PRECONCEPTION

WHEN IS THE RIGHT TIME TO START PLANNING?

It takes in excess of 120 days for a pre-ovulatory follicle to develop in females and approximately 80 days for spermatogenesis to occur in males. It is therefore ideal to start preparation for conception 3-4 months before trying to conceive.

THERE ARE SEVERAL THINGS THAT CAN BE DONE TO PREPARE THE BODY FOR CONCEPTION:

• Weight: Excess weight can increase risks in pregnancy and prevent fertility. Having a body mass index of >35 (obese category) on average doubles time to conception and being underweight (body mass index <19) increases time to conception four fold. Weight can also affect fertility of men as some studies indicate that every 20lbs that a man is above their ideal body weight, infertility increases by 10%.
• Stress management: High stress levels may inhibit ovulation, in addition to affecting sperm morphology and concentration. Regulating cortisol levels may come from good nutrition, lifestyle habits, and if necessary supplements and acupuncture.
• Environmental toxins: Certain environmental toxins are endocrine disruptors meaning that they have an effect on hormone levels. Exposure to these environmental toxins should be limited.
  • BPA: Primarily found in plastics and the lining of tin cans
  • Parabens: Located in preservatives of cosmetics and pharmaceuticals
  • Phalates: Added to plastics to make them more flexible. Located in soaps, detergents, food packaging, shampoos, and hairspray. Phalates may lower sperm count and affect motility.
• Getting off birth control pills: It can take a few months for a cycle to return to normal after being on birth control pills. In addition to this, other symptoms such as acne, PMS, menstrual cramps may occur during this time. It is important to identify whether hormonal issues are being caused by an underlying pathology (such as PCOS) or whether they are simply temporary symptoms.
• Preconception screening and care: Physical exams and blood work can be done through either an MD or ND. Blood work may include hormonal testing to screen for any potential issues that may arise. It is also important to be up to date on screening exams such as PAP tests prior to conception.
• Nutrition: During preconception, nutrition should be optimized and food intolerances identified and eliminated.
• Supplements: Nutrient deficiencies should be corrected prior to conception and prenatal vitamins started early. Supplements to support stress management, and egg or sperm quality may also be necessary.
• Smoking cessation: Smoking cessation is important in both male and female partners. In females, smoking lowers ovarian reserves, increases risk of miscarriage, low birth weight, stillbirth, and ADHD in the child. In males, smoking exposes the mother to second hand smoke, which can lead to similar negative effects including low birth weight, intra-uterine growth restriction, and preterm birth. Conception takes longer if one or both partners smoke.
• Understanding your cycle: In a women’s cycle, there are only a few days that she is able to conceive. Cervical mucous plays a very important role in conception. Sperm do not survive well in the vagina, as it is too acidic. Cervical mucous provides an alkaline environment not only help the sperm survive but assist them in travelling to the fallopian tube to fertilize an egg. Around ovulation, cervical mucous should increase and change in consistency so that it is similar in appearance to egg whites. A woman is most fertile on the last day that she notices these cervical mucous changes. If cervical mucous changes are not obvious, basal body temperature charting or ovulation predictor kits may help identify when a woman is most fertile.
• Realistic expectations: It is important to understand that it takes time to conceive. Every month, healthy young couples only have a 20% chance of conception. As a result, the average time to conceive is approximately 6 months. Within the first year of trying, 85% of couples will get pregnant.

Why seek advice from a Naturopathic Doctor for preconception:

• An ND will customize your treatment plan to your individual needs.
• Relevant lab testing may be ordered which may include hormone testing to screen for any potential issues that may arise.
• ND’s may help with all factors discussed including weight management, stress management, easing the transition off birth control pills, nutritional counseling and help with smoking cessation.
• A review of current supplements to determine if they are safe in pregnancy and recommendations of appropriate prenatal supplements.
• Acupuncture may help to reduce stress levels, increase pelvic blood flow and regulate hormones.
• An ND will be able to support you through all stages of conception: preconception, pregnancy, and post-partum.