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How to Know if You’re Pregnant: Signs of Early Pregnancy

Family Planning, Fertility, Pregnancy, Uncategorized

When your period is late, the thought “Am I pregnant?” may have crossed your mind. Wondering if you’re pregnant can lead to all kinds of emotions, positive or negative. (Sometimes conflicting feelings at the same time!)

You need to know if you’re pregnant so you can get the care you need as soon as possible.

While an ultrasound is the best way to confirm whether you are pregnant, your body may give you some other indicators. Some women might feel certain they are pregnant without taking a pregnancy test, but it’s best to confirm your suspicions to be absolutely sure!

Let’s take a look at the most common symptoms of early pregnancy, when to take a pregnancy test, and when to see a doctor to confirm if you are pregnant.

What to do if you think you could be pregnant

Identify the date of your last menstrual period (LMP).

When did your last period start? (Your OBGYN will ask you this question, too, so it’s an important date to keep track of.)

Tip: Some women have spotting that begins a day or two before their period. Note the first date you had bright red blood.

Check if your period is late.

Did your last period start more than four weeks ago?
How far apart are your periods usually? (The typical amount of time between periods is 28-32 days).

Tip: Even if your cycle is inconsistent or longer than 32 days from one period to the next, if you are more than one week past your expected period, and you have been sexually active, there is a chance you could be pregnant.

Check in with your body. Do you notice these signs of early pregnancy?

Nausea or vomiting
Breast enlargement or tenderness
Increased frequency of urination (without associated pain)
Fatigue

Other signs that typically occur later in pregnancy include:

Mild uterine cramping
Abdominal bloating
Constipation
Heartburn
Nasal congestion
Shortness of breath (mild)
Food cravings or aversions
Mood changes
Lightheadedness
Spider angiomas (small clusters of blood vessels on the skin)
Palmar erythema (palms of hands are very pink)
Skin pigmentation increases (blotches on face, areola darken, pigment under arms, dark line on abdomen)
Poor sleep
Lower back pain
Low pelvic discomfort

When to take a pregnancy test

A home pregnancy test may show up positive as soon as one week after ovulation (which could be one week before your expected period). However, we recommend you wait for your missed period. Some of these very early pregnancies do not continue. They are termed “chemical pregnancies.” If you have been trying for a long time to become pregnant, it may be especially beneficial for your mental health to wait for a more reliable test result.

Take a pregnancy test:

When you are one week past your missed period and have been sexually active.
When using hormonal birth control (including hormonal IUD) and your period flow is different than usual.
When you experience pregnancy symptoms while using birth control if you have been sexually active.
If you have an IUD and you cannot feel the strings when you were previously able to feel the strings.

Types of pregnancy tests

At-home pregnancy tests

The easiest and most convenient way to test if you are pregnant is to use a home pregnancy test. They are only a few dollars and are available at many stores, gas stations, grocery stores, and at your county health services.

The most accurate home pregnancy test is the brand First Response. It will pick up 97% of pregnancies at the time of your missed period. The e.p.t. home pregnancy test will pick up 54-67% of pregnancies at the time of a missed period. The brand Clear Blue offers two kinds of pregnancy tests: a manual one (64%) and a digital one (54%). (The digital Clear Blue Easy states the words “pregnant” or “not pregnant,” while the manual test simply shows one or two lines.)

Blood tests to determine pregnancy

Another way to take a pregnancy test is by having your blood tested for human chorionic gonadotropin (hCG), which is a hormone that is produced by the body during pregnancy. This test is called a beta-hCG test or quantitative hCG blood test. An hCG blood test for pregnancy is more common if you have not had a period and don’t know when your last period was, or if you have been using hormonal birth control.

Ultrasound to determine pregnancy

If your home pregnancy test or beta-hCG blood test is positive for pregnancy, the next step will be to confirm the pregnancy with an ultrasound. An ultrasound is typically planned for 5-6 weeks past the missed period. The ultrasound will confirm where the embryo has implanted, if there is more than one, and if the heart is beating.

