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If you are anything like me (and most of my 30-something girlfriends), once you've decided that you are ready to get pregnant and have a baby, you want it yesterday. But most of us learn that conception is easier said than done.
It doesn't have to be that way. If you are otherwise healthy, many new cool tools (as well as knowing some conception basics) can help you maximize your chances of conception right now. Such tools include wrist watches that detect whether there will be a welcome mat for sperm in the female genital tract and digital aids that predict your peak and not-so-peak fertility days.
First: Conception 101
"The first thing couples need to do is to keep track of the intervals between day one of bleeding and day one of their next cycle," explains fertility expert Mark P. Leondires, MD, medical director of Reproductive Medical Associates of Connecticut in Norwalk. "The biggest problem is that people do not pay attention in health class."
The solution involves some simple math, he says. If a woman is aware of her cycle interval and has a regular 28-day cycle, "you take that number [28] and subtract 14, and that should give you the approximate day of ovulation. That is the day to work around," he tells WebMD.
Specifically, he adds, to get pregnant: "Take that day that you presume you are ovulating and have intercourse every other day around it, such as on days 12, 14, and 16 if you ovulate on day 14 of your cycle," he says. "Sperm can last two to three days and this way, there should be sperm there waiting to greet the egg."
You'll even find web sites that do the math for you, including WebMD and BabyCenter.com. Enter your first day of your last menstrual period as well as the average length of your cycle and hit "calculate."
These days, busy couples who want to be pregnant may only be having sex on the weekend and missing their fertile window, which is as small as three to five days, Leondires says.
"We have pretty good evidence to suggest that having intercourse close to ovulation will maximize the chance of conception," agrees fertility expert Randy S. Morris, MD, medical director of IVF 1 in Chicago and Naperville, Ill.
"Plotting ovulation has never been demonstrated to increase the chances for most individuals," he says. "Most people do well enough on their own, but for busy women who travel or whose spouses travel or who are not comfortable having intercourse repeatedly over time, ovulation predictor kits may help further reduce the time frame."
That said, there are a number of methods to help you plot ovulation and increase your chances of conception quickly, Morris says. They include:
Basal body temperature: "Basal body temperature charting is helpful for women who are not sure if they are ovulating," Morris says. It does have some limitations though. For example, "It's an inexpensive way to see if you are ovulating, but it does not predict when ovulation occurs," he explains. "It can only tell you after the fact that ovulation has occurred -- not before."
Here's the deal: You take your temperature first thing each day and plot it on a chart. The goal is to identify a shift of at least 0.4 degrees Fahrenheit after ovulation, making your chart biphasic (which means showing low temperatures before ovulation in the follicular phase and higher ones after ovulation in the luteal phase).
For most women, 96 to 98 degrees is considered normal prior to ovulation and 97 to 99 degrees after ovulation. Many web sites allow users to download charts to plot basal body temperature.
Still, "some people will not have a rise in temperature when they ovulate and this method doesn't say exactly when it happens, so it may be a little bit too late," says George Attia, MD, director of the division of reproductive endocrinology and infertility at the University of Miami in Florida. The shift "can happen two to three days after ovulation. By that time, it's a little too late to try to have intercourse to achieve pregnancy."
"I think taking your temperature is difficult and prone to inaccuracy and it is stressful because you must wake up each morning and grab your thermometer," Leondires says. "I don't recommend it because ovulation predictor kits are easier and more sensitive and have less of an error rate."
Ovulation predictors: Some ovulation predictor kits test urine for hormones that signal that ovulation is imminent. Such tests typically detect levels of lutenizing hormone (LH), which is produced by the pituitary gland and triggers ovulation. LH generally rises 12 to 36 hours before ovulation occurs. To properly use these tests, "if you think you ovulate on day 14 of your cycle, start testing on day 11 so you can clearly see a negative and then clearly see a positive," Leondires says.
"Read the instructions," Leondires suggests. But "usually what is recommended is to test the 2nd morning, void [your urine] because most people start their LH surge around 3 am and it starts off really low. So if you get up at 6 am, you may not pick it up because the urine is so diluted," he says. "You should ovulate about 36 hours after you get the positive sign," he says.
When you see a positive, "have intercourse that day and the next day. In that way you have reliably timed intercourse and have the best chance of conceiving, assuming everything else is normal," Leondires says. These tests cost between $25 to $40 and usually contain five to seven test strips.
Donnica Moore, MD, a women's health expert based in Far Hills, N.J., says a more expensive digital monitoring system known as The Clearblue Easy Fertility Monitor may be more helpful. This electronic system also tests levels of hormones in the urine and tells you when you are at peak and low fertility. It costs about $200.
"Most other urine tests are geared toward the day you are ovulating, but the Clearblue Easy gives more of a window," she tells WebMD. This system monitors both estrogen and LH. "Most women are not aware that if you have a normal cycle, you have probably five days where you are most fertile, such as days 9 to 14 in a 28-day cycle."
Saliva testing: Ovulation predictor kits sold in drug stores can also test saliva and are far less expensive than urinary kits, Morris says. "These kits basically look at the mineral content in saliva when it dries," he says.
