aspects of conception and pregnancy planning.
Coping Strategies: The journey of conception and pregnancy planning is often fraught with stress, anxiety and emotional ups and downs. Coping strategies such as open and supportive communication, mindfulness and relaxation techniques may be utilised to smoothen the journey. Please don’t hesitate to see our in house psychologist for expert guidance.
Conceiving and planning for pregnancy is a multifaceted journey that requires careful consideration, preparation, and support. By optimising fertility, addressing preconception health, managing pre-existing conditions, minimising environmental exposures, and attending to emotional well-being, couples can enhance their chances of achieving a healthy and successful pregnancy. Through collaboration with healthcare providers and proactive engagement in their own care, couples can embark on this journey with confidence and optimism for the future.
Want to consult the best gynecologists in India? Please find the links below.
