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What should you consider if you want to get pregnant now or in the future?


factoren om rekening mee te houden als je zwanger wilt worden, zwangerschap

Everything you eat, drink, inhale, put on your skin, inject or otherwise come into contact with affects your genes, the DNA you pass on when you are pregnant. We don't give much thought to the fact that everything you do and consume determines the quality of the eggs you have been carrying since birth. This is important information if you want to get pregnant right now or later in the future. Let's look at what you need to consider.


In this blog, we will tell you what the factors are and what you can consider if you are trying to get pregnant or planning to get pregnant in the future.


Under normal circumstances, 92% of all couples get pregnant within a year (1). The chance in the first 3 months is 68%, it is not ‘bingo’ for everyone immediately. But although most couples get pregnant within a year, it is increasingly common for a desired pregnancy to fail. Fertility problems are complex and there are a number of factors that contribute to getting pregnant less quickly.


A lack of nutrients during pregnancy has been linked to several consequences for the child later in life. These include diabetes, cardiovascular disease and lung problems. In children, obesity, metabolic disorders and neurological problems. Too little protein consumption is associated with chronic increased inflammatory status and reduced metabolic health of the child already detectable at an early age.

1. Hormonal contraception


Long-term use of hormonal contraception (2 years or more) is associated with a temporary period of fertility problems during the first 12 to 18 months after taking the pill, for example. This does not mean that it is impossible to get pregnant, some women get pregnant immediately after stopping the pill, but on average women take up to twice as long to get pregnant after stopping contraception compared to women who did not use hormonal contraception.


A study [2] compared the time it took for 2841 women to get pregnant after stopping different contraceptive methods. The results indicated that when couples only used condoms during the time before the desire to have children they got pregnant the fastest when that desire actually occurred (81.5% were pregnant within 6 months and 91.3% within a year). Of the women who had used the minipill (progestin) or the combined pill, the majority were pregnant within 1 year. Had an IUD been used, more than 90% took longer to become pregnant (between 1- 2 years). Women who had used the oral contraceptive pill or implanon proved to be a lot less fertile, after 1 year only half of those women are pregnant.


zwanger worden na anticonceptie gebruik kan langer duren

Table: Pregnant after indicated period with used as contraception in the past.


If you have stopped taking the pill for more than 6 months and are still not pregnant, your body may need more time to recover and resume your normal cycle. If you also had cycle complaints or hormonal disturbances before starting contraception, you are likely to have them return. Contraception is not a therapy for treating the cause of those complaints, so it is better to stop contraception at least 1.5 years before you want to have children. Or even better: monitor your natural cycle from as early as your teens and accurately detect the fertile days. So that you don't run the risk of running into problems later on when the desire to have children is there.


  • 91.3% of women who did not use contraception for childbearing and had sex with a condom had a successful conception within 1 year.

  • 92% of women who did not use contraception for childbearing but used natural family planning to prevent pregnancy had a successful conception within 1 year. (2).


When do you stop contraception to start a family?


Contraception shrinks ovaries and suppresses your ovarian reserves. Ideally, stop as early as 1.5 years before you want to get pregnant to allow your ovaries to return to normal function. Further, take into account a transition period of 1.5 to 2 years to allow your body to come into balance. If your periods have not returned within 3 to 4 months of discontinuing contraception, you see more than 10 red days in your chart, low rise in temperature after ovulation or you have only green colours during menstrual days. Enough reason that we look along with your cycle progression and can give advice. Book an appointment.



2. Nutrition and nutritional supplements


A good step towards recovery of body (and mind) after hormonal contraception. In fact, scientific research has shown that contraception causes vitamin and mineral deficiencies. Complaints related to reduced fertility, as well as PCOS, endometriosis and menstrual disorders, are additionally triggered by incorrect nutrition.


Actually, healthy eating is not something temporary that you pick up as a woman in preparation for or during pregnancy. Of course, it is advisable to pursue optimal health at all times. Both women and men. Healthy food is food that is processed as little as possible, contains no artificial additives and is prepared in a healthy way (not in the microwave or in Teflon pans, for example). Lots of vegetables, varied and no pro-inflammatory foods like gluten, cow's milk and sugar. Some tips:


  • Drink at least 2.5 litres of (filtered) water a day

  • Eat plenty of vegetables, at least 500 grams a day

  • Eat 2 or 3 pieces of fruit a day

  • Eat oily fish (salmon, mackerel, sardines, herring) at least twice a week

  • Eat enough saturated fat from avocados, nuts, seeds, coconut oil, butter and/or olive oil

