First things first. This is a long blog (sorry not sorry) and who even has an attention span anymore. There are 10 sections covered, so perhaps you might bookmark this page, email it to yourself and scroll through to the pertinent areas. Don’t feel pressure to read it all at once, but there are some cracking gems in here, so do your best.
Ideally, both parents (or, the egg holder and sperm holder) will apply 3 months of pre-conception care BEFORE conception. Why 3 months? Because that is roughly how long it takes to make a dent in the health of the little egg and sperm that will be become your child.
Sperm literally turn over in a 3 monthly fashion, so lifestyle factors are HUGE.
With that in mind, let’s get to it.
- Pathology testing AND semen analysis.
Get straight into it. Are there any familial factors that could be considered? Is there a history of autoimmunity that could be investigated? Recommended tests are not static and will change depending on the person, so please speak to your practitioner about which tests will be best for you… and please be discerning when selecting your health provider (if you’re not able to see us here at MCM). Not everyone has pathology testing in their wheelhouse. Ensure that they are competent re what should be tested for your situation.
And yes. Get a semen analysis and have it read by us.
- Clean up your diet.
THIS DOES NOT MEAN YOU NEED TO GO ON A DIET OR LOSE WEIGHT. It means that I would like you to be eating a healthy and balanced diet.
As Michael Pollan famously wrote:
Not too much
Eat food that is recognisable as food. If the label has unrecognisable words on it, pick something else if possible. No, really. Have a think about how much of your food comes out of a packet, EVEN if you think it is a healthy choice. Cereal, rice crackers, bread, pasta, tortillas, vegetables, sauce etc etc. If it’s in a packet – it’s processed. Be discerning and reduce this where possible. Shop from the edges of the supermarket – fresh foods, meat, eggs etc etc.
And if preparing food is tough for you, consider a healthy meal delivery service for the times that you cannot be bothered.
– Do an internet search of organic meal delivery services and do look at how much filler the meal includes.
– A few that are local to Melbourne are Mama Goodness (who will feed you if you are not a parent also of course) My Goodness Organics and Soulara to name a few.
Because that is the real you and we want to support the real you. I would also encourage you to gently find excitement in food. Get yourself a recipe book that you love; follow a few food accounts on Instagram. Watch You-Tubers do their thing.
Generally speaking with dietary things, preparation is everything. What do you crave and when? When you’re hungry for snackies, are you actually thirsty? Have a glass of water first.
- Supplements and herbs
Please have these prescribed by a professional. Pretty please.
I definitely suggest utilising your own research and becoming your own advocate – there is much to be said for understanding your own personal journey. There are a number of instances that this is incredibly important and will help you, but I do become concerned when people come in to clinic to see me with a list a mile long, simply because they fit into a certain classification of people (advanced maternal age, PCOS, endo) and they take on every piece of advice they come across – this can be both good and bad.
This research and self-prescribing is done with the best of intentions, and to be honest, you can find GOOD advice on the internet and in forums. There are a lot of no-brainer supplements for certain conditions BUT what else are you taking? Are you taking something else (medicine or supplement) that interacts with it? Are you taking it at the wrong time of day? With food when it should be without or vice versa?
And what is the quality and form of the supplement that you are taking? Supermarket shelves bursting with supplements, quite honestly make me a little nervous.
Please don’t feel nervous about your medications that have been prescribed by your doctor or specialist for the health of your baby. If you require anti-depressants, then taking them may help you to be the parent you want to be.
But please do speak to your doctor about your baby making plans to see if the medication you are on is safe for those trying to conceive. And if it’s not, or the internet tells you it isn’t, be mindful of whether you need to taper off your dosage before going cold turkey. Please. Your doctor will advise at how to taper off OR what is safe in pregnancy.
Where do I start on alcohol consumption? Suffice to say, I am moved by how embarrassed and nervous my patients are to say no to a drink – oftentimes, it seems we are drinking more for social capital than enjoyment.
And I get it! You may not want people to know that you are trying for a child or are pregnant. What gets me is that in Australia, drinking culture is so explicit that the only conceivable reason for not drinking is that you’re pregnant.
My disappointment in this is extreme. Alcohol is fun and yum, but it is also extremely bad for your health, particularly in high quantities – and in Australia, we are having it in high quantities.
According to the ABS, Australians are more TWICE as likely to exceed the Australian Adult Alcohol Guideline (30%) compared to those born overseas (17.3%). The statistics on this page are staggering: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/alcohol-consumption/latest-release
I would encourage you to look into the sober curious movement and begin to consider a life with less or no alcohol, even if only for a brief time. It may also help you in those social settings when you are choosing not to drink, because (repeat after me) “I DO NOT NEED AN EXCUSE TO NOT DRINK ALCOHOL.”
It is well established that drinking during pregnancy is not in the best interests of the child, but what about in the pre-conception period for both parents? I would advise both parents to be kicking the booze for at least three months (or at the very least, greatly reducing).
All the small things matter. Yes, you can conceive drunk. Yes, you can conceive high. But we’re talking about having you at your best so that your bubba can be their best.
According to the Bureau of Statistics (ABS), 10.7% of Australian adults are smokers – 12.6% are men; 8.8% women. Interestingly, adults with fair or poor health are more likely to be smokers (17.7%).
