Whether you or your partner are trying to conceive or want to understand how you could better prepare, Progyny is here to support you each step of the way. We recently hosted a conversation to learn more from experts about overall health and wellness on a family building journey. Our discussion focused on what to know before you start trying to conceive, what to discuss with your provider, how to navigate your mental health when planning for a family, and understanding fertility testing.
This webinar featured:
- Dr. Katherine Palmerola, MD, FACOG
- Michelle Duchin, LCSW
- Anna Steigerwald, Progyny Patient Care Advocate
- Jasmine Dunham, Progyny Clinical Educator
What to know before trying to conceive
When we think about preconception health and trying to get pregnant, it can feel overwhelming. You may be ready to start actively trying to conceive, or just know that someday you hope to be a parent. With that goal in mind, it is always great to be thinking about your fertility health, which is really your general health. When you’re thinking about how to improve your lifestyle as you plan to build a family, it’s good to focus on:
- Choosing whole healthy foods instead of processed foods
- Understanding and limiting your toxin exposure
- Implementing consistent fiber in your diet
- Doing low impact exercises
It’s also important to think about your overall health and if there are any preexisting or underlying medical conditions you have been experiencing. If so, consult with your providers to ensure those conditions are optimized for your general health. In addition to that, if you are taking any medications, you would want to make sure they are safe for pregnancy.
For the majority of our lives we have been taught how to not get pregnant, but what about once someone is ready for pregnancy? 65% of people in their reproductive years use some kind of contraceptive, which leads to a misconception that as soon as you stop using it, you will get pregnant. Although with some contraceptives like condoms or an IUD, this could be the case, there are also hormonal birth controls that can suppress someone’s ability to get pregnant for months after taking it. Taking a hormonal birth control, like the birth control pill, suppresses your natural hormones since the pill produces its own. Depending on how long you take hormonal birth controls, it can impact how long it takes your body to wake up and create the natural hormones again.
Once we stop using contraceptives and are attempting to build a family, it is important to keep prenatal health at the forefront. Taking a prenatal vitamin is an important step before someone is actively trying to conceive, and there are a few components that are important to have included in the vitamins, such as folic acid, choline, iron, and iodine. The American College of Obstetricians and Gynecologists’ website (ACOG) is a great resource to find out more information about prenatal vitamins, which you can explore here.
As you are prepping your lifestyle and body for the possibility of building your family, it’s also important to be mindful of your mental wellness as we know this is a big decision. During this time, it is extremely important to check in with yourself or your partner to ensure everyone is grounded and feeling stable. One’s sense of self is a key factor to think about when progressing through the family building journey. Some thoughts to keep in mind to help if they journey becomes overwhelming could be – how am I able to cope? What are some mechanisms I can use to self sooth?
Trying to conceive (TTC)
If you are ready to build your family, it can be helpful to start off by discussing with an OB provider if there are any concerns before trying. Do you or a partner have irregular periods? Painful periods? Really heavy periods? These are all aspects that can impact a person’s ability to conceive. If you are a single parent by choice or an LGBTQ+ individual or couple, you will need assistance on building your family, so it’s great to speak about any concerns a provider may have with your fertility health before going through treatments or purchasing donor tissue.
Genetic screening can also be something to discuss with an OB provider prior to being pregnant. Often times the genetic screening occurs after 8-10 weeks of pregnancy to see if you or your partner are carriers of recessive conditions. If you are having these conversations with your OB provider prior to becoming pregnant, there is some testing you can get out of the way.
It can often be surprising to learn how many things have to align to get pregnant. It is important to understand your chances of success during this journey, especially since we were always taught that getting pregnant is easy. There are four phases of the menstrual cycle, which are menstruation, the follicular phase, ovulation, and the luteal phase. A period is a vital sign to assess one’s fertility. Abnormal periods may mean one’s hormones aren’t working as they should. When thinking about ovulation tracking and timing intercourse, it is great to start with marking the first day of a period. This can not only help track the frequency of a period but also when you are ovulating. If your period regularly comes, you can assume you are ovulating around 2 weeks after the first day of your period. The fertile window is the entire week before ovulation. Intercourse during that week will lead to the highest chances of fertility, which every month is about 20 – 25%.