  • Eat enough proteins (alternating between animal and vegetable proteins): fish, eggs, beef, poultry, mushrooms, leafy vegetables, nuts, seeds, (vegetable) protein powder

  • Provide sufficient variety in your diet and eat according to the seasons

  • Avoid sugar and fast carbohydrates (alcohol, biscuits, sweets, crisps, white bread, crackers)

  • Avoid ready-made food

  • Avoid refined oils and trans fats such as margarine, sunflower, rapeseed, rapeseed, soy and peanut oil

  • Limit caffeine intake

  • Avoid cow's milk products, preferring goat/sheep or vegetable ‘dairy’ products (but avoiding soy products)

  • Avoid gluten-rich grains (especially wheat)

  • Avoid hormone disruptors, tobacco smoke, including e-cigarette, parabens


Making the right health choices produces positive effects relatively quickly.

Well-nourished even before ovulation


Nutritional supplements can support you in getting pregnant. Studies show that the better a woman is supplied with folic acid, omega-3 fatty acids and vitamins such as C, D and E, the more likely she is to have a healthy baby. Don't start taking supplements only when you have a positive pregnancy test in your hands, but make sure your nutrient levels are already optimal before conception. Why? There are four good reasons for this:


  1. An optimal nutrient level increases the chances of a perfect interaction of fertility hormones - your chances of getting and staying pregnant increase.

  2. The endometrium can thus build up particularly well - the best conditions for a stable pregnancy.

  3. Only in this way can you positively influence the development and supply of the egg and embryo from the start - if you do not get your period, fertilisation has already taken place about a fortnight ago.

  4. You will feel fitter and more comfortable during pregnancy if your body does not lack important nutrients.


Vitamins and minerals for fertility


Back in 1992, a study with more than 8,000 participants showed that nutrients can affect fertility. In a group of women supplemented with vitamins A, C, D and E, B vitamins, iron, folic acid, magnesium, copper, manganese and zinc, significantly more women became pregnant during the nine-month study period than in the control group (3).


Folic acid, we now know, may have played a role here, but a second study in 2012 suggested that other vitamins, trace elements and minerals are also important for fertility. All 58 participants wanted a baby, suffered from luteal insufficiency and were treated with clomiphene (luteal insufficiency: here the cycle runs smoothly up to ovulation, but something goes wrong during the luteal phase, in the preparation of the endometrium). In addition, some women were given supplements with the above-mentioned nutrients and iodine. The control group received only folic acid. The women who took the multivitamins were more likely to get and stay pregnant (4).


Folate the active more absorbable processed folic acid


For years now we have been working with the active folic acid variant, folate (5-MTHF glucosamine salt, Quatrefolic®). Because it can be processed better in your body compared to standard drugstore folic acid. Many vitamins and minerals have active and less active variants. We opt for the optimally absorbable and processable versions. If you buy something, you want it to do something in your body. Otherwise it is a waste of money!



Groot tekort vitaminen en mineralen voor een zwangerschap, alleen uit voeding is niet voldoende

Including multi with active folic acid, the folate.


Detailed results are known about some nutrients and their effect on fertility:


  • Folic acid increases the chances of becoming pregnant. Moreover, taking it even before conception can reduce the risk of neural tube defect (e.g. spina bifida (‘spina bifida’) by up to 100 per cent. It also reduces the risk of heart defects and cleft lip and palate in offspring (3) (4).

  • Omega-3 fatty acids, improve the prospects of high-quality embryos, a successful pregnancy and a mentally and physically healthy baby (3).

  • Vitamin C improves the chances of pregnancy in women with luteal insufficiency (3).

  • High levels of vitamin D increase the chances of pregnancy in women undergoing fertility treatments. It also provides some protection against bacterial vaginosis (amine colpitis), which can lead to preterm birth (3).


Is your ovulation still not progressing the way you want? Is it wise to deal with that first.
This increases the chances because the follicles in the ovaries are the protectors of half of the DNA you pass on via the egg after ovulation during conception to the offspring!

Especially for supplementing deficiencies and restoring the cycle, we have created the Cyclus+ Package.



hoe krijg ik mijn cyclus en hormonen weer op orde na stoppen met anticonceptie


Nutrients, also for father!


If you want to create the best conditions in preparation for pregnancy, don't forget to include the father above all. Although the influence of nutrition on male fertility has not yet been extensively studied, it is clear that vitamins and minerals are also indispensable for optimal sperm quality and motility (5).


There are impressive research findings on vitamins C, E, polyunsaturated fatty acids (EPA and DHA), carnitine, N- acetylcysteine, selenium, zinc and coenzyme Q10. If the man is well supplied with these, not only does the likelihood of a high number of healthy, fully motile sperm in the ejaculate increase but what the father passes on through DNA is epigenetically better controlled.


