Fix This Before You Start Trying To Get Pregnant

This week, let’s talk about basic health parameters, or measurable issues, that it is best to normalize or improve before trying for a pregnancy. This is vital for both sperm and egg, so it is best if both parties involved in the conception participate. This is still within the 4-6 month preconception window and this is where an ND is an excellent addition to your healthcare team.

Lifestyle Choices That Matter Before You Try To Conceive

Lifestyle factors can change the length of time it takes to have a successful pregnancy and modifying these factors may enhance fertility. The recommendations below are based upon data from observational studies; no randomized trials have been performed.

1. Exercise: Exercise in a way that helps keep you in a healthy weight range. A body mass index (BMI) greater than 27 kg/m2 or less than 17 kg/m2 is associated with an increased risk of anovulatory infertility. Being outside of a healthy weight range changes how likely your body is to release a healthy egg each month. Also, even outside of weight change, exercise improves circulation to reproductive organs, improves hormone balance, and helps to improve blood sugars so it is a win on every level.

2. Limit Caffeine Intake: Women contemplating pregnancy should limit caffeine intake to no more than one or two cups of coffee per day (total of 200 mg caffeine).  Also be sure to check other sources of caffeine like tea, chocolate, and over the counter or prescription pain medications. Caffeine affects sperm quality as well and has been linked to higher incidence of genetic differences in sperm as well as longer time to pregnancy, which translates to reduced fertility.

3. Quit Smoking: Tobacco smoking cessation for couples who smoke makes a big difference in ease of conception and health of the pregnancy overall. Use of tobacco by the female partner, and possibly the male partner, appears to be associated with subfertility. For couples planning pregnancy, observational studies suggest fertility is enhanced when use of tobacco products is terminated. 

4. Avoid Alcohol: Moderate and heavy female drinkers tend to take longer to achieve a pregnancy and are at higher risk of undergoing an infertility evaluation. If women are getting infertility evaluations it is typically only because they have been trying, but not conceiving or carrying a baby. We suggest that women who are attempting to conceive avoid all alcohol, given a safe level of prenatal alcohol consumption with respect to the fetus has not been determined 

Blood Tests That Should Be Normal Before Trying To Conceive

There are some simple lab tests that can be performed easily by your doctor that can show you areas of weakness or compromise in your body, especially when it comes to building or contributing to a healthy baby.

1. Blood sugars: Insulin resistance, which is also called pre-diabetes, or metabolic syndrome, can reduce egg quality and make it more difficult to get pregnant even outside of fertility issues related to blood sugar like PCOS. Correcting your blood sugar in the 4-6 months before conception can really improve your chances and give your baby the best possible start. This means work on a low glycemic index diet, cut out sodas, sugary drinks, and artificial sweeteners. We will have a whole episode on a good fertility diet later in the season.  Metabolic syndrome is also linked to sperm dysfunction in men.

2. Iron levels: Mild iron deficiency anemia is something a lot of women just live with or accept as normal, especially if they have heavy periods.  When you’re working on fertility, it is really important to bring iron levels to normal including red blood cell levels, but also ferritin, which is your storage form of iron. See the quote below.

3. Blood pressure: Hypertension, or high blood pressure, is a rising issue in our society.  Hypertension has been shown to affect erectile function, sperm quality,  and semen volume in men. In women, high blood pressure affects sexual function, as well as maternal and fetal morbidity and mortality, meaning disease and death.

4. Thyroid function: We will devote an entire episode on this later in the season, but, thyroid function is generally simple to normalize and low thyroid levels have been linked to early pregnancy loss in women. In men, thyroid disorders have been linked to changes in sperm morphology and motility.

5. Your Genes: This is not a test your doctor will run, but if you have or suspect you have an MTHFR polymorphism, it helps to find out before you're trying to conceive so that you can take the appropriate type of folate for you and balance your methylation before a pregnancy. MTHFR has been linked to repeat miscarriages in women and lower reproductive success in men as well. The best way to test is to run your DNA with a service like 23andme or ancestry, then download your raw data and use the "Methylation Panel" service at geneticgenie.org.

Other Helpful Information When You're Trying To Get Pregnant

1. Age matters: Couples should be informed that delayed childbearing, especially after age 30 years, which many of us do, can decrease the probability of successful conception, and they should take this into account in family and career planning. 

2. Have lots of sex: Enjoy sexual intercourse two to three times per week from soon after cessation of menses through the day of ovulation to ensure that intercourse falls within the most fertile period, which can occur up to two days before ovulation, and semen quality is optimal.

3. Keep track: Start charting your menstrual cycles to pinpoint if and when you are ovulating

4. Both partners should take preconception supplements: We will discuss those next week. Bear in mind that you might need different supplements with different genetic polymorphisms, including MTHFR, PEMT, and MTRR.