Countdown to Pregnancy: Your Ultimate Five-Year Fertility Plan

Do you dream of becoming a parent one day? Even if you aren’t planning to conceive for years, intended mothers and fathers can take steps to increase fertility. “I would encourage people to prepare as early as possible – even years in advance,” says Mary Jane Minkin, M.D., a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine. “A healthy lifestyle prepares for a healthy pregnancy and conception.” Consider this guide as your ultimate five-year fertility plan.

Before trying to conceive (TTC), “you should be as close your ideal body weight as possible,” says Dr. Minken. She says being too heavy can mess up the ovulation cycle, and it may also increase your risk of miscarriage, gestational diabetes, high blood pressure, C-section, and other pregnancy complications. Babies born to overweight mothers may be larger than normal (macrosomia), leading to a difficult vaginal delivery.

Being too skinny also messes with ovulation, since an underweight body can stop producing estrogen. Too-thin mothers also have a higher chance of delivering a low-birth-weight baby, going into preterm labor, or becoming anemic.

A balanced diet and regular exercise can help women lose (or gain) weight, but it can take months or years to see lasting results. That’s why it’s important to adopt healthy habits years before attempting to get pregnant.

“Smoking impacts the baby during pregnancy, and it may also impact your ability to get pregnant,” says Dr. Minken. More specifically, smoking can affect hormone production and diminish the quality of your eggs. Another good reason to quit now: you won’t have to kick the cigarette habit cold turkey after conception. Smoking during pregnancy is correlated with an increased risk of miscarriage, preterm delivery, stillbirth, low birth rate, and sudden infant death syndrome (SIDS).

Having a partner who smokes is almost as detrimental, since Baby can still be affected by secondhand smoke in the womb. What’s more, smoking may damage DNA in a man’s sperm, which also affects fertility, according to the Centers for Disease Control and Prevention (CDC).

Being overweight or underweight can affect ovulation, but other factors can also prevent your ovaries from regularly releasing an egg. These include polycystic ovarian syndrome (PCOS), endometriosis, tubal disease, thyroid dysfunction, and more.

So how do you know if you’re ovulating properly? “Store-bought ovulation predictor kits (OPKs) are pretty accurate,” says Dr. Minken. “They detect the surge of a hormone called LH that women make before they ovulate.” She suggests using OPKs for a few months to evaluate your ovulation. Any problems should be discussed with your Ob-Gyn – you may need to regulate your cycle with medication like clomiphene, or you may need to treat the underlying cause of the ovulation issue.

Not only are sexually transmitted diseases (STDs) annoying and potentially painful, they can also affect your future fertility. “I encourage people to minimize their chance of getting an STD because pelvic infections can decrease their fertility,” says Dr. Minken. Pelvic infections can sometimes occur as a complication from chlamydia and gonorrhea. Left untreated, the infection can damage reproductive organs like the uterus and fallopian tubes.

“A woman should make an appointment with her healthcare provider a few months before she tries to gets pregnant. There are certain medical conditions and medications that can impact a pregnancy,” says Dr. Minken. Your doctor will assess your health history to determine if you need to take any special precautions. For example, those with high blood pressure, heart conditions, thyroid disease, or epilepsy may need close monitoring before and during pregnancy. The doctor should evaluate a woman’s diabetes risk, because “if a woman conceives with high blood sugar, she has a much higher chance of having a baby with a birth defect,” says Dr. Minken.

While visiting your healthcare provider, make sure you’re up-to-date on immunizations – particularly the chickenpox and MMR (measles, mumps, and rubella) vaccines, which are unsafe to get during pregnancy. You should also receive vaccines for the seasonal flu and Tdap (tetanus, diphtheria, and pertussis), if you haven’t already. And while you’re at it, make sure your partner is fully vaccinated as well.

Schedule an appointment with your dentist, since women with gum disease have a higher risk of preeclampsia, preterm birth, and miscarriage – yikes! Your dentist may also advise you on brushing and flossing to maintain oral health during pregnancy. If you’re due for X-rays, get them now – pregnant women shouldn’t be exposed to radiation.

If you’re taking hormonal birth control pills, you might want to start thinking about coming off of them. Some women gain their fertility back immediately after the last pill, but others won’t develop a regular cycle for months. Plus, stopping the pills lets you track your body’s natural menstrual cycle, which may help pinpoint ovulation.

If you have an IUD, remove it one month before trying to conceive. Stop using the NuvaRing or Patch about two cycles beforehand, and receive the last dose of Depo-Provera three months out, says Lisa Mazzullo, M.D., co-author of Before Your Pregnancy: A 90-Day Guide for Couples on How to Prepare for a Healthy Conception. Remember: you can always use a barrier method like condoms if you stop birth control before you want to conceive.

Have you ever missed a period during a particularly stressful time of life? That’s because stress can impact your hormones, potentially messing with ovulation and menstruation. Stress can also prevent an embryo from properly implanting in the uterus. Before getting pregnant, evaluate all aspects of your life, and eliminate commitments that cause you extra stress.

Before trying to conceive, a woman should take folic acid supplements. “Women who take folic acid see a significant drop in babies with neural tube defects and some birth defects,” says Dr. Minken, adding that you should start popping the pills about three to six before trying for a baby. Aim to get 400 milligrams of folic acid daily, and include high-folate foods in your diet. These include leafy greens, beans, whole grains, and citrus fruits.

In addition to folic acid, you may want to take a multivitamin. The following vitamins and minerals might help increase your chances of conception: vitamins B6 and B12, bromelain, vitamin C, coenzyme Q10 (CoQ10), vitamin D, vitamin E, iron, omega-3 fatty acids, selenium, and zinc.

Some over-the-counter and prescription medications may harm an unborn baby. And since some drugs take a while to clear from the body, it’s smart to stop taking them months before trying to conceive. Drugs that raise red flags include NSAIDs, steroids, some antidepressants and antipsychotics, anti-epileptic medications, and thyroid medications. Natural and herbal supplements could possibly have an effect on fertility – and since there’s not a lot of information or regulations related to them, you should stop taking them before trying to conceive.

“Guys who have heated-up testicles may have problems making sperm. Some people think it's better to wear underwear that’s not constricting, such as boxers instead of briefs,” says Dr. Minken. She also advises that men shouldn't spend large amounts of time in hot tubs, and they should avoid placing a laptop directly over the scrotum.

You should already be eating a healthy diet consisting mainly of fruits, vegetables, whole grains, and lean proteins. But when trying to conceive, you should also eliminate foods that could potentially harm your baby, including high-mercury fish (swordfish, shark, king mackerel, and tilefish), runny eggs, soft cheese, cold cuts, and raw fish or meat.

Drinking during pregnancy has been linked to fetal alcohol syndrome, miscarriage, stillbirth, premature birth, and SIDS, according to the American Academy of Pediatrics. To stay on the safe side, don’t drink alcohol when trying to conceive. You should also steer clear of marijuana, which some studies correlate with miscarriage, low birth weight, preterm birth, placental abruption, and behavioral issues as the baby ages.

Drinking excessive amounts of caffeine may mess with fertility – and some studies claim it increases the risk of miscarriage. Try limiting caffeine intake to 200 milligrams per day to avoid any possible complications. This is about the amount in two 6-ounce cups of coffee, although chocolate, soda, and other food items may contain caffeine as well.