What to do if you have been trying to conceive for less than 3 months, for 6 months or for more than a year?

Have you been trying to have a baby? For how long? It is important to ask yourself these questions because the length of time of this process can determine the decisions to be made. Regardless of the time that you have been trying to conceive, a healthy and balanced diet, going to bed early, exercising, no smoking or drinking alcohol, as well as avoiding excessive stress, are always good ideas and will favor your process towards having a baby. A healthy and balanced diet includes fruit and vegetables, healthy fats (olive oil, nuts, seeds), whole starchy foods like whole bread, pasta, rice, corn, and potatoes. Dairy food like milk, cheese, and yogurt are also recommended, as well as other protein-rich food sources such as lean meat, chicken, fish, eggs, beans, and lentils. The exact amount of portions depends on each individual (age, preferences, physical activity, health aspects), and a certified dietitian is the professional that can guide you better. Try to avoid processed foods and foods that are high in fats and sugar.

During the process of TTC and until the 12th week of pregnancy, you should take 400 micrograms of folic acid every day in order to prevent neural tube defects like spina bifida. In some cases higher doses are prescribed, so always remember to ask your doctor (1). It is very important that you’re able to identify your fertile window, which corresponds to the 6 days previous to your ovulation. Why is it this important? Because the chances to conceive are the highest in this period. Having intercourse during your fertile window gives you the best chance of getting pregnant If you have been trying to conceive for 6 months and you are 35 years or older, it might be the time to visit a fertility specialist. Why is this? Because after this age, the ovulation is less frequent, there are more cycles where no egg is released, and the quality and number of eggs decrease substantially (2). If you have been trying to conceive for a year or more than a year does not mean that you won’t be able to have a baby. The fertility specialist should perform a full medical check including blood tests, physical examination, and semen analysis. With this information, the specialist will guide you and give you the pharmacological, surgical, and/or assisted conception methods available that could fit better for you and your partner (3). Some pharmacological options include drugs that help with the egg’s release in women who do not ovulate regularly or cannot ovulate at all, like clomifene, gonadotropins, tamoxifen, gonadotropin-releasing hormone, and dopamine agonists. Some side effects could include nausea, vomiting, headaches, or hot flushes (4). On the other hand, surgical procedures could be fallopian tube surgery, which is performed when the fallopian tubes have become blocked or scarred. Also, laparoscopies can be useful to treat endometriosis or to remove submucosal fibroids (4). Last but not least, assisted conception options are also available, like intrauterine insemination (IUI), in vitro fertilization (IVF), an egg and/or sperm donation. IUI, also known as artificial insemination, involves inserting sperm directly into the womb via a thin plastic tube passed through the cervix (4). This is done around the time the ovary releases one or more eggs to be fertilized (5). In the case of IVF, it is when an egg is removed from the ovaries and fertilized outside the body in a laboratory. Fertility medicine is taken to encourage the ovaries to produce more eggs than usual and this procedure could be done using donor eggs. The fertilized egg (embryo) is then returned to the womb to grow and develop (4).

References: 1.NHS. Vitamins, supplements and nutrition in pregnancy. https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/ 2. American Pregnancy. Tring to convince after age 35. https://americanpregnancy.org/getting-pregnant/trying-to-conceive-after-age-35/ 3. Kindara. I’ve been TTC for over 2 years, and I’m still not pregnant. What now? https://www.kindara.com/blog/ive-been-ttc-for-over-2-years-and-im-still-not-pregnant.-what-now 4. NHS. Infertility. https://www.nhs.uk/conditions/infertility/ Mayoclinic. Intrauterine insemination (IUI). https://www.mayoclinic.org/tests-procedures/intrauterine-insemination/about/pac-20384722