Learn more about when and why ultrasounds are performed during pregnancy.

If you are pregnant

It’s important to know as soon as possible if you are pregnant. For example, if you’re having symptoms of pregnancy, an irregular period, or irregular bleeding, your OBGYN needs to rule out pregnancy as a cause so they can determine what else might be happening.

Contact your OBGYN as soon as you think (or know) you are pregnant

Call your OBGYN clinic as soon as you find out you’re pregnant. When you call in, your provider will review your medical history to determine the timing of your first prenatal visit. If you are a woman with no medical problems and under the age of 35, your first prenatal appointment will likely be 3-4 weeks after your missed period.

Some women should be seen sooner than others. For instance, if a woman has a history of ectopic pregnancy (or tubal pregnancy), she should be seen within a couple of days. Certain other medical conditions warrant an immediate visit with the provider.

Note: Ectopic pregnancy is when a fertilized egg grows outside of the uterus, such as in the fallopian tube. The earliest symptom of ectopic pregnancy is typically light vaginal bleeding soon after a positive pregnancy test. If this happens, call your OBGYN to schedule an ultrasound right away. The ultrasound will identify if the fertilized egg is growing in the uterus or if it has attached somewhere else.

An ectopic pregnancy cannot be moved to the uterus and requires treatment such as medication or surgery. If the ectopic pregnancy continues growing to 5 or 5.5 weeks after conception, it could cause more serious complications, such as a ruptured fallopian tube, which can result in life-threatening internal bleeding. Symptoms of a ruptured fallopian tube include sudden and severe pain, abnormal bleeding, lightheadedness, and shoulder pain.

Take care of your body

It’s also important so you can make good choices for your body to support your pregnancy and give your baby a healthy start in life. If you discover you are pregnant, you should follow the guidelines below.

Start (or continue) prenatal vitamins

Prenatal vitamins include an extra amount of folic acid, which is important for the development of your baby’s brain and nervous system. Ask your doctor what type of prenatal vitamins they recommend.

Avoid alcohol and certain medications

Avoid alcohol and certain medications if you are pregnant. Alcohol significantly affects fetal brain development. Some medications can also cause birth defects. Read more about medications in pregnancy.

Avoid smoking and drugs

Avoid recreational drugs, smoking, vaping, and marijuana when pregnant. These can also cause developmental issues and birth defects in babies. Smoking harms lung development and restricts blood flow to the placenta.

Eat right and exercise

When you let your provider know you’re pregnant, you will get helpful information about a healthy diet and exercise during pregnancy. You’ll receive a list of foods, activities, and environmental exposures to avoid. You’ll receive information about avoiding work-related exposures, too (especially if your job includes working with or around chemicals and dyes). Your provider will see if you are up-to-date on vaccinations or if there are any other recommended vaccinations you should receive.

Learning that you’re pregnant can be exciting or scary. Feeling all kinds of emotions when you find out is totally normal! That’s why it’s so important to speak with your provider early on. We’re here to help!

Dr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.

February 25, 2022/by Karla Dickmeyer

Exercise During Pregnancy: Which Activities are Safe and Which You Should Avoid

Pregnancy

Exercising during pregnancy is an excellent way to maintain a healthy pregnancy and create positive habits that you can pass along to your child. Exercise benefits both you and your baby in many ways.

As long as you exercise safely and follow recommendations from your OB provider, exercise has been shown to be safe in pregnancy without risks to your baby. While you may need to modify some exercises, especially as your baby grows and your body changes, you don’t need to purchase special equipment. Stay consistent and listen to your body and you can exercise safely throughout your pregnancy!

Benefits of Exercising During Pregnancy

When you exercise throughout your pregnancy, you’re more likely to achieve a healthy level of weight gain. (Read our blog post about how much weight you should gain while pregnant.) You’ll also be much less likely to experience gestational diabetes, gestational hypertension (high blood pressure), and other disorders. Your baby will benefit from your exercise, too, with lower rates of preterm birth, C-section deliveries and low birth weight.

