Conceiving a baby

Most women under the age of 40 who want to become pregnant (conceive) will do so within 12 months of starting to try. This article explains how you can improve your chances of getting pregnant and having a healthy baby.

Before you start trying#

If you are planning to become pregnant, it is important that you and your partner (if you have one) are as healthy as possible before you start trying.

Your doctor can carry out a pre-conception health check. This usually includes:

• a medical history and a general examination
• advice about lifestyle changes that can improve the chance of pregnancy and the health of the baby, such as managing your weight, physical activity, alcohol use, recreational drug use and whether you smoke
• advice about folate and iodine supplements before and during pregnancy for the health of your baby
• blood tests to check your hemoglobin level, blood group, and immunity to rubella (German measles), chickenpox (varicella), hepatitis B and human immunodeficiency virus (HIV)
• tests for any sexually transmissible infection (STI)
• a review of any prescription medicines either partner is taking
• referral to a specialist if either partner has a pre-existing medical condition that might affect the pregnancy, or referral for genetic counseling if needed

Timing and the fertile window#

To conceive, you need to have sex in the 5 days before you ovulate, or on the day you ovulate. This is called the “fertile window.”

When the fertile window occurs depends on the length of your menstrual cycle. Many women know that ovulation is approaching because they notice changes in their vaginal discharge, which becomes clear and slippery. Learning about your own cycle can help you work out when this happens.

Age, fertility and conception#

The most important factor for the chance of getting pregnant and having a healthy baby is the woman’s age. Fertility starts to slowly decline from around age 32. By age 35 the decline speeds up, and by age 40 fertility has fallen by about half.

Men’s age matters too, though the effect is less dramatic. Men aged 45 and older are less fertile, and some health conditions are more common in children with older fathers.

Weight, fertility and conception#

Being overweight or underweight can cause hormonal changes that interfere with ovulation and reduce fertility. On average, women who are obese take longer to conceive and are more likely to experience infertility. In men, obesity can also lower fertility, likely through a combination of factors including hormone problems, problems with erection, and other health conditions linked to obesity.

Diet, exercise and conception#

There is no special diet that improves the odds of conception, but a healthy range of foods that includes plenty of fresh fruit, vegetables and lean protein is recommended.

Vitamins and minerals (micronutrients) are essential for the body to function. Several, including folate, iodine, vitamin D, zinc and selenium, are important for fertility and pregnancy health.

Regular exercise also improves fertility. General guidelines recommend at least 30 minutes of moderate-intensity physical activity, such as brisk walking, gardening or dancing, on most and preferably all days of the week. If possible, also include some vigorous activity, such as running, fast cycling or fast swimming, each week.

For men and women who are overweight or obese, exercise can help to prevent further weight gain or achieve a modest weight loss that improves general health and fertility. As part of weight management, guidelines recommend that overweight or obese adults do 225-300 minutes of moderate-intensity exercise each week (about 35-45 minutes per day).

Tobacco, alcohol and drug use#

Tobacco, alcohol or recreational drug use reduces the chance of becoming pregnant. If you become pregnant and continue to smoke, drink alcohol or use recreational drugs, this can affect the health of your baby at birth and into adulthood.

To improve your own health and give your baby the best start in life, quit smoking before you try for a baby, and encourage your partner to do the same. Quitting can be very difficult, but help is available.

In men, alcohol can impair fertility because it can cause impotence, reduce libido and affect sperm quality. It is not clear what effect drinking small amounts of alcohol has on unborn babies, but high alcohol consumption is well known to be harmful, and the more alcohol consumed, the higher the risk. Binge drinking (more than six standard drinks on one occasion) can cause miscarriage, stillbirth, premature birth, low birth weight, and fetal alcohol spectrum disorder. If you are pregnant or planning a pregnancy, not drinking alcohol is the safest option.

Prescription medicines and recreational drugs can also affect the health of an unborn baby. If you take prescription medication, speak to your pharmacist or doctor before trying for a baby.

Having trouble conceiving?#

If you have not conceived within 12 months, there may be a fertility problem. About one in seven couples experiences infertility.

Fertility difficulties can be due to:

• female fertility problems (about 40 per cent), such as problems with ovulation including polycystic ovary syndrome (PCOS), blocked fallopian tubes, or endometriosis
• male fertility problems (about 40 per cent), such as poor sperm quality, blockage of the tube that transports sperm from the testis, or ejaculation disorders
• both male and female fertility problems (about 10 per cent)
• an unknown cause (about 10 per cent)

If you are having trouble getting pregnant, talk with your doctor, who can refer you for tests to find out the cause and discuss treatment options.

Key points#

• The most important factor for the chance of getting pregnant and having a healthy baby is the woman’s age.
• Men’s age is an important factor too, though its effect is less dramatic.
• Men aged 45 and older are less fertile, and some health conditions are more common in children with older fathers.
• Being overweight or underweight can cause hormonal changes that interfere with ovulation and reduce fertility.
• Vitamins and minerals (micronutrients) are essential for the body to function.

Where to get help#