How To Get Pregnant
and How Not To?
 Some couples seem to get pregnant
without even trying, sometimes while trying not to conceive,
while for others it takes plenty of patience and luck. If you
are seeking guidance on how to get pregnant or how not to get
pregnant, here is what you need to know – and when you need to
seek help.
BABY-MAKING 101
Conception is based on an intricate series of simultaneous
events.
About once a month, the lining of the uterus begins to thicken
in preparation to receive and nourish a fertilized egg. At the
same time, hormones from your pituitary gland stimulate your
ovaries to release an egg, or ovulate. This happens about 14
days before your next menstrual period is due. The egg is
released from your ovary and travels into your fallopian tube
where it can be fertilized by a sperm.
If you are looking to conceive, the best time to have
intercourse is from a day or two prior to ovulation, and for
about a day after ovulation. The egg has about 24 hours to unite
with a sperm. Sperm cells can last in your reproductive tract
about two to three days. If you are trying to get pregnant, this
time of ovulation is the best to have sex. Once the egg is
fertilized it will travel to the uterus and attach to the thick
uterine lining. This is where pregnancy begins. If the egg is
not fertilized during this critical time, it will disintegrate
in the uterus. Then since the thickened uterine lining is no
longer needed, it will be shed over a period of 2 to 8 days.
 WHEN ARE YOU MOST FERTILE?
Knowing just when you ovulate, and therefore when you are most
likely to conceive, is helpful in couples when you are trying to
get pregnant. Some techniques for determining just when you
ovulate include: calendar watching, changes in cervical mucus,
basal body temperatures, and ovulation monitoring kits.
Calendar watching
This is quite effective for women with regular predictable
menses. If you know that you have a menses every 30 days, then
you can fairly accurately calculate that you ovulate 14 days
prior to your next expected menses, or 16 days after the prior
menses started.
Changes in cervical mucus
The cervical mucus becomes thinner, clearer, and more hospitable
to sperm trying to navigate through the cervical canal and into
the uterus at the time of ovulation. Women can learn to
recognize this change in their cervical mucus at this time of
their cycle. At the time around ovulation, the cervical mucus
can be stretched between the fingers to a much longer strand
than at other times of the cycle. This is called Spinnbarkeit
testing, and is depicted at this web site:
www.fertilityuk.org/nfps401.html
Basal body temperature testing
The basal body temperature (BBT) is the temperature measured in
the morning before getting out of bed. It can be measured
accurately by taking a vaginal or rectal temperature using a
special thermometer that allows measuring body temperature to
the 1/10th of a degree. At the time of ovulation the increased
production of progesterone by the ovary causes a woman’s
temperature to rise by about 0.5 degrees Fahrenheit, and remains
elevated for about 7-10 days. When this basal body temperature
is measured daily, and charted on a graph, it shows this
increase well enough to show the time of ovulation, and
therefore the time of maximal fertility. See this link for an
example of an ovulatory cycle on a BBT graph.
www.fertilityplus.org/faq/bbt/bbtfaq.html
Ovulation monitoring kits
The hormone released from the pituitary gland that stimulates
the ovary to release the egg is called lutenizing hormone, or LH.
LH is excreted in the urine, and kits have been developed to
test urine for the presence of high levels of LH, in a fashion
similar to urine pregnancy kits testing for HCG, the hormone
present in high levels after conception. By testing for LH in
the urine about every 6 hours in the mid-cycle time when
ovulation is expected, a woman can pinpoint the time of her
ovulation quite accurately. This method is used in many
infertility clinics to know when to do artificial insemination
or to detect the presence of an ovulatory cycle. The drawback to
this testing is that it can be moderately expensive, and knowing
the time of ovulation with such accuracy is not usually needed
to give a couple a good chance of conception.
MAXIMIZING RESOURCES AND FERTILITY OPPORTUNITIES
1. Have sex frequently and especially during the time your egg
is released to the time it is traveling to your uterus.
2. Make lifestyle choices such as eating healthy, maintain a
healthy weight, excising regularly, and keeping stress
regulated.
3. Consider preconception planning with your physician. Your
physician can help identify lifestyle changes and improvements
that can better your chances for a healthy pregnancy.
4. Do not smoke because tobacco changes the cervical mucus,
which may keep the sperm from reaching the egg. Smoking also may
increase the risk of miscarriages and decrease the amount of
oxygen the baby is receiving.
SEEK HELP
Most healthy couples who are having frequent unprotected sex
should conceive within one year, however some couples may need
help. If you 35 years or older and your periods are more than 25
days apart or you or your partner has known or suspected
fertility issues you should seek help from your physician.