Regular physical activity can help reduce your body aches and pains, especially if you have back pain or sciatic pain. Exercise also helps strengthen your heart and blood vessels. Plus, you’ll find it easier to lose your pregnancy weight after your baby is born.

Physical activity even does wonders for your mental health! Aerobic exercise—whether you’re pregnant or not—reduces anxiety and depression during pregnancy and can help increase your energy levels. Women who exercise during pregnancy may be able to reduce their risks of postpartum depression.

How to Get Started Exercising While You’re Pregnant

Because every pregnancy and body is different, it’s important to meet with your OB provider before you get started. Some women can maintain their same level of activity and exercise throughout their pregnancy, and others may need to scale back in the beginning and at the end. Your doctor or midwife will help you determine the best approach.

It’s so important to listen to your body while you’re exercising. The easiest way to know if you’re “overdoing it,” is by doing a “talk test.” As long as you can carry on a light conversation while exercising, you’re probably not over-exerting yourself.

If exercise is a new habit you’re trying to build while pregnant, start slowly and add more minutes to your exercise routine each week. For example, start with 10-20 minutes per day 2-3 days a week, and then build up to maybe 30 minutes per day 3-5 days a week.

Some women like tracking their exercise and watching aerobics videos designed for pregnancy. Many of our patients have enjoyed using an app called Expecting and Empowered. While it isn’t free, it may help give you the motivation that you need to get started and stay consistent.

Here are some safe pregnancy exercises to get started.

Try any of these for 20-30 minutes a day, on most or all days of the week:

walking — this is the best way to get started!
swimming
stationary cycling / spinning
aerobic exercises
dancing
resistance exercises (weights, resistance bands, strength training) — use good ergonomics and form to avoid injury
stretching and prenatal yoga
hydrotherapy/water aerobics
kegels to strengthen your pelvic floor (do this during pregnancy and postpartum)

If you were already doing higher intensity and longer workouts before you got pregnant, like jogging and aerobics, and you have an uncomplicated pregnancy, you can probably keep up those activity levels. Your doctor will help you determine if you have any restrictions or if you need to increase your calorie intake.

Specialty Exercises During Pregnancy

If you experience back pain while pregnant, consider adding core strengthening exercises for your abdominals and your back. Yes, you CAN do abdominal exercises while you’re pregnant, but you will need to modify them a little bit and limit how much time you lay flat on your back. Your OB provider or physical therapist will be able to give you exercises that are safe for your specific situation.

You can strengthen your pelvic floor while you’re pregnant by performing kegels during and after your pregnancy. To perform kegels, contract the muscles that you would use to stop your urine stream. Hold for 3 seconds, and then relax for 3 seconds. Repeat this 10 times, in the morning, afternoon, and evening. Try to increase your hold by 1 second each week until you reach 10 second holds.

Exercises to Avoid While Pregnant

It’s important that you avoid activities that could increase your risk of falling or sustaining abdominal trauma. Be sure that when you’re exercising, you don’t raise your core body temperature to an unsafe level (that is, above 102.2° F).

Activities to avoid:

contact sports (football, volleyball, softball, wrestling, jiu jitsu, ultimate frisbee, etc.)
extensive jumping (some jumping may be ok as long as you modify the exercises to reduce the risk of losing your balance)
full sit-ups, leg raises
scuba diving
horseback riding
skiing, snowboarding
hot yoga
exercising in hot, humid weather

Who Shouldn’t Exercise While Pregnant

If you have a high risk or complicated pregnancy, make sure to ask your OB provider about the types of exercises you can do while pregnant. In general, it is always good to touch base with your OB provider regarding your exercise routine and goals in pregnancy so they help you establish a safe routine for YOU.

When to Stop Exercising During Pregnancy

It’s very important that you listen to your body while you exercise. If you can’t carry on a light conversation while you’re working out, slow down, drink some water and then resume at a lower intensity after you have caught your breath.

