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Planning for pregnancy

If you’re thinking about getting pregnant, it’s important to plan ahead as much as you can. By leading a healthy lifestyle and managing any long-term health problems, you and your partner can increase your chances of conceiving and having a healthy pregnancy.

By the time you know that you’re expecting a baby, you could be many weeks pregnant. Although it’s never too late to make changes, it's better to plan ahead and be prepared before you try to conceive.

A happy couple outside

Details

  • Contraception Stopping contraception

    If you’re using contraception, you’ll need to stop it in order to get pregnant. If you use a barrier method, such as condoms or a diaphragm, you can get pregnant as soon as you stop using it.

    If you’re taking the contraceptive pill, you will need to stop taking it. If you’re taking a combined pill, finish the pack you’re on. If you’re taking the progesterone only-pill, you can stop these at any time.

    If you have an IUD (intrauterine device) or an IUS (intrauterine system) fitted, you’ll need to have this taken out. If you’re using a hormone implant, this will also need to be taken out. Your fertility should return to its usual level a short time later.

    If you’ve been having contraceptive injections, your periods and fertility can take longer to return to normal. For some women, this can be up to a year.

  • Conception When is the best time to conceive?

    About eight in every 10 couples, where the woman is under 40, will conceive within a year of having regular, unprotected sex. Most other couples will get pregnant in the second year of trying.

    Some couples try to time having sex with ovulation, which is when an egg is released from one of the ovaries. But try not to worry too much about this. You can end up feeling more stressed, and that can make you feel less like you want to have sex, and affect your chances of conceiving. Your best chance of getting pregnant is to have sex every two to three days.

    If you've been trying for a baby for a year and you haven’t become pregnant, go and see your GP with your partner. You and your partner may be offered an assessment and investigations to see if there is any cause for not conceiving. As you get older, your fertility reduces, so this will be taken into consideration.

    • For women aged 35, around nine out of 10 who have regular unprotected sexual intercourse will get pregnant after three years of trying.
    • For women aged 38, about seven out of 10 will.
    • If you’re over 35, your GP may refer you to a specialist sooner.
  • Weight Healthy weight

    If you’re overweight, it can affect both your health and the health of your developing baby. Being overweight or obese is linked to miscarriage, diabetes in pregnancy, problems with blood pressure and development problems in your baby. If you’re a healthy weight, you’re less likely to have these problems, and you’re also more likely to get pregnant in the first place.

    If you think you may be overweight, use our body mass index (BMI) calculator to work out what your current, pre-pregnancy BMI is. Your BMI tells you roughly whether you’re the right weight for your height. A healthy BMI for an adult woman is between 19 and 25. If your BMI is over 29, you can improve your chances of ovulating, and therefore getting pregnant, by losing weight. Your GP will offer you advice how you lose weight, for example, by exercising regularly. They may refer you to a dietician for help and advice on a weight loss programme if they think this may help you.

    If you’re underweight (your BMI is less than 19), you may also find it more difficult to get pregnant. Being underweight sometimes stops you ovulating and your periods can stop completely. Putting on weight may help. So speak to your GP for advice if you’re struggling to gain weight through a balanced diet.

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  • Healthy eating Healthy eating

    By eating the right foods, you can help to make sure that your body is as well prepared as possible for being pregnant. A healthy diet for men will also help sperm to be in the best condition to fertilise an egg. That means eating:

    • at least five portions of fruit and vegetables a day
    • starchy foods, including wholegrain bread, pasta, rice and potatoes
    • protein, such as lean meat, fish, beans and lentils
    • fibre, which can be found in wholegrain bread, fruit and vegetables
    • dairy foods, such as milk, yogurt and cheese, which are good sources of calcium

    Drinking too much caffeine could make a miscarriage more likely and is linked to having a small baby. So, have only one or two drinks containing caffeine each day, or switch to decaffeinated drinks while you’re trying to conceive. Although a small amount of caffeine is unlikely to cause your baby any harm, you might decide to avoid caffeine altogether once you find out you’re pregnant. Remember, coffee and tea aren’t the only drinks that contain caffeine – many fizzy and sports drinks also contain it.

