Step 1: Optimizing your health before you get pregnant
For many people, how to NOT get pregnant is the most important question relating to fertility. Yet when the time comes to start a family, the anxiety can shift to the opposite camp and people begin to worry if they CAN get pregnant.
If you are in the early stages of trying to get pregnant or are thinking about getting pregnant in the near future, there are some things that you can do to optimize your chances of getting pregnant and of having a healthy pregnancy.
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Fitness:
Women with a normal body weight prior to pregnancy have lower rates of pregnancy complications including diabetes, pre-term delivery and preeclampsia. Women who are physically fit also have lower rates of cesarean section. Three hours of aerobic exercise per week should be the minimum goal of any woman trying to get pregnant.
If you are morbidly obese (BMI 40), you are at increased risk of many pregnancy complications including birth defects such as heart malformations and spina bifida. Alternatively, if you have been underweight and not ovulating or if you have been taking steroidal medications for a long time, you may be at increased risk of osteoporosis and of experiencing bone fractures during pregnancy.
Nutrition:
Women who are deficient in folic acid or other B vitamins have an increased risk of neural tube defects (or spina bifida). At a minimum, a woman should supplement her diet with 400 mcg, ideally 800 mcg daily.
It is also becoming apparent that Vitamin D is important in many aspects of health and pregnancy. Vitamin D is also important for bone health. Fish and sunlight are good sources of Vitamin D. The daily recommended intake of Vit D is 600 IU daily, which means many people need to take a supplement.
In general, a healthy diet will contain the RDA recommended nutrients and consist of 1200-1500 calories per day (depending on the weight of a woman).
Smoking:
Smokers and women married to smokers have lower monthly pregnancy rates. Smokers more frequently have small for gestational age babies.
Alcohol:
Even modest alcohol consumption has been shown to decrease pregnancy rates and increase miscarriage. In the IVF setting, 1 drink per day has been associated with both lower pregnancy rates and higher miscarriage rates. In natural populations heavy alcohol consumption is associated with high estrogen levels in women and this can impair egg growth and has been shown to cause a woman to stop ovulating.
Caffeine:
More than 300 mg of caffeine per day has been associated with miscarriage. Next time you’re at Starbucks check out the caffeine dose in a Grande coffee – 330 mg.
Summary:
A bad lifestyle is not birth control. So if you don’t want to get pregnant, I wouldn’t count on drugs, alcohol and cigarettes to save you.
On the other hand, if you are young and fit, a non-smoker, who doesn’t drink or have any medical problems then you’re off to a good start, but this does not mean you will be fertile. It doesn’t even mean you are nutritionally ready to conceive. In our next post we will discuss preconception counseling and the labs that are advised prior to conception.