Although it is helpful to know the timing of when you or a partner may be the most fertile, this can also cause stress on the relationship. When we go through challenging situations, we can often become preoccupied and distracted. This can lead to the inability to connect with a support system or be fully present. We often like to assume our support system knows what we are going through without even telling them and when they don’t ask or help, it can lead to avoiding feelings and not talking about it. The more we avoid, the stronger those feelings will come out. Although it may be difficult, it is key to connect with your support system to create sustainable boundaries. If you are not comfortable talking to family and friends about your experience, you can find a therapist or support group who is going through similar situations. The lack of control during this journey can be real and it may be uncomfortable to sit with it. Having support as well as boundaries can be a healthy step to continuing forward.
Understanding Your Options
You may be actively trying to build your family as a heterosexual couple and are frustrated by lack of results. There are general guidelines to keep in mind for when to seek fertility testing. Female age is a very important aspect in fertility. As a woman gets older, is becomes harder to get pregnant and there is an increased rate of miscarriages. If the female age is under 35, the recommendation is to try to conceive for 12 months before seeking additional fertility testing. If the female age is between 35-40, try to conceive for 6 months. If at the age of 40+, there is a steep decline in egg quality, so it is recommended to get evaluated by a fertility specialist sooner.
Underlying conditions may warrant an earlier visit to the fertility provider. Reasons to see a fertility doctor sooner can include:
- Surgery that impacts fertility
- Polycystic ovarian syndrome (PCOS)
- Endometriosis
- Male infertility issues
- Vasectomy
If you are a same-sex couple, LGBTQ+ individual, or single parent by choice, you will need reproductive assistance when building your family. If you are thinking about growing your family, it may be helpful to speak with a reproductive endocrinologist or reproductive urologist sooner.
Once you see a fertility doctor, there are many tests available. Some of the tests that can be facilitated are:
- Hormone testing: Hormone levels of thyroids and ovaries tested through blood work
- Fallopian tube screening: Testing to see if the tubes are open and have normal shape or if there is a blockage
- Uterus ultrasounds: To check for polyps, fibroids, scarring, that may impact fertility
- Sperm analysis: Sperm morphology, motility, and count
- Genetic screening: Testing for genetic compatibility
After getting these tests done or going through fertility treatment, the waiting period can feel especially challenging for the couple or individual involved. This may be a good time to lean into other aspects of your life purpose. These other aspects could include reading a new book, starting a new meditation routine, learning a new skill, or other healthy distractions that can take your focus away from the waiting game. If you are a Progyny member, don’t forget your PCA can chat through any questions you may have along your journey as you plan for your family.
Questions from the audience
1. I am a member of the LGBTQ+ community and my female partner and I are interested in starting to build our family and we know we will need to find a donor. What should we be sure to consider during this process as we prepare?
For same sex couples or individuals, one of the first choices you will have to make is to pick a donor. There are many different types of donors. You can use an anonymous donor, ID open donor, or known donor. All of these donor types come with different steps that need to be taken. For an anonymous donor their tissue has already been donated, frozen, and tested. With a known donor, this is someone who would have to go through testing with a fertility center. With each type of donor, there will need to be compatibility testing to ensure this tissue will be viable for you and/or your partner to use.
2. Are there things that could negatively affect your journey (hair die, nail polish, wine etc.) months before starting?
You can truly go down a rabbit hole when exploring what can negatively impact you on your family building journey. One important factor to consider is ensuring that whatever you are doing does not add stress. Follow a healthy lifestyle throughout the full journey, including before your officially start trying. When you are actively trying to conceive there are important aspects that can impact that healthy lifestyle:
- Limit caffeine to 80 mg daily: this typically equates to one American cup of coffee but there are other foods and drinks that include caffeine so be cognizant of your intake.
- Alcohol is toxic to pregnancy – whether or not you go through treatment or are in the two-week wait period after intercourse while ovulating, you should assume you are pregnant and cut alcohol from your consumption.
- Limit your exposure to toxins where possible and be mindful of processed foods and toxic cleaning supplies and beauty care. Be sure not to microwave plastic and be aware of consuming from water bottles that have been in the heat.
- This can be a very overwhelming time and there is a lot of information that can cause a stress. As you are on this journey be gentle with yourself and if there are things you can only gradually replace, that is alright to do.
If you have any other questions related to this webinar, please don’t hesitate to reach out to education@progyny.com. For those eligible for the Progyny benefit, we offer fertility and family building benefits inclusive of preconception support offering personalized coaching, education, and referral services to support your fertility and family-building goals, whether you are planning for that now or in the future.
Our dedicated Patient Care Advocates, or PCAs, and Clinical Educators are always available to answer any questions you might have. Please call 888.597.5065 to speak with our PCAs or Clinical Educators about any questions you may have. Please note this is not in place of medical advice and if you are experiencing any symptoms of male infertility, please consult a doctor.