Ask The Expert Series: The ABCs of TTC

Updated: Jan 4, 2019

Laura O' Leary is my guest writer on The Woman and The Apron. Truth be told she is not a guest. She is my sister in law and my friend.


Laura lived and breathed my IVF journey so .. she knows too much about infertility and I fear I may have traumatized her in a way.


She's well known for naming what she loves (even inanimate objects) which told me how much she cherished my own miracles when she went on to name my 3 precious embryos: Snap, Crackle and Pop. Pop was Casey. He was known as Pop to everyone for 9 months.


Laura is like my editor and chief on this blog, she is a talented writer with an exceptional brain and has just started down her own path of trying to become a parent. Read her blog post HERE. We put our heads together to bring the #ttccommunity and those thinking about #tryingtoconceive some expert advice and peace of mind by asking out expert fertility friends over at the Waterstone Clinic the questions Laura wishes she knew before getting started.


So here they are:

1. How best should you prepare before starting trying to conceive, e.g. visit GP for general check-up, bloods, etc. ?


To prepare for pregnancy, your health is of upmost importance. There are simple things to do to prepare. Know the link between age and fertility: the earlier the better. Maintain a healthy weight as it helps to regulate your cycle, and be active in an exercise you enjoy. Eat a healthy, balanced diet as that plays such an important role in pregnancy. Start taking folic acid and vitamin supplements. The only things you need to reduce are alcohol and smoking (better to quit!).

You should also take note of your menstrual cycle – get to know what’s called your “fertile window”. In a 28 day cycle, a woman will ovulate on day 14: the fertile window is three days before this, so it’s on day 12, 13 and 14 that you have the best chance of getting pregnant.

Chatting to your mum will also be very helpful for knowing what to expect: did she have trouble? Did she have early menopause, or endometriosis? This will help give you an idea of what you might expect. Also, talk to your partner about your medical histories: did he have surgery on his testicles when he was young, has he ever had chemotherapy? Have you ever had ovarian cysts?


2. Where is the best place to get proper medically or professionally approved information about preparing for pregnancy with regard health and fertility?


Always talk to a healthcare professional. This an either be a fertility specialist or your own GP, but they will be able to give you specific advice based on you, rather than generic advice. There are plenty great resources on the internet – such as www.myfertilitycheck.ie – and many personal blogs that will give great advice, but just make sure everything is backed up by experts!

3. What timelines should you be thinking about in terms of conceiving? 1 month, 6 months, 1 year?


Out of 100 couples trying to conceive naturally:

20 will conceive within one month

70 will conceive within six months

85 will conceive within one year


1 in 6 couples have trouble conceiving, so you are very much not alone! If you are under 35, you could try naturally for up to a year before looking for help, but if you are over 35, it is a good idea to consult specialists after 6 months of trying.


4. Are there any red flags that I could possibly identify before starting trying for a baby that might indicate a couple will need a little more help or preparation, e.g. irregular cycles?


There are a few red flags that might push you to seeing a fertility specialist when you are planning on getting pregnant. There can be red flags for the female partner and the male partner. For the woman, her age and cycle are really important. Fertility starts to decline after 32, and you might need a little more help if you are over 35. With regard to the cycles, if you don’t get a monthly period, it might mean that your ovaries are not releasing eggs at all. If your periods are very short (e.g 20-22 days) or lengthening (35days+) you should check in with your GP. Very painful periods may also be a cause for concern: many women will need to take some pain killers during their period, but others may need time off work – and that level of pain may indicate something like endometriosis.


Other red flags might be in your medical history: have you ever had surgery on your fallopian tubes, ovaries, or on fibroids? Some women find that after small surgeries (maybe to remove a cyst) that their tubes are not open, that their ovaries don’t have many eggs, or that they had fibroids in their uterine cavity. Your family history can also give a good insight – did your mum, sister or family members have difficulties conceiving?


Your partner’s medical history is also important: did he have undescended testicles as a child? Did he ever have mumps? Have any of his family members needed fertility treatment? Has he had chemotherapy in the past?


5. What are the things I absolutely should be tracking and what are the things that are maybe a nice to have but also could over complicate things for an over thinker like me, for example, start tracking ovulation 6+ months before trying but no need to track basal temperatures every day?


The main thing to understand and track is your menstrual cycle. The menstrual cycle starts with the first day of your period (with red blood) and ends when the next period begins (when you start back at Day 1). It is helpful to track your period, and any symptoms such as pain or tenderness, moods, or discharge as that will give you clues as to where you are in your cycle. There are many free period tracker apps that can help with the collection of all the data!