If you’re used to using a heart rate monitor during exercise, you may find that it isn’t as useful of a tool to measure your exertion levels. That’s because your heart rate rises during pregnancy. Passing the “talk test” will be a more reliable measure of how hard your body is working.

If you experience any of the following warning signs, stop exercising and follow up with your OB provider:

vaginal bleeding;
abdominal pain;
regular painful contractions;
amniotic fluid leakage;
shortness of breath BEFORE exertion;
dizziness;
headaches;
chest pain;
muscle weakness affecting balance;
or calf pain or swelling.

Listen to Your Body to Stay Healthy & Safe!

Whether you’re new to regular exercise or wondering if you need to scale back from pre-pregnancy activity, the most important thing to do is listen to your body! Stay well hydrated. And stop if you experience any of the above warning signs. Your OB provider will be your best resource as you get started or resume activity.

Exercising has so many benefits for you before, during, and after your pregnancy. At Madison Women’s Health, we’re excited to support you in your journey toward health and wellness. We’re glad that you’re interested in developing healthy habits for you and your family that will serve you for years to come.

Check out our prenatal yoga classes for our pregnant patients.

Dr. Shefaali Sharma has been providing healthcare to women in Madison since 2012 and joined Madison Women’s Health in 2016. She specializes in high- and low-risk obstetrics, pre-conception counseling, management of abnormal uterine bleeding, multi-modal approaches to pelvic pain, and contraceptive counseling.

July 21, 2020/by Dr. Shefaali Sharma

Pregnancy Weight Gain: What is Average and What is Recommended by OBGYNs?

Family Planning, Pregnancy

Your weight gain during pregnancy is important not only for your baby’s growth and development, but also for your health during and after your pregnancy.

It’s important to have a healthy perspective on pregnancy weight gain even though it can be a very sensitive, personal topic. While some women enjoy the “freedom of eating for two” as soon as the first trimester’s morning sickness goes away, others get upset when they see the scale creep past numbers they’ve never seen before. Most women are concerned about getting back to their pre-baby weight.

But a healthier perspective falls somewhere in the middle.

The weight you gain while pregnant supports your baby’s growth and development while you are pregnant and supports breastfeeding your newborn. However, too much weight gain can lead to problems like diabetes, heart disease, pre-term delivery, or even miscarriage and still birth. And even your pre-pregnancy weight affects your child’s weight and health as they grow older.

Paying attention to your pregnancy weight gain and returning to your pre-baby weight is not about meeting body image or societal standards—rather, it’s about achieving optimal health for you and your baby. At Madison Women’s Health, we care about your health and your baby’s health. That’s why we want to help you understand the recommended weight gain for pregnancy and the risk factors for carrying an unhealthy amount of weight while you’re pregnant.

So what is the “right” amount of weight you should gain while pregnant?

The National Academy of Medicine created these guidelines to help women estimate how much weight they should gain while pregnant, based on her BMI (body mass index) before pregnancy.

Average Weight Gain During Pregnancy:

Underweight: Gain 28-40 pounds
Healthy weight: Gain 25-35 pounds
Overweight: Gain 15-25 pounds
Obesity: Gain 10-20 pounds

If you have twins, you’ll gain a little more weight:

Healthy weight: Gain 37-54 pounds
Overweight: Gain 31-50 pounds
Obesity: Gain 25-42 pounds

Gaining Weight at the Right Rate

Your pregnancy weight gain will be gradual, with some jumps and plateaus. What matters the most is your overall weight gain. Most women don’t gain very much weight during their first trimester. But in the second and third trimesters, you can expect to gain 1/2 to 1 pound per week.

Your OBGYN will track your weight gain with you at your monthly check-ups and may recommend changes to your nutrition or activity levels. Experiencing major weight gains, like 15 pounds in 4 weeks, would not be considered healthy. Your doctor will make recommendations to help you slow your weight gain.