In short: men also need to get started with lifestyle, nutrition and supplements if they want to achieve better results!

3. Sperm quality


Men's sperm quality plays a major role in fulfilling a pregnancy wish. But unfortunately, it has been found that in recent decades, the quality of most men's sperm is going downhill. We often think of infertility as a woman's issue, but infertility in men is as often a factor in unfulfilled childbearing desire as infertility in women.


The causes of reduced fertility in men are ranging:


  • Stress

  • Hormonal imbalance (testosterone deficiency)

  • Oxidative damage to sperm cells (reduces sperm motility and ability to enter the egg).

  • Too high temperature of the scrotum (pants/underpants too tight)

  • Obesity, diabetes

  • Electromagnetic radiation: so the mobile phone out of the pocket! Radiation affects sperm quality (6) (7).

  • Exposure to chemicals, pesticides, radioactivity

  • STDs

  • Congenital abnormalities

  • Chemotherapy or radiation

  • Smoking, alcohol, and drugs


Advice to increase male fertility


  • Eat a healthy and varied diet (see aforementioned dietary recommendations)

  • Increase zinc intake: pumpkin seeds, Brazil nuts, hemp seeds, flaxseed, cocoa, oysters. Zinc deficiency is characterised by reduced sperm count [8]. Daily reference intake for reduced fertility male 1 x daily 30 mg to improve sperm motility and protect against oxidative damage.

  • Adequate antioxidants: foods high in vitamin C (peppers, Brussels sprouts, blackcurrants, kale, kiwi, strawberries red cabbage) and vitamin E (nuts, seeds, eggs, spinach, avocado)

  • Avoid E-numbers, additives and allergens

  • Avoid alcohol

  • Stop smoking

  • Exercise at least half an hour of moderate intensity every day


To increase male fertility, it can also help to avoid prolonged heat. Think sauna visits, cycling, horse riding, motorcycling or sitting in a very hot bath for a long time. This is not good for sperm quality.


4. Precise timing


If you want to get pregnant, timing is essential! There is only 1 day per cycle when it is possible to guess pregnant, the day of ovulation. Five days before that, sperm can maximise internal survival. So, sexual intercourse shortly before expected ovulation increases the chances of getting pregnant. A scientific study found that 81% of women who had tracked their cycle and planned intercourse accordingly were pregnant within six months. The average time to conceive was 4.5 months. (9).


meet je cyclus, controleer je ovulatie, vruchtbare en onvruchtbare dagen

Measuring with Daysy the cycle tracker


Books indicate that ovulation occurs on day 14 in a 28-day cycle. But in reality, 70% of women ovulate outside the expected range of day 13-15 in the cycle. So most women do not ovulate exactly on half the cycle! But when do they? Ladies who measure with Daysy have insight into this.



Daysy tells you when your fertile and infertile days are including the expected ovulation day. This can vary, for example, not every cycle is the same length, nor does ovulation always have to be at the same time. Daysy moves with you and indicates what your body is showing at that time. At least five days before your expected ovulation day, Daysy indicates red fertile days and every reading after that will confirm whether your fertile days are over or not.





How great is it that with Daysy you can accurately track your fertility? Because you want to take advantage of the days shortly before ovulation and not depend on when the ovulation test turns positive, because then you might be too late. With Daysy, you can prepare because you can see in the app when ovulation is expected.


In our own survey of Daysy users (pictured below), 63% reported getting pregnant during the first cycle they tried. A whopping 89% of those surveyed reported getting pregnant within three months with Daysy. Of course, getting your cycle right is a must. If the cycle hormones do not alternate adequately, you will see it in your temperatures and colours. After all, having your period with regularity says nothing about how fertile you are!


kinderwens nog steeds niet zwanger waar kan het aan liggen


Fertile mucus


Building on the timing, it is good to have sex when you are producing fertile mucus. Fertile mucus is the discharge that is noticeable when wiping after peeing at the time when you are producing a lot of oestrogen. This is when the amount of fertile mucus is highest, looks and feels like raw egg white. You can have quite a lot of this slippery discharge. The main job of fertile mucus (whose production is stimulated by oestrogen) is to help the sperm survive and ensure that the sperm reaches its destination (through the fallopian tubes to the egg).


Fertile mucus is an important part of natural family planning but be alert. You usually have fertile mucus on days prior to ovulation, but in principle, you can already have it when your oestrogen levels are high. If your follicular phase is long, for instance due to stress, your oestrogen levels will rise and fall. As a result, you may have fertile mucus several times before you finally ovulate. Therefore, do not rely solely on fertile mucus as a sign of ovulation, but combine it with measuring basal body temperature as with the sensor on the Daysy.


