I'm always so envious of the couples who have their reproductive schedule so planned out. Planning means you're adding anticipation and preparation, and it adds something a little extra special to such an exciting time. If I ever have another one — baby, that is — I want to have the experience of planning before conceiving. I love my magical surprise baby, but there are measures to take ahead of time to make sure you're in the best physical health for pregnancy and childbirth. So if you're planning on trying to conceive in 2019, here's what you should be doing now.
I checked in with Dr. Alan Copperman, a fertility expert and Medical Director at Progyny, and Dr. Edward Marut of Fertility Centers of Illinois to see what should be on your New Year TTC to-do list. I asked about all kinds of vitamins, supplements, if there was anything that should be given up (starting now), as well as what dads should be doing to help ensure you have the best possible pregnancy outcome and the healthiest little babe.
When it comes to supplements and vitamins, Dr. Copperman cites The American College of Obstetricians and Gynecologists, saying that women looking to conceive should be taking "at least 400 micrograms of folic acid daily to help prevent major birth defects of the fetal brain and spine" both before and during pregnancy. He also mentions vitamins such as Vitamin C and Vitamin D, as well as "adequate" amounts of Vitamin B-12, as things that can help "improve outcomes for both mom and child." Dr. Marut recommends that women take a calcium supplement because "calcium helps to maintain the bone density that is lost while a baby develops," while Dr. Copperman mentions that some women may need more iron during their pregnancy to boost red blood cell production and overall health (so definitely check with your doctor to see if you're one of those women, just in case).
In fact, Dr. Copperman says that "preconceptual care can be really important, as it is far easier to prevent disease than it is to cure it." Some things you can start doing now are, "taking a prenatal vitamin, which can prevent neural tube defects, and maintaining an ideal body weight" can be helpful to both mom and baby. Moderating drinking and stopping smoking is also advised. When asked how long a woman should wait to conceive after she stops smoking, Dr. Copperman says that time isn't as important as stopping before conception. Same goes for drinking. Dr. Copperman says it's okay to drink 1-2 drinks per week but make sure it's before your ovulation and once you try to conceive, stop drinking all together, just in case.
When it comes to your reproductive checkup, Dr. Copperman says some of the things you may expect at your appointment are, "an ultrasound to evaluate the ovaries, and a blood test for AMH (anti-Mullerian Hormone) drawn to evaluate ovarian reserve." He mentions genetic testing as well, which is easily accessible and can give you answers about many possible genetic defects very quickly.
But what about the dads? It seems like it's probably important for the men get in on all the preparation as well. Indeed, Dr. Copperman says the latest research suggests that "paternal micronutrients could affect the development of offspring through mechanisms called 'epigenetics' that involve gene regulation." As far as supplements dads-to-be should be taking, if any, Dr. Marut says that men looking to optimize their fertility potential can benefit from Coenzyme Q10, which has been shown to increase sperm count and motility (movement).
"Vitamin E can also improve sperm count while folic acid can decrease chromosomal abnormalities," he adds. "Fish oil and multivitamins may also improve sperm quality." Look how far science has come! See? It's not just all up to the moms now; dad needs to prepare too. Even if that means going to the doctor.
Dr. Copperman says it's "reasonable for a man to go in for a checkup, as well. A simple semen analysis will assess the count, the motility, and the morphology (shape) of the sperm and will let a couple know whether there is an issue that needs to be addressed." Those potential issues could include low sperm count as a result of everything from hormones to structural defects to infections or environmental factors. But whatever your partner's issue might be, the faster you can treat it, the sooner you can focus on the best possible outcome. Dr. Marut sites the American Society for Reproductive Medicine. stating that "men and women are diagnosed with infertility equally." Which means it's best for both mom and dad to get checked out so doctors can address any issues early on.
Dr. Marut says that a woman should see a fertility doctor if she has been trying for a year and is under age 35, or if she has been trying for six months and is over age 35. He also mentions that women who have irregular periods, "have been diagnosed with Polycystic Ovarian Syndrome (PCOS), endometriosis, fibroids, ovulatory disorders, damage or blockage to the fallopian tubes or have undergone any cancer treatment" should see a fertility specialist right away.
For men who have undergone cancer treatment, experienced trauma to the genitals, or are taking certain medications or athletic performance supplements, Dr. Marut says it's wise to make an appointment with your doctor or fertility specialist for a "semen analysis and medical exam."
Some more advice for hopeful future parents from Dr. Marut is to "get in shape before you try to conceive and strive for a normal body mass index."
"Obesity in both men and women will have negative effects on fertility, and make the pregnancy risky," he says. Dr. Copperman agrees, confirming that "focusing on health and wellness is always a good idea. Eating well and getting rest make good common sense."
I guess it's time to start making some green smoothies. (Don't worry though, you'll learn to love them.)
If you're beginning your journey to conception in 2019, just know that science is on your side. Take your vitamins, eat healthy, drink less and track your menstrual cycles so you can better predict ovulation. There are plenty of ovulation prediction apps out there that can help. And remember, if you try for 6-12 months with no success, it's not the end of the world. The sooner you check in with a specialist, the sooner you can get on the right track!
After experiencing a traumatic c-section, this mother sought out a doula to support her through her second child’s delivery. Watch as that doula helps this mom reclaim the birth she felt robbed of with her first child, in Episode Three of Romper's Doula Diaries, Season Two, below. Visit Bustle Digital Group's YouTube page for more episodes, launching Mondays in December.