Infertility affects both men and women equally, but treatments
are available. For a man the first step is a sperm test and for
a women doctors will run a test to see if the ovaries are
working properly. Drugs or surgeries are common treatment.
According to the National Women’s Health Information Center,
two-thirds of couples treated for infertility go on to have
babies. For more information about infertility visit the
American Society of Reproductive Medicine at
www.asrm.org/Patients/faqs.html.
BIRTH CONTROL
There are several types contraception choices available, and
with good reason; because no two people are alike, no one method
is right for everyone. The most popular methods of birth control
are condoms, the pill, injection, the patch, IUD, and the
NuvaRing. However, there are a multitude of methods of
contraception. SFM has in-depth
guide to help you with contraception choices.
Condoms
A condom is a thin shield that is fitted directly on a man’s
penis. It traps the semen expelled from the penis during
intercourse, preventing sperm from fertilizing an egg. There
are many types of condoms available; most are made of latex
rubber, but some are made from animal tissue like lambskin (also
called “natural” condoms). They may be lubricated or ribbed or
treated with a spermicide.
Latex condoms, especially those that are treated with a
spermicide, help prevent both partners from giving each other
sexually transmitted diseases (STDs). Condoms can be bought
without a prescription. A condom is worn on the penis. It
collects semen and prevents sperm from entering the uterus.
Although condoms are quite effective, they may tear or slip off
during intercourse.
The Pill
Oral contraceptives suppress the hormones that cause ovulation.
The process of ovulation is directed by hormones, chemicals made
by the body. Some hormones signal for egg follicles to mature in
the ovary, for example, others trigger the thickening of the
uterine wall. Oral contraceptives consist of man‑made versions
of two of these hormones; taken daily, they block the usual
hormone "messages" that direct ovulation. No eggs are produced,
so conception is prevented.
Other effects of oral contraceptives help prevent sperm from
reaching the egg and reduce the chance of the egg implanting in
the uterus. Oral contraceptives are one of the most effective
forms of reversible birth control currently available. There are
several types of oral contraceptives, with different levels and
types of hormones.
Injection
Contraceptive injections are given to you by your doctor as a
hormone "shot" into the muscle of your upper arm. Once
administered, a low dose of this hormone, progestin is released
into your system over a period of 3 months. This progestin,
similar to the progestin in birth control pills, suppresses
ovulation and provides effective contraception for 3 months.
The Patch
The patch is thin, beige, plastic patch that sticks to your
skin. The patch is usually placed on the skin of the buttocks,
stomach, upper arm, or torso once a week for three weeks in a
row. The patch much like the pill releases synthetic estrogen
and progestin into the blood stream. The patch is 99% effective
with proper use.
Intrauterine Device
The IUD is a small plastic device, containing copper or the
hormone progesterone that is placed by a doctor or health care
professional inside the uterus for an extended length of time.
In fact, the copper IUD may be used for up to 8 years. It is a
highly effective contraceptive and is thought to work by
preventing sperm from reaching or fertilizing the egg. The
modern IUD is one of the most effective forms of birth control
available.
The NuvaRing
The NuvaRing is a soft flexible ring that is approximately two
inches in diameter and is worn in the vagina for three weeks.
The ring contains a combination of estrogen and progestin
hormones similar to the hormones used in the pill. The hormones
contain within the ring are absorbed continuously, direct into
the blood stream through the vaginal walls. According to studies
provided to the Food and Drug Administration (FDA) during the
approval process, effectiveness ratings are listed at 99% when
used according to label instructions. This is comparable to the
patch and better than the Pill’s effectiveness ratings.
LAST RESORT
If you have had sex without birth control or your birth control
method has failed within the past 3 days, you can use Plan B to
reduce your risk of pregnancy. If it has been longer than 3 days
consult your physician.
Plan B
Plan B is an emergency contraception or back up method of birth
control that can only be ordered and taken by women. A
prescription from a doctor is NOT necessary to order this
product and you can buy Plan B at most big pharmacies. Plan B
contains large doses of levonorgestrel that can be found in a
single birth control pill. It will decrease your chances of
getting pregnant up to 89%. The advantage to Plan B is that
easily accessible to women years 18 or older without a
prescription and it is more effective the sooner you take it.
FURTHER QUESTIONS
If you think you may be pregnant SFM has
free pregnancy testing.
We have bountiful resources and advise to help you
choose a
maternity physician, and start your 9-month trek.
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