    There are also some foods that you shouldn’t eat while you’re trying to get pregnant. Certain foods can increase your risk of food poisoning and make you ill. The bacteria can cause serious health problems in your baby. If you're planning to get pregnant, or are pregnant, don't eat:

    • uncooked meat, fish and eggs – always make sure that food is piping hot all the way through
    • pâté (meat or fish)
    • unpasteurised milk or milk products
    • raw shellfish, such as prawns
    • unripened soft cheeses, such as Brie, Camembert or blue-veined cheese (like Stilton)
    • unwashed fruit and vegetables

    Some foods also contain substances that can potentially be harmful for a developing baby. While you’re trying to get pregnant, and once you’re pregnant, don’t eat:

    • liver or liver products, or take vitamin A supplements
    • fish that contain large amounts of mercury, such as shark, swordfish, tuna and marlin

    Folic acid

    It's important to start taking folic acid when you decide to try and get pregnant.

    Most women take 400 micrograms (400mcg) a day for the first 12 weeks of pregnancy. This reduces the risk of your baby having a neural tube defect, such as spina bifida. You may need to take a bigger dose of folic acid if you have another health condition, such as diabetes, or if you’ve already had a child with a neural tube defect. Your GP or midwife will tell you if you need to do this.

    Vitamin D

    Your body produces vitamin D naturally when your skin is exposed to the sun. You can also get small amounts of it from some foods, such as oily fish. If you’re not getting enough vitamin D, it can affect your baby’s growth.

    Your GP will advise you to take 10mcg of vitamin D every day when you’re trying to get pregnant. This will help to make sure that both you and your baby get enough. Your GP or midwife can give you more information about this. You can buy pregnancy supplements that contain the right amount of both folic acid and vitamin D from most pharmacies and supermarkets.

  • Smoking, alcohol and medicines What to stop before trying for a baby

    Smoking

    If you or your partner smokes, then stopping can help to increase your chances of getting pregnant. Smoking is linked to infertility in women and sperm problems in men. It’s best to stop smoking altogether if you’re planning to have a baby. Smoking when you’re pregnant can cause severe damage to your baby’s health as well as yours. If you smoke, you’re more likely to:

    • have a miscarriage
    • have complications when you’re pregnant or giving birth
    • give birth too early
    • have a small baby

    If you or your partner needs support or advice on stopping smoking, talk to your pharmacist, GP or practice nurse.

    Alcohol

    Alcohol can harm your unborn baby, and the more you drink the greater the risks. It’s safest for your baby if you don’t drink alcohol at all while you’re trying to get pregnant and throughout your pregnancy.

    Recreational drugs

    If you’re taking recreational drugs, such as cocaine or cannabis, you should stop if you want to get pregnant. They can interfere with ovulation in women and reduce sperm count in men making it hard to conceive. They can cause serious health and development problems for your unborn baby. If you need support about drug use, talk to your GP, or contact a local support group or service.

    Medicines

    If you’re taking any medicines, tell your GP that you’re planning to get pregnant. This includes herbal medicines. This is because some medicines can affect your chances of conceiving as well as the development of your baby.

    Generally, it's best to take as few medicines as possible when you’re trying to get pregnant. Ask your pharmacist, GP, nurse or midwife for more information about specific medicines.

  • Work Hazards at work

    Some jobs can be risky if you’re trying to get pregnant. If you’re exposed to potentially harmful substances, such as chemicals or radioactive substances, get advice about your safety. You should also do this if you’re likely to come into contact with either animals or people with infections. Speak to your employer or whoever is responsible for health and safety in your workplace.

