Trying to Conceive is a Marathon, Not a Sprint
By Jessica Joseph, RN, BSN, MHA
The views and opinions expressed are those of the authors and should not be considered medical advice. Always consult your doctor, or a mental health professional, for the most appropriate treatment.
Embarking on the path to parenthood can be an exciting yet sometimes challenging endeavor, as the timeline for growing your family is not always as straightforward as you had thought it would be. Though each fertility journey is unique, some common themes often appear. First, couples often spend a few months trying to conceive (TTC) naturally, usually after they’ve stopped birth control and noticed that their regular periods have resumed. Then, to be more proactive, women often start tracking their menstrual cycle (length and period duration), as well as their ovulation, through basal body temperature (BBT), cervical mucus and even ovulation predictor kits (OPKs). Aspiring parents may start to read and research articles, books, and websites on how to get pregnant. And even when timing intercourse perfectly during your fertile window, the two-week wait (TWW) becomes agony, only to often end with another negative pregnancy test or your period. As months of trying go by, those on the fertility journey may become increasingly upset that it is taking longer than expected to get pregnant and experience a mix of emotions: frustration, sadness, and a sense of defeat. Rest assured: if you are going through a similar experience, you are not alone. Thousands of women and families are in your shoes.
Fortunately, though the path may feel long, there are a variety of options along the way that can increase your chances of conceiving, naturally or with fertility treatments. Sometimes, it might feel like you are training for a marathon, going the long distance, with a lot of preparation involved, especially if it is your first time TTC. But with a proactive, holistic approach to your fertility, you can start to incorporate simple lifestyle modifications, such as nutrition, exercise, sleep, and stress management, which may all improve your overall well-being, along with your odds of getting pregnant. These lifestyle interventions may increase your chance of pregnancy by improving egg quality, along with your partner’s sperm quality. They may also help with weight loss and in lowering your BMI, which is also a factor that can affect fertility.
If you feel you’ve already optimized your lifestyle for fertility, then conservative or advanced treatment options for infertility, such as intrauterine insemination (IUI) or in-vitro fertilization (IVF), are also available with the help of a fertility specialist (reproductive endocrinologist or RE).
Physical Preparation for Pregnancy
To begin your “marathon training,” and to optimize your chances of conceiving whether you plan on trying naturally or through fertility treatment, you should maintain a healthy lifestyle and eat fertility-boosting foods. One aspect of fertility nutrition includes consuming fish high in omega-3s. An easy way to remember which fish to eat is to think of the acronym SMASH: salmon, mackerel, anchovies, sardines, and herring. Other fertility foods to keep in mind are antioxidant-rich vegetables (tomatoes, peppers, carrots) high in vitamin C, as well as vitamin E-rich foods such as nuts, seeds, and legumes. The Mediterranean diet is a great guide to follow since it incorporates many of the foods mentioned. Just keep in mind that nutritional changes, including supplements, may take up to three months to have a positive effect on your body, and should all be discussed with your healthcare provider.
The American Pregnancy Association recommends taking a prenatal vitamin as early as three months to one year before trying to conceive. A comprehensive prenatal vitamin with folate and omega-3 (DHA) will help your body prepare for pregnancy, and may even increase your chances of conceiving. Other nutrients to consider include vitamin D3, which should be tested to determine the appropriate dose, and CoQ10, which might increase pregnancy chances by improving egg quality.
Lifestyle interventions also include regular exercise, which the American College of Obstetricians and Gynecologists (ACOG) recommends for women trying to conceive. Moderate exercise is suggested over high-intensity exercise, since high intensity can raise cortisol (the stress hormone), which can be detrimental to fertility. A good goal includes cardio (aerobic) exercise for 30 minutes daily, at least five times a week. Strength training is equally important, using either light weights or your own body weight (calisthenics) such as squats, planks, sit-ups, pull-ups, and pushups. Strength training is recommended at least 30 minutes daily for 2-3 days a week. If you are not used to working out, it is best to start gradually and increase weekly to prevent injury and increase compliance. Also make sure to find an activity you enjoy, such as walking your dog, swimming, dancing or working out with a friend who motivates you.
