There are a lot of misconceptions about fertility and trying to get pregnant. You may know someone who seems to get pregnant on a rotating basis, and someone else who has been battling infertility for 10 years. Basically, everyone's road to baby is different. But there are some basics that all women who are trying to conceive should know about.
Luckily, I got a chance to talk with Sarah Lindahl, a Physician Assistant in a busy California OB practice, who sees multiple patients every week who want to conceive and it hasn’t happened yet. Here are six things she wished more women knew about their own fertility and getting pregnant:
1. You can start trying right after stopping your birth control.
Doctors see many pregnant patients surprised that they conceived so quickly after stopping birth control. For many years, the thought was women had to wait three months after stopping the pill before getting pregnant, and a back-up birth control method used, lest she cause harm to her baby before the hormones were out of her system. The truth? This three month wait is actually to allow you to track your cycles and figure out when you are most fertile. If you get pregnant in the first month, congratulations! You found your fertile window without doing any charting. Regardless of which hormonal contraception is used, there is no relationship between birth control and return to fertility. The Depo shot is the only exception.
2. It’s helpful to figure out when you ovulate.
A normal menstrual cycle is between 21 and 35 days, not the 28-day cycle we think of. However, even though your entire cycle may fluctuate, the one thing that’s consistent is the time period between when you actually ovulate and when you get your period or a positive pregnancy test, which is usually 14 days. To calculate your cycle correctly, count day 1 as the first day of full flow and continue until the next day 1 of full flow. Once you know your cycle length, you subtract the number 14. So a woman with a 25-day cycle ovulated on day 11. Ovulation predictor kits (OPKs) are useful especially for women who have inconsistent cycles, but you have to know how to use them correctly and they may not work for everyone.
3. Please understand what is “normal" fertility.
Reproduction in humans is very inefficient. Other species do it much better than we do. Why do we suck at it so much? Unlike men, a woman is only capable of getting pregnant with a lone egg once a month for a limited time during her life. Men have millions of sperm at their disposal for most of their lives. They have access to them whenever they want, and they can even waste their sperm recreationally. Even if a young healthy couple has no barriers for fertility, they only have a 25% chance of conceiving if they get the timing right. That means that 75% of normal, fertile couples won't conceive even if they did everything correct.
That 25% chance every month means that half of these couples will get pregnant in six months, and 85% of them will be successful at the end of one year. Do these numbers sound familiar? That’s because they’re really old, like WWII post-baby boom old, but they’re still relevant. After a year, infertility can start to be considered, but it still doesn’t mean you’re infertile.
Here’s a little secret you may not know: The pregnancy tests at a doctor's office are cheap.
4. Surprise! Home pregnancy tests are just as accurate as the tests in a doctor's office.
How many women come in to the doctor’s office for confirmation after taking three home pregnancy tests because they assumes the one at the clinic is superior? Here’s a little secret you may not know: The pregnancy tests at a doctor's office are cheap. They buy them in bulk and the medical assistants almost always run two of them. If you have one positive home test, that’s all the confirmation your provider needs. Call your OB to schedule an appointment. There’s no need to come in to come to confirm with an inferior test.
5. Think you’re infertile? That may not be the case.
If you don't conceive within one year, it doesn't mean that you can’t or won't ever conceive, but rather it's time to look for reasons why. There are only a few diagnoses out there that make you or your partner infertile to the point where you can’t have a child without intervention. Almost everyone has heard that story about a couple who finally became pregnant when they stopped trying. Or the couple who became pregnant after adopting a baby. Maybe you know someone who got knocked up on vacation. The reality is that it was just her time. None of those things influence fertility. Eggs and sperm have no cognitive powers to know if a couple wants to get knocked up.
6. Don’t compare your fertility to your best friend’s.
Your path to parenthood may not mirror the experience of your friends or your family members. Don't expect to conceive on your first attempt just because your sister did, and don't anticipate that you might be infertile just because your best friend did IVF. Enjoy your journey and make it your own.