  • Issues to discuss Issues to discuss with your GP

    Any medical conditions

    If you already have a health condition, speak to your GP before you start trying for a baby. Some long-term health problems, such as epilepsy or diabetes, can affect both yours and your baby’s health. The medicines you take to manage health problems can also affect your baby. However, don’t stop taking any prescribed medicines without advice from your GP, because this could put your health at risk.

    Genetic counselling

    If you or your partner has a health condition that runs in your family, such as sickle-cell anaemia or cystic fibrosis, tell your GP. Your GP may refer you for genetic testing and counselling, to see what the risk of passing the condition on to your baby is.

    Immunisations

    Ask your GP to check whether you have had all the immunisations you need to have a healthy pregnancy and protect your baby. These include the following.

    • Rubella (German measles) and measles. If you aren't immune to rubella or measles, and you catch either while you’re pregnant, it can cause some potentially serious problems for you and your baby. You won’t be screened for either of these once you’re pregnant, so ask your GP to check whether you have had the MMR vaccination. If you haven’t, you should wait at least 28 days after you’ve had it before you try to get pregnant.
    • Hepatitis B. If you’re likely to come into contact with hepatitis B; for example, if you’re a health professional, you should check whether you have immunity to it.

    Another vaccination your GP may offer you if you’re planning to get pregnant is chickenpox. You won’t need it if you’ve already had chickenpox or shingles though. Only certain women need this; for example, if you’re a health professional and likely to come into direct contact with people with the infection. Ask your GP or occupational health department for more information if you think this applies to you.

  • Advice for men Advice for men

    Men need to be in the best of health too, to increase the chances of conception. For around one in three couples, the fertility of the man is what has the most effect on their ability to get pregnant.

    To be in the best health possible and to have high-quality sperm you can do the following.

    • If you smoke, stop. Smoking can lower the quality of your sperm.
    • Be a healthy weight for your height. If you’re very overweight, it can affect the number and quality of your sperm.
    • If you drink alcohol, stay within the recommended limits per week. That means drinking no more than 14 units spread over a week.
    • Keep your testicles as cool as possible. Sperm production can be affected by high temperatures. So, it may help to wear loose fitting clothes and stay out of saunas and hot showers. There is also some research that shows that resting laptops on testicles could reduce fertility.
  • FAQ: Ovulation How do I know when I am ovulating?

    You're most likely to get pregnant just after you ovulate. Ovulation is when an egg is released from one of your ovaries. You can get to know when you're ovulating by keeping track of the changes to your vaginal mucus. This changes throughout your menstrual cycle.

    Explanation

    How long your menstrual cycle is varies from woman to woman (from 21 to 35 days), but on average it's 28 days. However long your menstrual cycle is, you will usually ovulate around 14 days before you have your period.

    After you have your period, an egg grows and develops in one of your ovaries before it's released, which is called ovulation. The egg travels to your womb (uterus). At the same time, the lining of your womb gets thicker. This is so that if the egg is fertilised by a sperm, your womb is ready to receive it and it can grow.

    After you have sex, sperm can live in your vagina for up to three days. If there are sperm there when you ovulate, or for up to 24 hours after, there is a chance the egg could be fertilised and you could become pregnant.

    At the beginning and end of your menstrual cycle, your vaginal secretions will usually be sticky and thick. Around the time you ovulate, they become wetter, thinner and clearer with a texture a bit like raw egg white. The thinner the mucus the easier it is for sperm to swim through. By checking your vaginal mucus regularly, you should be able to tell when you’re ovulating.

    Some women also take their temperature regularly, as after you ovulate it goes up by a small amount (about 0.5 degrees). This doesn’t tell you when you’re at your most fertile, so isn’t a very accurate way of predicting when you ovulate.

    Another way to tell when you’re ovulating is to use an ovulation predictor kit or monitoring device, which you can buy from a pharmacy. This measures a hormone in your urine which is there when you’re about to ovulate.

    It can be difficult to measure when you're ovulating, so don't worry if you're unsure. The National Institute for Health and Care Excellence (NICE) recommends having sex every two to three days as the best way to conceive. This is the same whether you're ovulating or not.