Overview:


  • Long-term use of hormonal contraception (2 years or more) is associated with a temporary period of fertility problems during the first 12 to 18 months after the pill, for example.

  • Results from one study (1) indicated that when couples used only condoms during the time before the desire to have children they were most likely to get pregnant when that desire actually occurred (81.5% were pregnant within 6 months and 91.3% within a year). Women who had used the contraceptive pill or implanon were found to be a lot less fertile, after 1 year only half of those women are pregnant!

  • Contraception shrinks ovaries and suppresses your ovarian reserves. Ideally, stop as early as 1.5 years before you want to get pregnant to allow your ovaries to return to normal function. Further, take into account a transition period of 1.5 to 2 years to allow your body to come into balance.

  • Your periods should definitely have started within 4 to 6 months of discontinuing contraception. It can take 12 to 18 months for your cycle course to normalise. Not nice because that obviously causes all sorts of symptoms so seek professional support from an orthomolecular therapist specialising in fertility and menstrual cycle, you've probably already been to your GP. Actually I hope then we can have a Zoom call with you earlier when you have measurements from 3 or 4 months with the Daysy or LadyComp. Because that already shows so much to be able to advise you towards improvement. Then you can actually achieve a lot in the first six months, no need to wait any longer, better to take action early!

  • Healthy nutrition is a good step towards recovery of body (and mind) after hormonal contraception. In fact, scientific research has shown that contraception causes deficiencies in vitamins and minerals. Complaints related to reduced fertility, as well as PCOS, endometriosis and menstrual disorders, are additionally triggered by incorrect nutrition.

  • Nutritional supplements can support you in getting pregnant. Studies show that the better a woman is supplied with folate, omega-3 fatty acids and vitamins such as C, D and E, the more likely she is to have a healthy baby. Don't start taking supplements only when you have a positive pregnancy test in your hands, but make sure your nutrient levels are already optimal before conception.

  • If you want to create the best conditions in preparation for pregnancy, don't forget especially to include the father. Although the influence of nutrition on male fertility has not yet been extensively studied, it is clear that vitamins and minerals are also essential for optimal sperm quality and motility (5).

  • There are impressive research findings on vitamins and minerals for men increases the likelihood of high numbers of healthy, fully motile sperm in the ejaculate. (5).

  • If you want to get pregnant, timing is essential! There are only 1 day per cycle that you are fertile. So intercourse 3 days before expected ovulation is recommended. Sperm survive internally for a maximum of 5 days hence Daysy before the expected ovulation those 5 days are already turning red.

  • Continuing on the timing; it is good to have sex when you signal fertile vaginal mucus. The main job of fertile mucus (whose production is stimulated by oestrogen) is to help sperm survive and ensure that the sperm reaches its destination (through the fallopian tubes to the egg).



Sources


  1. Verywellfamily. How quickly can you expect to get pregnant 1960290

  2. BMJ content 327 7412 434

  3. Time to pregnancy: results of the German prospective study and impact on the management of infertility

  4. Is previous use of hormonal contraception associated with a detrimental effect on subsequent fecundity?

  5. NCBI pubmed 19268187

  6. Bühling, K.J. Ernährung und Nahrungsergänzungsmittel bei Kinderwunsch der Frau. Gynäkologische Endokrinologie 17, 3–10 (2019). doi 10.1007/s10304-018-0229-4

  7. Czeizel AE, Dudás I, Vereczkey A, Bánhidy F. Folate deficiency and folic acid supplementation: the prevention of neural-tube defects and congenital heart defects. Nutrients. 2013 Nov 21;5(11):4760-75. dx.doi.org/10.3390/nu5114760

  8. Vanderhout SM, Rastegar Panah M, Garcia-Bailo B, Grace-Farfaglia P, Samsel K, Dockray J, Jarvi K, El-Sohemy A. Nutrition, genetic variation and male fertility. Transl Androl Urol. 2021 Mar;10(3):1410-1431. doi: 10.21037/tau-20-592

  9. Agarwal, Ashok, et al. “Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study.” Fertility and sterility1 (2008): 124-128.

  10. Mobile phones affect multiple sperm quality traits: a meta-analysis doi: 10.12688

  11. Bedwal RS, Bahuguna A. Zinc, copper and selenium in reproduction. Experientia 205; 50: 626-640.

  12. C Gnoth et. al. Hum Reprod. 2003 Sep;18(9):1959-66



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