If you want to get pregnant in five years...
See your doctor. If you want to keep your body baby-ready, staying in top physical shape is essential. That means getting any fertility-sapping health issuesÃ¢â‚¬”like diabetes, polycystic ovary syndrome (PCOS), or endometriosisÃ¢â‚¬”under control; diagnosing and treating STDs; and devising a healthy diet and exercise plan. If you're past 35 and wondering whether you have the option of waiting a few more years, you can also ask your doc to do a little detective work on what's known as your ovarian reserve.
"All women are born with a certain number of eggs, and you lose them over your reproductive life span," explains Michael Soules, M. D., medical director of Seattle Reproductive Medicine. "At some pointÃ¢â‚¬” about 10 years before the onset of menopauseÃ¢â‚¬” the number drops to a level where your fertility is compromised." But there are fertility tests that can gauge how many eggs are still sitting on the bench waiting for their turn at bat. The best ones are an ultrasound to count the number of follicles in your ovaries and a blood test to check your hormone levels at certain points in your cycle. These tests, which Soules says are usually covered by insuranceÃ¢â‚¬”check with your plan to make sureÃ¢â‚¬”can't guarantee that you're fertile (too many other factors come into play). But they can tell you how loudly your clock is ticking and whether you need to consider speeding up your schedule.
>Brush and floss. Could something as simple as flossing your teeth help keep you fertile? Perhaps. "Several studies have indicated that a woman's oral health may be related to her reproductive success," says Susan Karabin, D. D. S., a spokesperson for the American Academy of Periodontology. In one study, women who needed fertility treatments had higher levels of gum bleeding and inflammation than those who conceived naturally, the Journal of Periodontology reports. "Brush and floss every day and get a professional cleaning and exam every six months," advises Karabin, who adds that not smoking and avoiding sugary foods and drinks are also key to keeping your teeth and gums healthy.
>Practice safe sex. You wouldn't think condoms would come up in a conversation about getting pregnant, but safe sex can be a crucial factor in your future ability to get knocked up. If you contract an STD such as gonorrhea or chlamydia (which could be in your system without causing symptoms) and it goes untreated, it can lead to a serious condition called pelvic inflammatory disease, which can scar the fallopian tubes, causing infertility. So get tested regularlyÃ¢â‚¬”and make sure your partners do, too.
>Stamp out cigarettes. If higher rates of lung cancer and breast cancer haven't made you swear off smoking, consider this: The American Society for Reproductive Medicine (ASRM) estimates that lighting up is linked to 13 percent of infertility cases. Tobacco messes with your fertility in all kinds of ways: It makes your eggs deteriorate faster than they naturally would with age, increases your risk of early miscarriage and ectopic pregnancy (a dangerous condition in which the egg implants in your fallopian tubes or ovaries instead of your uterus), and can bring on early menopause (up to four years earlier, compared with nonsmokers). Plus, if you wind up needing in vitro fertilization (IVF), smoking will reduce your chances of success by 34 percent. The encouraging news, though, is that once you do quit smoking, your fertility level will return to normal in about a year (considering that it takes the average puffer two to four tries before quitting for good, you should start trying to kick the habit well before that). While you're at it, recruit your partner, parents, and friends to quit with you: A recent study in Tobacco Control found that women who were exposed to secondhand smoke six or more hours a day as adults were 36 percent more likely to have trouble getting pregnant.
>Take your vitamins. "Every woman of reproductive ageÃ¢â‚¬”even if you're not actively trying to get pregnantÃ¢â‚¬”should take a multivitamin containing folic acid," says Jorge Chavarro, M. D., an instructor at Harvard Medical School and co-author of The Fertility Diet" According to Chavarro, folic acid appears to improve fertility by stimulating ovulation and giving an embryo essential proteins needed for survival. His research also found that women who took iron supplements were 40 percent less likely to have fertility problems, so look for a vitamin with at least 40 milligrams of iron and 400 micrograms of folic acid, and get in the habit of downing the pill every morning.
If you want to get pregnant in two years, do all of the above, plus...
>Switch up your grocery list. In Chavarro's groundbreaking study of the dietary habits of more than 18,000 nurses who were trying to get pregnant, he found some striking connections between food and fertility. There are four basic rules of a baby-friendly diet:
1. Choose slowly digested carbohydrates (such as vegetables and whole grains) over highly processed ones (such as white bread and white rice).
2. Eliminate trans fats (aka partially hydrogenated oils).
3. Pick unsaturated fats over saturated fats.
4. Get the majority of your protein from plants rather than animals.
This type of low-glycemic diet, which keeps your blood-sugar level nice and steady, has long been known to fight diabetes and improve cardiovascular health, but it also can have a profound effect on fertility. "When you eat foods that spike your blood sugar, such as simple carbohydrates, your body produces more insulin, and that in turn leads to a higher amount of testosterone circulating throughout your body," Chavarro says. "Over time that can interfere with ovulation." He explains that different types of fats and proteins also affect blood levels of glucose and insulin. So get into the habit of eating lots of fruits and veggies, and trade red meat for fish, nuts, eggs, and beans whenever you can.