Source: https://nam.edu//www/wp-content/uploads/2019/12/Table-1.png

What Makes Up Your Pregnancy Weight

Based on a healthy pregnancy weight gain of about 25 pounds, this is where your pregnancy weight goes:

baby: 7-8 lbs
amniotic fluid: 2 lbs
placenta: 1.5 lbs
increased blood volume: 3-4 lbs
increased fluid volume: 2-3 lbs
larger breasts and uterus: 3-5 lbs
increased fat stores to support nutrition during pregnancy and for breastfeeding afterward: 6-8 lbs

(Source: https://nam.edu/the-current-understanding-of-gestational-weight-gain-among-women-with-obesity-and-the-need-for-future-research/)

Risks of Gaining Too Much Weight While Pregnant

Your weight before and during pregnancy plays a large role in your health and your baby’s health. If you are overweight at the time of conception, or if you gain more than the recommended amount during pregnancy, you and your baby can be at risk of the following:

fetal anomalies,
preeclampsia,
heart disease,
gestational diabetes,
depression,
stopping breastfeeding early,
developing sleep apnea,
preterm delivery,
delivery requiring induction,
C-section,
miscarriage,
and still birth.

In addition to those risk factors, babies who are born to women who are obese are also at risk of:

higher percentage of body fat,
childhood obesity,
lifelong metabolic syndrome,
and asthma.

But there is good news! If women who are overweight or who have obesity lose even a small percentage of weight prior to conception, they can impact the health of their pregnancy. For example, if a woman weighing 300 pounds loses just 15 pounds, she would improve both her health and her baby’s health. A 5% weight loss is the perfect starting goal prior to pregnancy – and can reduce the risk of complications. Once that goal is reached, it’s good to reassess and set a new goal.

Risks of Gaining Too Little Weight While Pregnant

Some women struggle to gain weight during pregnancy. This is typically caused by hyperemesis, which is excessive nausea and vomiting in pregnancy. Eating disorders that lead to continued restrictive eating are also causes.

If a woman doesn’t gain enough weight, her baby is at risk because it isn’t getting the proper nutrients. Babies born to underweight women are at risk of:

being small for gestational age,
growth problems,
and failure to thrive.

How to Achieve Healthy Weight Gain While Pregnant

Instead of becoming anxious about weight gain or permissive about unhealthy eating habits, focus on staying active and eating a balanced diet.

Make an eating plan

Choose a healthy eating plan that you can continue. There isn’t one specific pregnancy diet to follow. Instead, your healthy pregnancy diet should consist of lean proteins, healthy fats, fruits and vegetables. (Whether my patients are pregnant or not, I usually recommend the Mediterranean diet—it meets all the nutrition requirements, isn’t very restrictive, and will give you many satisfying meal plan options.)

Eat nutritious food

Focus 95% of your diet on healthy, nutritious food. Then, the remaining 5% should be other choices you really enjoy. If ice cream is your thing, take time to savor it—it’s ok! For more information about food during pregnancy, read our article about food cravings, aversions, what to eat and what to avoid.

Add a Few Calories

Add about 300 calories per day to maintain a healthy weight while you’re pregnant. That’s like adding another slice of bread, a cup of cottage cheese, or a couple more ounces of meat at your meals. If you are overweight, you will not need to add as many calories. There is no need to “eat for two!”

Listen to your body

Pay attention to your hunger cues. Stop eating before you feel too full.

Stay Active

Stay moderately active every day. If you struggle with your weight or body image, your pregnancy is a great time to reset your focus on overall health and establish healthy eating and exercise habits. You’ll be making a positive step for your child and yourself.

Any patient at Madison Women’s Health who starts a pregnancy when overweight or obese is given the option of a nutrition consultation. When you work with a nutritionist, you will learn how to choose healthier options, how to create healthier habits, and even how you could change your dietary preferences.

Getting Back to Your Pre-Baby Weight

The majority of women gain a healthy amount of weight during pregnancy, and much of that weight is lost soon after delivery. But about 60% of the time, women still retain about 10 pounds of their pregnancy weight gain 12 months later. And 40% of women maintain 20 pounds of their weight gain even after their baby is one year old.

When should you lose that baby weight so it doesn’t become a permanent weight gain?

