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Fertility

It seems so simple: you stop with contraception, have sex and wait. But, there is more you can do to become pregnant, especially to have a healthy pregnancy. In the last few years it has become clear that the health and lifestyle of both men and women are of influence on the development of a pregnancy and the baby.

Conceiving

When trying to conceive it is good to know what days you are most fertile. By looking at your periods you can figure this out.

In most women the length of a menstrual cycle is between 21 and 35 days, counting from the first day of your period to the first day of your next period. The most ideal length is 28 days, which happens in 15 % of women.

In a cycle of 28 days the ovulation (the egg leaves the ovary) often happens on the 14th day. In a cycle that is longer the ovulation happens later. You are most fertile in the 3 days before the ovulation and the first day after ovulation. To become pregnant it is not necessary to have an extreme amount of sex during this time. Roughly every 2 – 3 days should be sufficient as male sperm can survive for a few days.


Healthy lifestyle

The time just before your pregnancy and the first few months of your pregnancy are of more influence on the health of your pregnancy and your baby then we previously thought. Your medical health and lifestyle of both you and your partner are very important.

  • Folic acid: Taking a folic acid supplement (Vit B11) lowers the chance of a baby born with neural tube defects or spina bifida. It is recommended that all women planning a pregnancy should start taking a folic acid supplement daily of at least 400 micrograms. When on contraception start taking folic acid four weeks before stopping the contraception so that the amount of folic acid in your body is sufficient. Women who have an increased risk of conceiving a child with neural tube defects require a higher dose of folic acid: 5mg, daily. Folic acid should ideally be taken for at least four weeks prior to conception and continued for the first 12 weeks of pregnancy. Women with an increased risk for conceiving a baby with spina bifida include those who:
    • are affected by neural tube defects themselves, or have a family history of neural tube defects (including the partner and the partner’s family)
    • Have previously had a pregnancy affected by neural tube defects.
    • Have a BMI > 30
    • Have diabetes mellitus
    • Have coeliac disease (or other risk of malabsorption)
    • Are taking medicines known to affect folic acid metabolism e.g. anticonvulsants.
  • Alcohol: People may think that one glass of alcohol now and then won’t do any harm to your baby. In fact study has shown that the amount of alcohol causing damage to your baby is unknown. For this reason it is best to stop drinking alcohol when trying to become pregnant, during pregnancy and breastfeeding. This increases the chance of a healthy pregnancy and baby. Alcohol consumption around the time of conception by either the woman or her partner does increase the chance of spontaneous miscarriage.
  • Smoking: Quitting smoking is one of the most important things a woman can do. But not just the woman. Also other household and family/whanau members should quit, as second hand smoke is harmful to a developing pregnancy, the infant and post partum smoking relapse is more common for women who live in a household where other people smoke. Smoking habits of either you or your partner also affects fertility chances. If you want to conceive and you struggle to quit smoking then we advice to contact your health care professional for smoking cessation advice.
  • BMI and exercise: The optimal pre-pregnancy body mass index (BMI) is 20-25 kg/m2. Falling outside this range, being over- or underweight, can affect the chance of becoming pregnant but also can result in adverse pregnancy outcomes. Studies have shown that overweight and obese women have an increased risk of high blood pressure issues and diabetes during pregnancy, and underweight women have an increased risk of pre- term delivery. For this reason it is recommended weight loss or gain to attain a healthy pregnancy weight as appropriate. Before becoming pregnant try to eat healthy and to exercise regularly.