When you are trying to conceive, you might want a little more information than what you learned about the birds and the bees in middle school. Preconception counseling can include some review of the reproductive system along with fertility facts and a quick check for infertility risk factors. The American College of Obstetrics and Gynecology offers a checklist of topics that may be covered in a fertility evaluation when you are trying to conceive.
Am I ovulating normally? To get pregnant, the female body has a monthly cycle that sets the stage for the release of an egg, fertilization of the egg, growth of a fertilized egg into an embryo and implantation into a uterus. During preconception counseling, your doctor will want to find out if your monthly cycles are normal in length and if you are releasing eggs at the right time each month.
When you’re trying to conceive, you might have been advised to monitor your basal body temperature (BBT) over several menstrual cycles to determine whether your ovaries release eggs (ovulate) regularly and to time intercourse to optimize your chances of pregnancy. This method is over-rated for several reasons: Many factors can interfere with BBT monitoring, including irregular sleep-wake patterns, caffeine, or exercise schedules. Also, by the time you note a rise in BBT, ovulation has already occurred, and the optimal window for fertilization has passed. So, a rise in BBT only helps to confirm that you ovulated, but cannot help you predict ovulation and cannot alert you to the best time to try to conceive.
A better option is an ovulation prediction kit (OPK) which measures the level of luteinizing hormone (LH) in your urine. These kits can be purchased over the counter and are better at predicting ovulation when used properly. Take a look at Univfy’s blog on “Best Days to Conceive: Timing for Ovulation” for when and how to use OPK’s when you’re trying to conceive.
Using ovulation prediction kits for two months and timing intercourse with ovulation may be all you need to become pregnant. Sometimes tracking ovulation with ovulation prediction kits shows you a problem with ovulation, or you may already know that your cycles length vary more than is considered normal. Although we are taught that the human menstrual cycle is 28 days, normal cycle lengths can range between 21 to 45 days. Other features of the cycle including days of flow and heaviness of flow are also considered when defining "normal." More information about what is a normal menstrual cycle can be found here.
Are my hormones in order? If you have hormonal imbalances, these may contribute to problems with ovulation and normal cycle length. If you and your partner are trying to conceive and suspect you have infertility, the preconception infertility evaluation may become more extensive to try to diagnose and optimize your reproductive success. Your doctor may order blood tests for hormones, such as progesterone, prolactin, and thyroid, to diagnose factors contributing to the lack of monthly ovulation.
Are my fallopian tubes free and clear? After your egg is released from your ovary, the egg travels through your fallopian tubes to your uterus. If the egg becomes fertilized in the fallopian tubes, it continues to grow into an embryo as it moves along the tube. In a few days, your embryo moves down into the uterus where it can implant, and in-turn you can become pregnant. Blockage in the fallopian tube can cause infertility by preventing the above process from happening. Blocked tubes (a form of tubal disease) also put you at risk for an ectopic pregnancy. A blocked tube prevents the passage of the embryo to the uterus, and the embryo ends up implanting in the tube instead of the uterus. An ectopic pregnancy, where the embryo implants outside the uterus, can’t support the development of a baby. It can be very dangerous, even fatal, to the mother if not diagnosed and treated early.
If your doctor suspects that you may have blocked fallopian tubes or other structural problems in your uterus, he or she can use various outpatient imaging tests to examine you, including:
When trying to conceive, don’t be discouraged if you encounter these challenges. Armed with knowledge about your own reproductive health, you can seek the care and monitoring that you need.
Visit Trying To Get Pregnant for more fertility health information and interactive tools to personalize your fertility path.