Weeks 1-6: Don’t worry about your pregnancy weight for your first six weeks with your new baby. Instead, focus on recovery, connecting with your baby, getting enough sleep, and establishing breastfeeding. Check with your OBGYN about resuming more activities at your postpartum visit!
Months 3-6: It’s okay to begin working toward a healthy weight at this point. This should be gradual and your diet should continue to support breastfeeding.
Months 7-12: Add more activity to your daily routine. Just as you gained your pregnancy weight gradually, you will lose it gradually. Give yourself time to lose the weight in a healthy way.

If you haven’t returned to your pre-baby weight by the time your baby is one year old, then consider making more changes to your nutrition and exercise. You can also request a nutrition consult to learn how to get all the nutrients your body needs without overdoing it on calories.

At Madison Women’s Health, we want to support your health before, during, and after your pregnancy. We’re here to help you learn how to make the best decisions so you can be well.

Dr. Kate Sample has been providing healthcare to women in Madison since 2002 and is a founding member of Madison Women’s Health, specializing in high and low risk obstetrics; minimally invasive surgical techniques; pelvic floor disorders; and exercise, weight loss and obesity. She is a Diplomate of the American Board of Obesity Medicine and is trained in Cognitive Behavioral Therapy for weight loss through The Beck Institute.

May 26, 2020/by Kate Sample

Getting Pregnant: Fertility Tips for Problems Conceiving

Blog, Fertility, Pregnancy

Thinking about getting pregnant and starting a family can be an exciting time. But when it takes longer than you expect to get that positive pregnancy test, you may start to wonder “Why am I not getting pregnant?”

As a Madison OBGYN, I meet with many women who are wondering what they can do to get pregnant faster. I enjoy supporting women in their “trying to conceive” journeys and want to answer the most common questions I’m asked as well as address misinformation that can be confusing and even hurtful.

Chances of Getting Pregnant by Age

Your age plays a role in your fertility. Women are born with a fixed number of eggs and your total number of eggs declines with age. The term “ovarian reserve” refers to your egg supply.

Women in their 20s have peak fertility. Their fertility starts a slow decline around age 32, with a more rapid decline around age 37.

A healthy woman in her 20s has a 25% chance of conceiving naturally each month.
A healthy woman in her 30s has a 20% chance of conceiving naturally each month.
A healthy woman in her 40s has a 5% chance of conceiving naturally each month.

When You Should See a Doctor About Getting Pregnant

About 80% of couples conceive in the first 6 months of trying. That number increases to 85% after 12 months. If you have regular menstrual cycles and have been trying to conceive for a year, then it’s a good idea to talk to your OBGYN about it. We will evaluate to see if there are other issues that make it harder for you and your partner to conceive.

If you’re over 35 years old, have this conversation with your doctor sooner—after you’ve been trying to conceive for 6 months. If you are in your 40s and want to have a baby, it’s better to speak with your OBGYN right away because often fertility treatments can be started right away.

No matter your age, if you know you have irregular periods (consistent cycles less than 25 days or greater than 35 days apart), get evaluated sooner. If you have other health problems, make a preconception visit to make sure these conditions are optimized prior to conceiving.

Before you are referred to a fertility clinic, your OBGYN can rule out and/or treat common issues. Sometimes we can recommend small changes that can help you get pregnant.

Madison Women’s Health OBGYN clinic refers patients to fertility clinics when:

you are 40+;
there is concern about early menopause;
after 3-6 months of using Clomid or Letrozole to induce ovulation (or a little longer if we can prove you are ovulating on these medications);
there are abnormal semen parameters that require intervention;
or there is any other reason to expedite your chances of conception.

Problems Conceiving? How to Prepare for Your First OBGYN Visit

Track your menstrual cycle. Cycle length and regularity are important for fertility. Tracking your menstrual cycle will help your doctor know if you are ovulating each month. Use a calendar or a tracking app to mark the first day your period begins (first day of red bleeding). Most apps have other parameters you can input, but your period is most important. Bring your calendar or app!
Know your medical history and family history of genetic conditions. If you are visiting Madison Women’s Health for the first time, be sure to bring your health records and any testing or blood work you might have done previously.

