Trying to get pregnant

• There are many steps you can take to help you get pregnant.
• Most couples who try to get pregnant do so within 1 year.
• Talk to your provider about any questions you may have.

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You've thought carefully about having a baby and decided you're ready. You stopped smoking and drinking alcohol. You're eating healthy foods and taking a multivitamin with 400 micrograms of folic acid every day. You've visited your health care provider, and you're putting money in your savings account each month. You're ready to start trying to get pregnant.

How pregnancy happens
A woman's ovaries release an egg every month, about 14 days before the first day of her period. This is called ovulation. When a couple has sexual intercourse (and does not use birth control) around the time of ovulation, a man's sperm swim to meet the woman's egg. When a sperm penetrates the egg, it's called fertilization or conception. The fertilized egg (embryo) then travels to the woman's uterus (womb), where it burrows into the lining of the uterus and begins to grow.

A word about birth control
There are no rules about how long you should wait to start trying to get pregnant after stopping birth control. You can begin trying right away. But if you don't have regular periods, it may be more difficult to determine the right time for conception.

• If you've been on birth control pills, you may not have regular periods for a month or two after stopping the pills.
• If you take Depo-Provera, it can take from three months to one year to ovulate regularly after your last injection.
• If you have an IUD (intrauterine device) or implants, you can start trying to get pregnant as soon as you have the device removed.
• The barrier methods - such as condoms, diaphragms and spermicides - stop working as soon as you stop using them.

When is your body ready to get pregnant?
A woman's egg is fertile for only 12 to 24 hours after its release. A man's sperm can live up to 72 hours after intercourse. So the best time to have sex if you're trying to conceive is:

• A few days before ovulation
• The day of ovulation

The closer intercourse is to ovulation, the more likely it is you'll get pregnant. And the more often you have sex, the more likely you are to get pregnant.

Figuring out the best time to try to get pregnant

If your period is regular (it comes the same number of days apart every month): Use the March of Dimes ovulation calendar to help you figure out when you can get pregnant.

If your periods are irregular (the number of days apart varies from month to month): There are a number of fertility tracking methods that can help you determine when you're ovulating. They are listed below. It's important to talk to your health care provider to learn more about the most effective way to use them.

• The temperature method: Use a basal body thermometer to take your temperature every day before you get out of bed. Your temperature will rise by up to 1 degree just as you ovulate. Having intercourse as close as possible to this temperature rise improves your chances of getting pregnant.
• The cervical mucus method: Pay attention to the mucus in your vagina. It gets thinner, slippery, clearer and more plentiful just before ovulation.
• Ovulation prediction kit: Ovulation prediction kits test urine for a substance called luteinizing hormone (LH). This hormone increases each month during ovulation and causes the ovaries to release eggs. The kit will tell you if your LH is increasing. You can purchase ovulation prediction kits at pharmacies.

If you use the temperature or cervical mucus methods, begin tracking changes a few months before you want to conceive. If you're using an ovulation predictor kit, begin using it about 10 days after the start of your last period.

Signs of pregnancy
How will you know you're pregnant? Be sure to learn the signs of pregnancy.

When things don't go as planned
If you don't get pregnant right away, don't worry. Nearly 9 out of 10 couples who try to get pregnant do so within 1 year. It may not happen immediately, but the odds are it will happen soon.

If you've been trying to get pregnant for more than a year (or 6 months, if you're over 35 ), talk to your health care provider. You can get tests to find out why you're having problems getting pregnant. Some women have irregular or infrequent ovulation or damage to the tubes that carry the egg to the womb. Some men have low sperm counts or abnormal sperm. Many couples can overcome these problems with medical treatment.

Remember: It takes two to get pregnant!
If you're having trouble getting pregnant, your partner can do things to help his sperm production. He can:

• Quit smoking.
• Limit the amount of alcohol he drinks.
• Give up marijuana and other drugs.
• Wear boxers and loose pants instead of briefs and tight pants.
• Ask his provider about his prescription medications. Some medications used to treat high blood pressure, infections and other health conditions can make a man less fertile.

March 2007