>Maintain a healthy weight. When it comes to your weight, the "fertility zone" is a body mass index between 20 and 24, Chavarro says. (To calculate your BMI, go to nhlbisupport.com/bmi).
In fact, the ASRM estimates that 12 percent of infertility cases are due to weight problems, divided equally between the underweight and overweight. Weigh too much and you have a greater likelihood of irregular periods and ovulation disorders (though even a moderate loss of 5 to 10 percent of your body weight can help kick-start your ovulation); weigh too little and you may not ovulate at all, since body fat triggers the hormones that tell your ovaries to release an egg.
>Move your butt. "Our research found that 30 minutes of moderate to vigorous exercise each day on most days of the week is related to a lower risk of infertility," says Chavarro. If you need an extra push to get there, he suggests adding a mix of strength training, stretching, and aerobic exercise such as biking, hiking, or swimming. Too much exercise, thoughÃ¢â‚¬”anything that brings you to less than 17 percent body fat, or a BMI of 19 or lowerÃ¢â‚¬”can interfere with ovulation. But unless you're doing an Olympic-level training program, you probably need more exercise, not less.
>Upgrade your water bottle. While you're working up a sweat, you'll work up a thirstÃ¢â‚¬”but make sure you swig your water from a BPA-free bottle. Researchers at the University of California, San Francisco, recently looked at the BPA (bisphenol-A) levels in women undergoing IVF and found a correlation between the level of the chemical in the blood and the ability to conceive. The theory is that BPA, which mimics estrogen, can mess with the balance of hormones in your body. The chemical can be found in the linings of canned goods and sports water bottles, but many companies are now marketing bottles made from safer materials such as stainless steel.
If you want to get pregnant in one year, do all of the above, plus...
>Save your calories for ice cream. Our favorite bit of health news ever. If you add one serving of full-fat dairy to your diet per day, such as whole milk on your cereal instead of skim, you can actually increase your chances of getting pregnant, according to Chavarro's research. There is one caveat, however: "You have to make adjustments to the rest of your diet so you don't gain weight," Chavarro says. He also stresses that this should not be a lifetime changeÃ¢â‚¬”once there's a bun in your oven, you can go back to drinking skim and eating low-fat fro-yo.
>Rethink your birth control. Now that you're getting closer to wanting a little munchkin, it's time to think about what's kept you from having one in the past. Barrier methods (such as condoms or a diaphragm) are easy: simply stop using them the day you're ready to get pregnant. If you have an IUD, your fertility will return as soon as your doctor takes it out. The same goes for Pill users: Whether you've been taking it for one year or 20, don't believe the rumor that it'll be months before your ovulation revs back up, says Vanessa Cullins, M. D., vice president for medical affairs at Planned Parenthood of America. "Women may have a few irregular cycles at first, but ovulation can happen within two weeks after you toss your last pack," she says. But, Cullins points out, there is one form of birth control that takes time to exit your system before you can get pregnant: If you've had Depo-Provera injections, it can take up to 10 months to become fertile again.
>Cut down on the booze and caffeine. Some studies show that having one to five alcoholic drinks per week can drop your chances of conceiving that month by as much as 50 percent. While other studies have found little connection between moderate drinking and fertility, Chavarro points out that sobriety certainly couldn't hurt, and it might help. And while you're at it, cut back on the triple-shot lattes. While there is no real consensus, some studies suggest that consuming more than 300 milligrams of caffeine a day (about two eight-ounce cups of regular coffee) may increase your risk of endometriosis or fallopian tube problems.
>Reduce stress. "There's nothing a couple that is trying to get pregnant wants to hear less than 'Relax, you're trying too hard,'" says Janis Fox, M. D., a fertility specialist at Brigham and Women's Hospital in Boston. But stress can put a damper on fertility by messing with the brain signals that tell your body to ovulate. A study in Human Reproduction showed that couples were more likely to conceive during months they considered themselves relaxed. An effective way to start reducing stress now is to focus on what you appreciate in your life today, says Leslee Kagan, director of women's health at the Benson-Henry Institute for Mind Body Medicine in Boston. Every day, write down three things that you love about your life (No diapers to change! The chance to spend endless, uninterrupted hours reading a great novel!), and take at least 15 minutes to meditate, do yoga, or listen to relaxing music. Believe us, a few years from now, when that baby you waited for is finally here, and you're groggily but happily dealing with colic and diaper rash, these relaxation skills will come in handy!