At school we were taught all the things about how not to get pregnant…

As Coach Carr from Mean Girls says “Don't have sex, because you will get pregnant and die!”

Obviously this is humour, but I feel like this is the narrative many of us had to live by until we got to the stage when we actually do want to have a baby. Yes, we learnt all about safe sex, which is all extremely important. However, we were never taught what to do when we want to fall pregnant. Or what to do when we can’t fall pregnant. Or why you can’t fall pregnant.

So… Let's learn the basic fundamentals of fertility, the reasons why you might not be falling pregnant, why we should consider preconception and where to go if you are feeling lost.

There are many reasons why you might not be falling pregnant. Let me give you the rundown on the things you should consider even before you start thinking about having a baby.

Preconception Care

Preconception is all about optimising mum and dad’s health before conceiving!

Evidence shows that the preconception period is crucial for optimising mum and bub’s short and long-term health. Yet, in Australia, only 50% of pregnancies are planned.

For a mother's egg to develop and mature, it takes approximately three months. However, the health of a woman's egg and its genetic material is actually determined by the grandmother! Although we cannot change our grandmother's health, we can optimise the health of our own eggs by starting a preconception plan at least three months before conceiving.

Preconception is not just about taking a prenatal vitamin.

Preconception includes optimising both yours AND your partners, physical and mental health. It’s about changing your lifestyle choices to become the healthiest parents you can be before bub arrives.

Not only does preconception put you in a better position to transition into parenthood, it has been shown to reduce miscarriages, preterm birth, and abnormal birth weight; improve the growth and brain development of the baby, reduce neural tube defects, reduce the chances of the offspring becoming obese and developing metabolic diseases, as well as, reduce the risk of postnatal depression.

Stress is another crucial factor to consider preconception. When we are stressed, our bodies are not in a stable position to procreate. Stress can be a major factor that can interfere with fertility. Read more about stress and preconception here.

2. Timing

After preconception care is taken care of, the next question is, do you know when you are ovulating, and are you having sex on the right day? Did you know females are only fertile for approximately 5-6 days a month? If you don’t know when you are ovulating or when you are fertile, please read about basal body temperature tracking here.

3. Do you have a hormonal imbalance?

Hormonal imbalances are one of the main causes of infertility for females. This can mean that the body is producing too much or not enough hormones and can't regulate and respond to them properly. Our hormones need to be in harmony for regular and efficient menstrual cycles. Without a happy cycle, we cannot ovulate, and we need to ovulate to make a baby.

There are many factors that can contribute to hormonal imbalances: poor diet, including over or under-eating, stress, some medications, drug/alcohol use, environmental toxins, poor sleep, dysfunctional thyroid, and other pathological conditions. However, is possible to treat hormonal imbalances with lifestyle changes.

Signs and symptoms of hormonal imbalance:

Absent or irregular periods.
Heavy or painful periods.
Spotting between periods.
Increased hair growth on the face, neck, chest, and back.
PMS
Unexplained weight gain or weight loss.

PCOS and anovulation are the most common causes of infertility in women and are both driven by hormonal imbalances.

PCOS- is a common hormonal condition that results in anovulatory cycles (no ovulation). PCOS is characterised by excess androgens (male hormones). Although PCOS is the most common hormonal condition in women, it can be treated and ovulation can return. Read more about PCOS here.
Hypothalamic amenorrhea (HA)- this is a condition where a menstrual period is missing for more than six months. It is generally caused by under-eating, where your body decides it doesn’t have enough nutrients to reproduce, so it shuts down ovulation.
Conditions and nutrient deficiencies that affect the thyroid gland can also contribute to imbalances between your reproductive hormones. Not only that, the thyroid is vital for maintaining a healthy pregnancy!

4. Have you recently come off the oral contraceptive pill?

The next thing to consider is - did you stop taking the pill because you decided to have a baby? If so, following a preconception plan is even MORE important. Why?..

The pill can mask hormonal imbalances and hormonal conditions like PCOS and HA. How many of you were put on the pill to “regulate” your period? If that is the case, it is likely that your cycle is still irregular and you may need treatment for PCOS or HA.
The pill depletes the body from so many crucial nutrients, which are in even more demand during pregnancy. Getting your levels back up to optimal before you start thinking about conceiving is so important. Think about it.. If your body is depleted, then your growing baby takes everything you’ve got, imagine how you will feel postpartum. You can see how postpartum depression is so prevalent....
The pill fills your body with synthetic hormones. It can take time for your body to clear these out and kick back into gear to produce your own hormones. Your hormones can be out of balance for some time, and it can take time before your body is regulating and making enough hormones for consistent menstrual cycles and ovulation.
The pill can alter the vaginal and gut microbiome. The health of the mother's microbiome is extremely important for healthy outcomes for bub - the mother's microbiome determines bub's microbiome. During birth, a mother's microbiome is passed on to the baby. An optimal microbiome should set bub up a robust immune system. The first step for a healthy microbiome is looking after your gut health. Improving gut health has been linked to successful pregnancy outcomes in those who were subfertile.

Fertility is not easy for some. Understanding what is involved in conceiving before you spend thousands of dollars on IVF treatment could help you go a long way.

I have created a step-by-step guide on how to optimise your fertility with easy, practical and proven implementations. If you would like to learn more, please click here.