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Preparing for pregnancy

It always seems a bit bizarre when most of adulthood is spent trying to avoid an unplanned pregnancy, that when caution is thrown to the wind, it doesn’t always automatically result in instant conception!

For most couples pregnancy does come along within 12 months, and hopefully with some good fun along the way.

One in five couples will need some help. Those who know there is a problem and women over 40 should come along to the clinic before trying.

Women with known medical issues may need to see their own specialists beforehand too.

There is lots of pre pregnancy advice here to guide you so good luck to those of you at the start of the journey, and for anyone having problems, then you can read about the investigations and treatments we recommend.

So, here goes! You have decided to start a family. How exciting! You are likely to be a heterosexual couple, but you could also be a single lady or a gay couple.

Obviously the latter options usually require my input from the start so I am going to refer you to my specific sections for more information, but some things for everyone to consider are:

  • Think about your lifestyle, your work, your finances
  • Stop smoking and think about healthy diet options
  • Normalise your weight – that might mean gaining or losing pounds
  • Start some regular exercise, or for some, exercise less!
  • Reduce your alcohol and stop all recreational drugs

Folic acid supplements are proven to prevent neural tube defects such as spina bifida, and in winter time in the UK, everyone should also be taking vitamin D. I recommend a specially formulated multivitamin containing those 2 essentials, and an omega 3 supplement daily for younger women, and also a supplement of co-enzyme Q 10 (ubiquinone) if you are older. Some older women may benefit from DHEA, which I can provide. You should avoid taking herbal preparations that have phytooestrogenic properties such as agnus castus or macca, unless under medical supervision.

Men should take an all round multivitamin and a cod liver oil capsule. That simple combination has the right recipe for healthy sperm, but there are also specially formulated supplements out there that claim to be preferential.

See a doctor to go through your medical history and your family history, and discuss any prescribed medications you take.

Think about how much time you might take off on maternity or paternity leave, and the financial consequences of that.

Do you have family and friends around to support you when you have your new baby?

Our heterosexual couples need to think about sex!

You need to have sex at least twice a week but no more than once a day, and I do recommend daily around ovulation.

It doesn’t matter if the lady doesn’t orgasm, or what positions you choose, the time of day, or what you have eaten for dinner!

If you use a lubricant, then it needs to be a sperm friendly one like Preseed®, or plain olive oil is fine (but a bit messy on the sheets).

Ovulation predictor kits can be very useful to pinpoint the best time to have sex. The easiest urine based test to use is the Clearblue® range, either the monitor that takes you from low fertility to ovulation, or the very popular smiley face test, where you test daily and wait for a solid smiley face to appear. Remember that ovulation happens 1-2 days after most ovulation monitors register positive.

There is no need to adopt an extreme yoga position after sex to help sperm stay inside! The fast swimmers have already gone after 10 minutes whether you are upside down or simply recumbent. The fluid that comes out after that is simply the supporting fluid and the guys that were never going to make it!

Initial investigations

A blood test to check hormone levels, thyroid function, vitamin D, Iron levels, rubella immunity and blood count. Some people need other more specialist tests depending on their medical and family history.

An ultrasound scan of the womb and ovaries (this is an internal scan best done with an empty bladder).

A sperm test.

A check to assess whether the fallopian tubes are open. This may performed during an operation called a laparoscopy if recommended for other reasons, or with a special x-ray called a hysterosalpingogram (HSG).