They include a glass slide and microscope to look for a "ferning" pattern, or a pattern that resembles a fern leaf. This pattern means a woman will ovulate sometime in the next several days. The cervical mucus has been thinned and prepared by the hormone estrogen for the passage of sperm. If it does not fern, the mucus will be hostile to the passage of the sperm.
Unlike urine tests, which are disposable, this type of test can be used forever and costs about $30 to $40.
Do-it-yourself semen analysis: Today, most drugstores also sell male infertility tests that help measure sperm concentration.
"An over-the-counter sperm test doesn't give you all the specific information you would get from a semen analysis, but it can tell if you have less than the minimum amount of motile sperm," Morris says. Sperm need motility to be able to swim well and survive for a number of hours in the female reproductive tract. "As a tool, these tests may help identify some couples who have a problem early in the process," he says.
Leondires agrees: "The home semen analysis kits don't provide enough information, but if their results are bad, it's bad," he says. "We are so focused on female infertility that we forget about males. The two big issues with male-factor fertility is: boxers over briefs, meaning no tight pants or Speedo bathing suits. The other is that now is not the time to hang out in a Jacuzzi or hot bath," Moore says.
Both briefs and too much time in a hot tub can affect male fertility.
Ovulation wristwatch: Another high-tech option to help predict ovulation is a new wristwatch that measures changes in sodium concentration. Such changes reflect what is going on in with cervical mucus.
At ovulation, cervical mucus increases and becomes more pliable and slippery to help sperm enter the female reproductive tract. These changes are reflected in perspiration, explains A. F. Haney, a professor of obstetrics/gynecology and chairman of the department of obstetrics/gynecology at the University of Chicago in Illinois. Haney helped invent the watch.
"A sodium monitor in the back off the watch measures perspiration and looks for a preovulatory rise in estrogen that lasts many days," he says.
Only worn while sleeping, the watches "provide a window of opportunity that is fairly large," he says. "The watch gives an interval of time; it's not 24 hour thing There are four to five days when intercourse is reasonable and this doesn't put on pressure on couples to say 'Monday at 2 p.m.'"
Put another way: "You are looking at preovulation estrogen rise as measured by sodium changes. So you can have intercourse multiple times on your own volition and get a better cumulative likelihood of conception," he says.
The watch, sold commercially as the OV watch, costs $189 for a starter kit, which includes a three-month supply of sensors.
Supplements May Also Aid Conception
According to Lynn Westphal, MD, assistant professor of obstetrics and gynecology at Stanford University in Stanford, Calif, a certain supplement known as FertilityBlend for Women may help women get pregnant sooner.
The supplement contains Vitex (chasteberry), the amino acid L-arginine, antioxidants (such as green tea and vitamin E), selenium and other minerals, and B vitamins, including folic acid, which is in prenatal vitamins to reduce the risk of neural tube birth defects.
In a pilot study conducted at Stanford, 26% of women taking the supplement daily were pregnant within three months, compared with a pregnancy rate of 10% among women taking a dummy pill, Westphal tells WebMD.
"No one knows exactly how it works, but it does seem to make the corpus luteum function better and normalize ovulation," she says. The corpus luteum secretes the hormone progesterone, which thickens the uterine lining in preparation for receiving a fertilized egg.
"Women who most benefit are the ones with more irregular cycles and a big percentage of these women are polycystic ovarian syndrome patients," she says. "Our next goal is to look more specifically at PCOS." PCOS is a leading cause of infertility.
The supplement is "very well tolerated, but some people have a little nausea with the supplements as they do with prenatal vitamins," she adds.
But many in the fertility field are skeptical about any and all supplements. "Avoid herbal remedies or supplements," Morris warns. "Some of them, such as [the immune booster] echinacea, can inhibit sperm penetration and may have real adverse effects. At the very least, they are not studied, so the safest thing is to avoid them."
Still Not Pregnant?
If you've haven't conceived, took into getting some medical advice to get pregnant. "If you are doing everything right and are not pregnant in six months, it's not unreasonable to seek help," Leondires tells WebMD.
Doing everything right entails "documenting ovulation, timing intercourse appropriately, and at six months, get the rest of your system checked," he says.
A doctor would then perform a test to make sure that your fallopian tubes are open and order a semen analysis for the male partner, he says. Depending on your case, other tests may be ordered as well.
Published July 18, 2005.
SOURCES: Mark P. Leondires, MD, medical director, Reproductive Medical Associates of Connecticut, Norwalk. Randy S. Morris, MD, medical director, IVF 1, Chicago and Naperville, Ill. Lynn Westphal, MD, assistant professor of obstetrics and gynecology, Stanford University, Stanford, Calif. Donnica Moore, MD, a women's health expert based in Far Hills, N.J. George Attia, MD, director of the division of reproductive endocrinology and infertility, University of Miami, Florida; A. F. Haney, professor of obstetrics/gynecology; chairman, department of obstetrics/gynecology, University of Chicago.