When you are trying to conceive, it is really important to know your own cycle and what is normal for you. One of the things tracking your period will help you find out is your fertile window. Ovulation happens 14 days before your period arrives, but your most fertile time is the three days before you ovulate: it is those three days where you have the best chance of becoming pregnant naturally.


6. Before the year mark, is it a waste of money to be getting hormone blood tests and / or using at home sperm count checkers?


There is no real need for the tests when you are first starting out, unless you have a concern. If you are concerned about your fertility, the tests can help you alleviate those and put you on the right path. If it turns out that something wasn’t right, then you’ll have caught it quickly and be able to mitigate it. If there’s nothing wrong, then you can continue trying without the worry.

Proper robust tests are always better than home kits, however. When you go to your GP or fertility specialist, you can have the tests done within a few days and when you are tested you will have the results the same day and the specialist will be able to explain and discuss the results with you, and answer all your questions: You can have tests within a few days and results within the hour or so. Fertility clinics or even GPs will be able to explain the results to you rather than trying to interpret home kits.


7. How much does stress really impact fertility?


Stress is very unique to each person, but trying to get pregnant can cause a lot of stress for couples. While stress doesn’t cause infertility, it can make things difficult for, and between couples. Sometimes couples find all the waiting to be very stressful, and it can often help to put a date in the diary to alleviate stress: if nothing is happening by this date, to go see a specialist. If you have a plan, that can take away some of the stress.


Going to see a specialist for a fertility assessment can often reduce your stress as it takes away the worry. Our fertility specialists often give couples the good news that nothing is wrong, and help them work out their natural fertility window.


It’s also a good idea to pinpoint the stressful situations in your life and see what you can do to reduce the stress in that area. It might be to do with trying to lose weight, financial issues or events such as weddings, christenings or Christmas. Talking to your partner is really essential. Find out what might work to mitigate the stress, find coping mechanisms that work for one or both of you, and if needs be, talk to a counsellor: your relationship is central to everything and it’s important to look after each other.


8. What is actually considered ‘late’ when it comes to a period? Can you take a home pregnancy test if you are a day later than usual or should you wait a few days longer, and if so….how long! You’ve already been waiting 2 weeks!


Pharmacy pregnancy tests are quite sensitive now and can pick up low levels of hormones as soon as your period is late. For many people, however, although they may have predictable periods, they may not be ‘late’ on the day they think, so they may be left disappointed. If possible, it is better to wait a few days, and to test with the first urine in the morning when the hormones will be strongest.


9. Should I completely avoid alcohol and coffee while TTC? And if so, that’s a whole year of avoiding those things which can really impact social life and activities?


Avoiding or limiting caffeine and alcohol is a personal choice. We do know that there is no safe limit for alcohol in early pregnancy, and many people may not be aware when they are in the early stages of pregnancy. At the same time, it is important to keep your life as normal as possible, keeping your stress levels down, and to enjoy your life while keeping your health in mind and using moderation.


10. How many times do you really need to be having sex the week you are ovulating?


Continue your sex life as normal. There’s no need to cause strain in your relationship thinking that you must have sex a certain amount of times. If you’re trying to get pregnant, you just need to make sure you have sex a minimum of once during your fertile window in the month.


11. When is it time to make an appointment with a fertility clinic ?


The best answer for that is it’s time to talk to the fertility clinic when you decide it’s time to talk to the fertility clinic. This might be at the start of your journey, before you start trying when you might want to find out your fertility baseline and get reassurance and advice on how best to try naturally for a baby. It might be later if you have a concern about your fertility, or if you’re over 35, or have been trying for over a year. Your fertility journey is yours, and you can seek help when you feel ready for it.


12. What do I need to know before going to the fertility clinic?


Most clinics will have a patient liaison/support person who will guide you through your first visit and what to expect. It’s a good idea to write down your questions beforehand so you can work through a list with the team. If you take notes during your visit, you can go back through the answers and follow up on anything you want to. The team will work through a lot of questions, so it’s a good idea to know things like the length of your cycle, any changes you might have noticed, an idea of how long you’ve been trying, your medical history and your partner’s medical history, etc. At most initial visits, you will also have a transvaginal scan which is an ultrasound scan performed with a small probe. It is not painful, but may be a little uncomfortable. The scan will show you your womb and ovaries and the doctor will be able to give you advice and lay out a fertility plan for you.


The team will always be very welcoming and you’ll be glad you went: taking control over your fertility journey and making a plan can only be a good thing!

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