As with all posts, you should always consult your personal health care provider. This is meant to provide information, never as your own medical advice or treatment recommendations.
It’s kind of crazy that a lot of us spend so much of our lives worrying about NOT getting pregnant and then you go straight from that to worrying about getting pregnant. This, like many issues addressed here, can be influenced by many personal health issues and some things may not apply to you, but here’s an overview.
So you think you want to get pregnant…
Number 1: Start a prenatal vitamin. *Ideally* you’re already taking one if you are of childbearing age (aka teens through 40s). If not, start NOW. You should be on a prenatal vitamin at least 3 months, and ideally 1 year before you conceive. What if you’re already trying to conceive? Start now. Better today than next week. Just, the sooner the better.
Which prenatal vitamin is right for me? There are lots of brands, gummy options, drinkable options, etc… to choose from. Find one that you can tolerate taking. The basics it needs to have are 400-1000mcg of folate, 27mg iron, 1000 units vitamin D, and 100mcg iodine. If your diet does not have a lot of healthy omega oils, also get a 1000mg daily DHA/EPA supplement. I personally have used Honest Company Prenatal and DHA or Ritual Prenatal. Both are available with convenient subscription option so you don’t run out.
Talk to your health care provider about any medications you’re taking and if they are safe while trying to conceive. Make sure any chronic health issues such as thyroid problems, diabetes, or high blood pressure have been checked and are in good control. Plan ahead for these!
When to get off birth control…
This depends a little on what you were using. You CAN get pregnant the month (or week) you stop any form of birth control. So don’t stop using anything unless you are A-OK with being pregnant right away. That being said, hormonal birth control is more likely to have a “wash-out” period where you don’t ovulate regularly and are less likely to conceive. DepoProvera, oral pills (especially if you’re skipping periods), the patch, the nuva-ring and Nexplanon/Implanon all have a 3-6 month expected wash-out. I have seen it take up to a year with Depo. IUDs are less likely to have wash-out, but we wouldn’t be surprised if it took 3 months or so.
So, let’s say you want to get pregnant “sometime in 2021”. Easy. Go off birth control after you have that New Year’s blow-out party. What if you have a more specific window? You can plan to go off birth control 3-6 months in advance of that window, but use condoms to prevent pregnancy until then. Know that condoms are only 85% effective at best and you could still get pregnant earlier than you think. So, if, for example it would be devastating to get pregnant in February (calculate due date from theoretical conception date out here), don’t stop birth control until after that.
How to get pregnant….
SO, um, there are of course some basics here I’m assuming everyone knows about human reproduction. If you’re confused on the what goes where, may I refer you back to wikipedia under “birds and bees”. If you’re not in a relationship where sperm is readily available or you can’t have intercourse for any reason – see a fertility specialist about how to get that all going.
If those exceptions above don’t apply to you… the most reliable way to get pregnant is also the simplest. Have unprotected intercourse every other day from right after your bleeding stops until you start bleeding again. Every. Other. Day. Not every 3 days. Not twice a day (but good for you if this is your issue!). This gives you optimal semen volume and you will never miss your fertile window because it lasts 2-4 days. Boom.
Now we get to the people who are absolutely opposed to having sex every other day. For some couples, that’s not sustainable over the several months it can take to get pregnant. That’s totally fine! If that’s the case, I usually recommend the Glow Ovulation, Period Tracker App or Natural Cycles App. Glow lets you track cervical mucus, basal body temperature, ovulation sticks and pregnancy tests, sexy time and everything else about your cycle (for recommended products to do those things, click links). Take at least 1 month to track everything while still using condoms so you get some understanding of your cycle.
Then, go for that fertile window! Again, sex every other day or daily. What kind of sex? Pretty much whatever. Position doesn’t matter. Ideally, the person trying to conceive should have an orgasm during or after because theory goes that the contraction of the vagina and uterus helps propel the sperm through (though there isn’t super strong evidence that this is necessary, it has little down side!). And if you’re gonna use lube, use this lubricant. Chill out for 5-10 minutes after sperm gets in there then go about your business.
Did you say cervical mucus? Sounds so gross, but is actually the easiest way to check if you are fertile. Just look at the TP after you wipe when you go pee. When you’re approaching fertility and fertile, you’ll notice a clear discharge like egg white. When this is super gooey/stretchy – that’s peak fertility. More nitty gritty details here.
How long is this going to take?
If you’re under age 35 it is normal to take up to 1 year to get pregnant depending on your health and the health of your partner. Most couples will get pregnant within 3-6 months. If you’re over 35, the timing gets a little more pressured because fertility starts to decline significantly around age 37. In this case, we would usually only give you 6 months or less before further testing. If you’ve already been trying to conceive for that long – go see your doc.
Final note: Don’t sabotage your efforts.
If you’re in the exciting phase of normal/natural ‘trying to conceive’, don’t do things that are going to stress you out and make it harder or threaten an early pregnancy. Ask your health care provider if any medications you’re taking are safe. Don’t go binge drinking. Don’t smoke marijuana. Don’t smoke anything for that matter. Avoid household toxins. Have your sperm provider avoid hot-tubs, tight underwear and long bike rides. Eat lots of healthy fruits and vegetables and proteins and fats (first trimester is ROUGH ya’ll, you will need those nutrients stocked up). Exercise regularly but gently – ideal fertile BMI is 20-25, the upper end of normal. Avoid over the counter medicines other than tylenol and tums without asking your healthcare provider. And… enjoy the ride!
Dr. Annie is a family physician and married mom of 2 in the Sacramento Area.