Fertility And Conception: Fact Versus Fiction

From the SSM Health St. Clare Hospital - Fenton:

June 1, 2021

If you’re contemplating having a baby or you’ve been actively trying to get pregnant, you’ve probably been inundated with lots of tips, advice, cautionary tales, conspiracy theories, and personal stories from family members, friends, co-workers, neighbors and even the stranger at the grocery store. Or, if you’ve ever conducted a simple internet search, you’ve likely unearthed even crazier ideas and suggestions from random people in the comments section.

These days, it seems there’s no shortage of people with opinions and convictions, who are all too willing to impart their fertility “wisdom” – whether you solicited their advice or not. For many women who are trying to get pregnant, the whole process can be daunting; not to mention trying to sift through all of the information – and misinformation – to figure out what’s fact and fiction.

That’s why the best place to start is with your OB/GYN, who has the training, experience, and medical knowledge to help you find the answers to your fertility and conception questions. We asked our own Amy Bilyeu, MD, a SLUCare OB/GYN who practices at SSM Health St. Mary’s Hospital in St. Louis, Mo., to answer some of the most common questions she gets from patients on the topic of getting pregnant.

Q. How do I know my cycle and when I’m ovulating?

A. Knowing your cycle is important to getting pregnant. Most women likely ovulate 14 days prior to their next period. However, I recommend using an app that will help you keep track of all your cycles. As you put more data in the app, it will tell you when you’re most likely to ovulate based on your previous cycles. Only about 15 percent of women have 28-day cycles, so it’s best to know your body so you can optimize when to have sex instead of having sex on “Day 14” of your cycle.

Q. When is the best time to have sex to get pregnant, and are there optimal positions?

A. I recommend having sex every other day from day 12 to 21 of your cycle so if you ovulate a little early or later, there will be sperm in your body when you ovulate. Sperm last in your body for approximately 72 hours, so having sex every other day is more than sufficient for conception.

As far as recommended positions, those are really myths. There really aren’t any sexual positions that have been shown to increase the chances of conception. Keep in mind: hundreds of millions of sperm are released with a single male orgasm, so if you have sex around your ovulation time – no matter what sexual position you’re using – you can get pregnant.

Q. I’ve been trying to get pregnant for six months with no luck. Does this mean I’m infertile?

A. Not necessarily. There are several factors at play, including your age, biological factors, and overall health. Consider this: if you’re a healthy woman in your 20s or early 30s, the chance that you’ll become pregnant is anywhere from 25 to 30 percent in any single menstrual cycle. This percentage starts to decline as you enter your early 30s. It declines more rapidly after the age of 37. And, by the age of 40, your chances of getting pregnant drops to less than 10 percent per menstrual cycle. A man’s fertility also declines with age, but not at the same pace.

Here are some guidelines to consider: if you’ve been actively trying to conceive for one year without using any form of birth control, you may want to consider an infertility evaluation. If you’re over the age of 35 and have been trying for six months, it may be time for an infertility evaluation. If you’re over the age of 40, consult with your OB/GYN as soon as possible.

Q. Which foods should I eat when trying to conceive?

A. When it comes to diet recommendations for getting pregnant, I follow the American College of Obstetricians and Gynecologists (ACOG), which advises eating a healthy, balanced diet and taking a daily prenatal vitamin. Try to eat more fruits and veggies and reduce your sugar intake. For example, spinach, oranges, and chickpeas are all good foods to add in when you’re trying to get pregnant. They are packed with various vitamins, minerals and even protein. However, most women don’t change their diets and still conceive without any issues, especially since 50 percent of pregnancies are unintended.

Q. Which foods or products should I avoid?

A. As far as foods or products to avoid or limit, I first recommend that you stop using any tobacco products, avoid alcohol, and decrease your caffeine intake to less than 300mg/day. I also tell my patients to avoid any foods that you’d normally avoid during pregnancy since most women don’t often know they’re pregnant until four to five weeks – foods such as high mercury fish (swordfish, tilefish, king mackerel and shark, which can harm a baby’s developing nervous system even before conception); trans fats, unpasteurized dairy and any raw animal or fish products.

However, it’s not just women who need to monitor their diets and lifestyle choices. Their male counterparts also need to be mindful of certain things if they’re hoping to conceive. For example, I tell hopeful dads-to-be to avoid trans fats and limit alcohol consumption, which can decrease sperm count and quality. It’s also good for men to avoid using cigarette smoking, which can impair sperm motility and damage sperm’s DNA.

Again, most women get pregnant without changing their diets at all. So, as far as conceiving, there really isn’t any reliable data regarding what foods you should avoid to boost your chances of conception. Making healthy food and lifestyle choices is generally a good rule of thumb.

Q. Can stress really affect my chances of getting pregnant?

A. Yes! Stress is a major factor that often gets overlooked. Stress can affect our menstrual cycles and can even cause a woman to stop ovulating altogether. If you don’t ovulate, you can’t get pregnant. Additionally, high cortisol levels from stress not only decrease your chances of getting pregnant, but it can also affect your baby’s development in utero.

That’s why we say it’s important to focus on our mental well-being just as much as optimizing our physical health prior to pregnancy, whether that includes talking to a therapist, incorporating regular exercise/yoga, and/or taking some form of medication. I often remind my patients that you can’t have a healthy pregnancy and baby without a healthy (both physically and mentally) mom.

Of course, controlling stress is easier said than done, but it’s critical for both conception and throughout the pregnancy. Identifying the source of your stress is the first step, so you can figure out how to eliminate or limit that stressor for you. Be sure to talk to your doctor for more guidance and suggestions about how to manage your stress.

Q. Any other tips?

A. Talk to your OB/GYN as you begin family planning. Getting a pre-pregnancy care checkup is a good first step on the road to pregnancy. Your doctor will review your medical history, diet and lifestyle, vaccinations, and medications to better prepare you (and your body) for a future pregnancy. This also gives you a chance to ask your doctor about any concerns or questions you have.

I always give my patients the American College of Obstetricians and Gynecologists (ACOG) guide on good health before pregnancy, which contains a great deal of helpful information and recommendations:

Learn more about fertility, family planning services and maternity care at SSM Health.

Amy Bilyeu, MD, is an OB/GYN, who practices with the SLUCare Physician Group at SSM Health St. Mary’s Hospital – St. Louis. She provides obstetric and gynecological care, with interest in family planning, HIV/AIDS, and abnormal uterine bleeding. She uses innovative techniques in her practice, such as laparoscopic and vaginal surgery. Dr. Bilyeu is an assistant professor in the Department of Obstetrics, Gynecology, and Women’s Health, Division of General Obstetrics and Gynecology, at Saint Louis University School of Medicine. She is also a member of the American College of Obstetricians and Gynecologists. To make an appointment with Dr. Bilyeu, call (314) 977-7455.

This press release was produced by the SSM Health St. Clare Hospital - Fenton. The views expressed are the author's own.