There are plentiful studies on how smoking might impact sperm parameters including count, motility and morphology.
As per my points on alcohol – yes, you may be able to conceive as a heavy smoker, but is that the best thing for the health of your child?
We have such a high level of environmental toxins these days – do we really need some being fed directly into the body?
- Recreational drugs
Yes, marijuana is included.
Please pause them all. It doesn’t have to be forever, but I would encourage you to do your best to avoid them in the year before trying to conceive or at the very least in the 6 months prior.
People seem quite convinced that marijuana is a plant and so it won’t affect their fertility, but it really is participating in lowering fertility rates – it does this by affecting sperm health, potentially across all parameters: https://pubmed.ncbi.nlm.nih.gov/30916627/#:~:text=Research%20supports%20a%20role%20for,inhibiting%20capacitation%20and%20fertilizing%20capacity.
The research is not great regarding females, but there is evidence to suggest that it might have an affect on ovulation. Any smoking risks would apply here also.
- Movement and exercise
Please note that I’m talking about movement here – movement is good. We’re in a pandemic of sitters. Everyone’s necks and backs hurt. And it seems to me that people often feel it’s all or nothing when it comes to exercise.
This “all or nothing” mindset concerns me.
5 yoga classes a week or nothing.
Running every morning or nothing.
Then we have those who rely on intense exercise to feel good and I must admit – I become concerned that this particular type of person is feeling better only because they’ve gotten their stress hormones pumping. The job of a stress hormone is to mask any discomfort you may feel so that you FEEL better and can continue to cope with the stress… that’s why you feel better and then slump heavily 1-3 hours later.
Intense exercise is great if you enjoy it, but it must be in moderation.
Sitting on the couch is great in moderation also. Both can co-exist. And in my opinion we should be monitoring both as we do it.
– Ask yourself, “do I have the energy for this workout?”
– “Does my body feel a little too still to continue sitting?”
– In both instances, a walk around the block might be the answer.
And I would ask you to do away with this “I’m an all or nothing kind of person” attitude, because you are literally setting yourself up for failure. Which is odd.
It may be nice to begin with picking one class a week to go to. Or one day to go for a run. And then go from there. Allow exercise or movement to bring you joy! Walk to the shops if you can. Jump on your bike for 10 minutes. Do a handful of spinal rolls daily.
- Menstrual cycle literacy + BBT charting
Where to begin with menstrual cycle literacy!
In clinic, over and over again, I see people express embarrassment or shame that they don’t understand more about their menstrual cycle as though we should be born with this insight. We are not. And we’re kind of taught how to pretend it doesn’t exist and that if you look at sperm you will become pregnant, so please go easy on yourself.
Often people think they thought they can get pregnant any day of their cycle (there’s 5 days that you can – 6 days if you’re lucky). Or think that they ovulate halfway through their cycle, no matter how long their cycle is (you ovulate 11-16 days BEFORE the 1st day of your period).
I was having these “aha” moments at uni while studying Chinese Medicine, so please forgive yourself for not knowing how our fertility works – you are not alone.
There are a few ways you can go about menstrual literacy. You can pick up a book and do a deep dive (Period Power by Maisy Hill is a favourite of mine or The Period Repair Manual by Lara Briden). You can listen to one of a million podcasts that are out there (Maisy Hill has one, there is Heavy Flow with Amanda Laird (there are no new eps, but the back catalogue is incredible).
You can also just book in with a practitioner who can teach you along the way. Patients develop menstrual literacy as we work together and it is a zero pressure environment.
Basal body temperature (BBT) charting is an incredible tool we use to understand the ins and outs of your cycle. It is an invaluable tool to showing us when (and how) you’re ovulating and can guide us in our diagnosis.
Please be guided by a great teacher and don’t let the internet scare you with BBT charting. It is an incredible resource and I just love when a patient walks in to their first appointment with 2 months worth of charts and says, “here you go”. That is not a requirement, but it certainly is a fun way to start.
- Support yourself sexually and have fun!
Some people have difficulty climaxing. If the man is having difficulty we need to isolate if it’s performance anxiety (fair enough!) or a physical issue.
If performance anxiety is an issue, some find the use of home insemination to be an easy way to get around it. If you are in a couple, you can still enjoy each other’s company in the process and bring the woman to climax after insemination. It’s a well trodden path to baby.
If it is physical, then approaching your GP and perhaps seeing a urologist or fertility specialist will be the path for you.
If you are a woman or person with a vagina and experience pain during penetrative sex, please know that your discomfort is valid and that you don’t need to push through. It can be utterly debilitating and at times that very pushing through creates more physical and emotional stress.
Seeking out the help of a pelvic floor physiotherapist who specialized in women’s health or a sexologist might be an excellent first step.
If your body does not provide you with enough lubrication, pretty please buy yourself a fertility-friendly one (they are not all good for fertility!). I would encourage you to spend a little time with yourself to see what feels good. Masturbation is a great practice to understand your own pleasure so that you can better communicate your needs to your partner – no matter HOW long you’ve been together. Our bodies and needs change.
Ok, wow, well done you for getting to the bottom of this page! I hope you’ve found at least a few helpful nuggets in this blog to set you on your way towards baby and better health.
Caz Butler works on a Thursday and Friday from 2pm to 8pm.
138 Tanti Avenue, Mornington, VIC
03 5973 6886