Beyond nutrition and exercise, it’s important to learn and understand how your unique body works when it comes to your menstrual cycle and fertility health. Thanks to technological advancements and modern medicine, you can track your cycles and monitor your hormone levels in the comfort of your own home. There are devices and kits that provide numerical values for key reproductive hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, and progesterone. Since these devices use urine, you can test frequently at home, instead of going to a lab or a doctor’s office to get blood work done. Think of this like the half marathon prep: this type of early monitoring can make you aware of any early signs that something may be wrong (hormonally or with your menstrual cycle), which should help you seek further clarification from a fertility specialist.
Fertility Treatment Options
As time goes on, you might start to wonder if there is an underlying issue that is hindering you from getting pregnant. The American Society for Reproductive Medicine (ASRM) recommends a baseline fertility evaluation if you are under the age of 35 and have been trying to conceive for one year, or if you are 35 and older and have been trying to conceive for at least six months.
Know that seeing a fertility specialist (RE) doesn’t necessarily mean that you’ll be fast tracked to fertility treatments like IVF (though IVF is often a first choice option for many aspiring parents). Most fertility doctors take a strategic, measured approach before recommending fertility treatments. For instance, you’ll likely go through routine diagnostic testing such as blood work, transvaginal ultrasound, saline ultrasound, hysterosalpingogram (HSG, a test for blocked fallopian tubes), and semen analysis. These tests might reveal an underlying cause that can be corrected via conservative approaches, such as medications and/or a minor procedure. Once completed, you can often try to conceive on your own again. If these conservative interventions and/or timed intercourse have not proven helpful, then your fertility doctor might move on to more advanced interventions, such as an IUI or IVF cycle.
While these fertility treatment options might feel like the fastest way to cross the finish line, remember that these too can take time. From preparing for treatment, gathering insurance and payment information, ordering medications, timing your cycle, and then going through the treatment itself, both the IUI and IVF process can take weeks and even months to complete. The IVF process includes not only the egg retrieval, but also a fresh or frozen embryo transfer, which often occurs many weeks (or longer) after the embryos have been created. The good news is that while going through fertility treatment, you are proactively “doing” something, which helps many aspiring parents feel a sense of control and empowerment throughout the process. You are running that marathon.
Mental Preparation for Pregnancy
As you pursue parenthood, resilience and determination may fall by the wayside. Taking care of your mental health while trying to conceive might prove challenging. There are measures you can take to combat some of the stress, anxiety, and depression that might come along the fertility journey. Relying on a trusted confidant, whether a family member, friend, partner, colleague, fertility coach and/or therapist, can help you deal with whatever comes your way throughout the path to parenthood. You do not necessarily need an army of people by your side, but having one or two people in your inner circle that you can lean on when times get challenging can make a big difference.
You might also find comfort in joining a support group for women and families trying to conceive. Connecting with others going through similar experiences can give you a sense of understanding, empathy, encouragement and even hope. Support groups offer a safe space to share emotions, seek advice, and gather insights from those who are in the thick of it, or have even successfully conceived.
Another option that can help reduce stress and anxiety is fertility yoga. Generally, yoga has therapeutic benefits since it incorporates breath work, meditation, and mindfulness, which are known to reduce stress and anxiety, and stabilize your heart rate and blood pressure. Fertility yoga specifically includes strategic poses that help increase blood flow to the reproductive tract and soften the muscles of the vaginal wall, which may make conception more likely.
Focusing on self-care, practicing relaxation techniques, and maintaining an open line of communication (especially with your partner) can all help make your TTC journey better. Together, you can navigate the ups and downs, supporting each other through all the trials and tribulations of the fertility journey. Although the road to conception may take longer than initially anticipated, and may feel like a marathon instead of a sprint, you can draw on strength from the knowledge that you are taking proactive steps to increase your chances of getting pregnant, while also embracing the support and understanding of your loved ones.