  • FAQ: Health problems that affect conception Which health problems could affect my chances of conceiving?

    There are some health problems that can affect your fertility and your chances of getting pregnant.

    For women, these include:

    • a previous sexually transmitted disease, particularly chlamydia and gonorrhoea
    • polycystic ovary syndrome (PCOS)
    • fibroids
    • endometriosis
    • infection, such as pelvic inflammatory disease

    For men, these include:

    • enlarged veins inside your scrotum (varicocele)
    • undescended testicle
    • not enough testosterone (hypogonadism)

    If you or your partner has any of these conditions, or if you’re at all worried about whether you can conceive, talk to your GP.

  • Other helpful websites Other helpful websites

    Further information

    Sources

    • Antenatal care. BMJ Best Practice. bestpractice.bmj.com, last updated September 2016
    • Pre-conception counselling. PatientPlus. patient.info/patientplus, last checked January 2016
    • Stopping contraception. Tommy’s. www.tommys.org, last reviewed April 2014
    • Long acting reversible contraception. National Institute for Health and Care Excellence (NICE), 2014. www.nice.org.uk
    • Fertility problems: assessment and treatment. National Institute for Health and Clinical Excellence (NICE), 2016. www.nice.org.uk
    • Pregnancy: pre-pregnancy care. GP Update Handbook (online). GP Update Ltd, gpcpd.com, accessed 9 December 2016
    • Top tips for conception. Tommy’s. www.tommys.org, last reviewed April 2014
    • Fertility basics. Human Fertilisation and Embryology Authority. www.hfea.gov.uk, last updated August 2014
    • Pre-conception advice and management. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised June 2012
    • Obesity: identification, assessment and management. National Institute for Health and Clinical Excellence (NICE), 2014. www.nice.org.uk
    • Amenorrhoea. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2014
    • Improve your chances of getting pregnant. Human Fertilisation and Embryology Authority. www.hfea.gov.uk, last updated August 2014
    • Pregnancy. Oxford handbook of general practice (online). Oxford Medicine Online. oxfordmedicine.com, published April 2014
    • Maternal and child nutrition. National Institute for Health and Care Excellence (NICE), 2014. www.nice.org.uk
    • Vitamin D. The MSD Manual. www.merckmanuals.com, last full review September 2016
    • Smoking and reproduction. ASH. ash.org.uk, published August 2013
    • UK Chief Medical Officers’ Alcohol Guidelines Review. Department of Health. www.gov.uk, published 2016
    • Pregnancy: investigating pregnant women exposed to a rash. GP Update Handbook (online). GP Update Ltd, gpcpd.com, accessed 9 December 2016
    • Pregnancy: rubella immunity screening antenatally. GP Update Handbook (online). GP Update Ltd, gpcpd.com, accessed 9 December 2016
    • Infertility – male. PatientPlus. patient.info/patientplus, last checked April 2016
    • Male factor infertility. BMJ best Practice. bestpractice.bmj.com, last updated November 2016
    • Avendano C, Mata A, Sanchez Sarmiento CAS, et al. Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation. Fertil Steril 2012; 97(1):39–45. doi: 10.1016/j.fertnstert.2011.10.012
    • Conception and prenatal development. The MSD Manuals. www.merckmanuals.com, last full review October 2016
    • Female reproductive endocrinology. The MSD Manuals. www.msdmanuals.com, last full review August 2016
    • How conception works. Tommy’s www.tommys.org, last reviewed April 2014
    • Menorrhagia. PatientPlus. patient.info/patientplus, last checked February 2016
    • Infertility in women. BMJ Best Practice. bestpractice.bmj.com, last updated November 2016
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    Reviewed by Alice Rossiter, Specialist Health Editor, March 2017.
    Expert reviewer, Dr Evelyn Ferguson, Obstetrician Gynaecologist.
    Next review due March 2020.

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