Misconceptions of Preconception
By Leigh Lewis ND, L.Ac, Naturopathic Doctor
Are you hoping for pregnancy in 2018? If so, keep reading for information that may help you reach you goals. You may be surprised to learn that the conception rate for any one act of intercourse at the right time of the month, when the stars are aligned and without any fertility issues, is only about 25%. Yet, even knowing this, many couples expect to be able to conceive easily without much forethought or planning. This may be in part because we, especially as women, have spent most of our lives trying NOT to get pregnant. As such, it is not surprising that many couples are blindsided if they are not pregnant within the first several months of trying. However, there are a few simple things you can do to increases your chance for a timely & healthy pregnancy.
Preparation is Key: General Recommendations for All
Prenatal lifestyle & supplements: As with many goals in life, the path to a successful conception and a healthy pregnancy is planning. Lifestyle factors, including cigarette, alcohol & caffeine consumption, and marijuana and other recreational or prescription drug use in either partner can increase time to conception and increase risk of miscarriage & chronic health issues in children. Current research suggests that even if you have very regular and normal cycles starting a prenatal vitamin with adequate methylfolate several months prior to intended conception has numerous benefits in decreasing the risk of nutritional deficiencies, decreasing time to conception, preventing birth defects and decreasing risk of miscarriage as well as decreasing the risk of future autism spectrum disorders and other learning disabilities. While a prenatal helps correct nutritional deficiencies, some women may need additional vitamin D, B12 and iron depending on lab levels. These nutrients, if low, can interfere with one’s ability to get and maintain a healthy pregnancy. The omega 3 fatty acid derived from fish oil, DHA, has been found to benefit brain development and should also be part of the pre-conception plan. Finally, finding prenatal supplements that are well-tolerated prior to pregnancy can help avoid problems with consistency if nausea and vomiting are an issue early in pregnancy. A well-rounded multivitamin and mineral can also improve many aspects of sperm health when taken for at least 3 months prior to planned conception. First pregnancy and want to improve chances? Be sure to seek help on tracking ovulation and cycle via basal body temps or apps combined with timing intercourse (see resources below).
Pre-conception weight: Another recommendation that can decrease time to conception and increase probability of a healthy pregnancy is a normal weight. Being overweight or underweight can interfere with fertility by decreasing ovulatory cycles. Being overweight can also predispose to gestational diabetes and hypertension that can increase the risk of both conditions for mother and baby later in life. Normal weight has also been found to improve the success of fertility treatments like IVF. In short, it stands to reason that taking 3-6 months to address any weight issues can go a long way to improving health parameters for both mother and baby. Special diets or intense exercise can also cause some deficiencies that can be ruled-out with simple blood tests.
Contraception: It should be noted that it may take up to 12 months to re-establish normal ovulation and cycles after discontinuing hormonal contraception. That said, some women may be able to conceive the month after stopping contraception. The best course of action is to stop any hormonal contraception a year prior to intended conception, using non-hormonal forms (i.e. condoms) until conception is desired, to allow the body to re-set. This would also be a good time for both partners to start their respective supplements mentioned above. For those that are trying to avoid or delay pregnancy, remember prevention is the best medicine…there are several safe and effective forms of contraception to choose from. Finally, a word about lactation: While breastfeeding can help to space babies, it is not fool-proof and many women will return to fertility while breastfeeding, some even before regular menstruation resumes. For some women however, even breastfeeding infrequently can delay another conception. Please keep this in mind whether hoping for a pregnancy or to prevent one.
For those with fertility problems:
According to the CDC, American infertility statistics between 2011-2015 were as follows:
- 12.1% women aged 15-44 with impaired fertility
- 7.3 million women aged 15-44 who have ever used infertility services
While as many as 30% of couples never find the cause of their infertility, we do know several possible contributing factors that may play a role:
- Age: fertility rates within one year decrease & time to conception increases after 30 years of age
30s: 75% chance
At 40: 40% chance
By age 43: 1-2%
- Underweight, overweight and nutritional deficiencies (see above).
- Hormonal imbalances: thyroid disorders, endometriosis, polycystic ovarian syndrome, low estrogen and/or progesterone.
- Stress, anxiety, & depression: evolution may have set us up to delay conception at times of emotional stress
- Structural issues: blocked tubes from prior infections, uterine fibroids/polyps, adhesions or scarring from endometriosis or previous pelvic surgery
- Chronic illness such as autoimmune conditions
Infertility is diagnosed as no conception within 12 months of trying if under 35 years and 6 months if over 35 years. It helps to recognize the importance of these definitions as further lab testing, semen analysis, pelvic imaging and consultation may be recommended at this time.
Couples with any of the above issues should consider when they ideally would like to conceive and give themselves at least 6-12 months to get healthy by following the above general recommendations and seek guidance from a practitioner who specializes in women’s health and fertility to address specific issues in particular. The same could be said for women in between pregnancies in order to prep selves for a future conception as pregnancy, breastfeeding and caring for a growing family can take a toll on the body and mind.
If ovulatory, menstrual, or hormonal irregularities are suspected, addressing them by ruling out underlying factors is key. Research shows that acupuncture and specific herbal formulas and supplements may help normalize hormones and cycles, facilitate conception and improve the health and wellbeing during pregnancy and increase the success of conventional fertility treatments.
Fertility issues can be stressful, especially when combined with pre-existing insomnia, depression, or anxiety, and this can interfere with fertility and exacerbate emotional issues; truly a vicious cycle. However, there are safe ways to address these issues through meditation, yoga, acupuncture, herbs and supplements. In some cases medications may be the safest option with several studies showing that medications are preferable to “white-knuckling it” through depression and anxiety.
We here at ilumina are here to help you at any stage: from pre-conception and prenatal to postpartum and beyond, we offer diet & lifestyle counseling, mental health support, acupuncture, western & oriental herbs and supplements, massage and medications to address these issues. Please feel free to contact us today to get started on your pre-conception health & wellness plan.
1. Taking Control of Your Fertility
2. RESOLVE: The National Infertility Association
3. American Society for Reproductive Medicine (ASRM)
4. American Board of Oriental Reproductive Medicine (ABORM)
5. Clue: Menstrual/Fertility Tracker App