Best Apps for Tracking Your Fertile Window

When it comes to tracking your menstrual cycle and your “fertile window” (the days when you are most likely to get pregnant) you can go as high-tech or low-tech as you want. Whether you want a basic calendar or an app that syncs with all your devices, choose something you know you can use consistently.

There are hundreds of apps to help identify your fertile window, but only about 20 that research has considered to be reliable and easy to use. It’s important to choose an app that is based on accurate scientific data. The app that I recommend to my patients is the Glow App. It’s available on the iTunes App Store and on the Google Play Store. There are both free and paid versions. You can even join online communities with people who are trying to conceive (just be careful about following advice from people who aren’t medical professionals).

Getting Pregnant with Irregular Periods

If you have irregular periods, it’s important to discover what is causing them. Too-short or too-long of cycles can be caused by anovulation (not ovulating), thyroid conditions (hyperthyroidism, hypothyroidism), being underweight or overweight, extreme stress, and being near puberty or menopause. We have blood tests to help us find the cause.

Common Tests for Fertility

In addition to checking blood work, your OBGYN will also evaluate your uterus to make sure there isn’t anything about your uterine anatomy that makes it difficult to get pregnant.

At Madison Women’s Health, we can do a Saline Infusion Sonohysterogram, often called an SIS. After injecting saline fluid in the uterus, we use ultrasound equipment to evaluate the uterine cavity.

It’s also important to know if your fallopian tubes are open so a sperm and egg can meet. The hysterosalpingogram, or HSP, is like an SIS but uses an x-ray machine to view your uterus and test if your fallopian tubes are patent (open).

Testing Male Factor

Because male factor infertility is very prevalent (in approximately 10% of infertility cases, a male factor is the only identifiable cause), a semen analysis is an important step in the process. His tests are less costly and much less invasive. While we don’t evaluate male factor infertility at Madison Women’s Health, we can place the order for your partner to have a semen analysis done in Madison. Abnormal semen parameters warrant referral to a specialist for infertility.

Prescriptions to Induce Ovulation

If your test results show that you aren’t ovulating, your doctor may prescribe a medication to give your ovaries a boost. Clomid and Letrozole work by making the body think your estrogen is low. This makes the ovaries ramp up production of follicles that lead to ovulation.

Clomid has been used for many years without known adverse long-term effects. Common short-term side effects are hot flashes, nausea, bloating, mood swings, and headaches.

Letrozole is a newer medication used to induce ovulation. It is not FDA approved for this, but has been documented as safe and effective. We often recommend this instead of Clomid. Your OBGYN will work with you to prescribe the best medication for your situation.

Natural Ways to Increase Your Fertility

Not everyone needs or wants medical intervention to get pregnant. There are natural things you can do to increase your chances of getting pregnant each month.

Timed intercourse during your fertile window. If you’re tracking your cycle each month, you’ll know approximately when you’re ovulating. Have sex every 1-2 days during your fertile window, which is about 5-6 days before you ovulate. (For example, if you have a 28 day cycle, with day 1 being the first day of your period, you can estimate your fertile window to be days 9-14 of your cycle.)
Avoid using lubrication. Most over-the-counter lubricants inhibit sperm. If you need lubrication during intercourse, use a lubricant specifically made for couples who are trying to conceive, like Pre-Seed. You can also use canola oil or mineral oil.
Healthy weight. If you are underweight or overweight, you may not ovulate or have a regular menstrual cycle. If you are overweight with frequently missed periods, decreasing your weight by as little as 5% can increase your chances of having regular periods and conceiving.
Limit alcohol to 2 drinks per day. Cut alcohol completely out when you are actively trying to get pregnant.
Reduce caffeine. At typical levels of caffeine intake, there does not appear to be an association between caffeine consumption and inability to conceive. Some studies suggest that going overboard may not be helpful, however, so try to limit to no more than two 8oz cups of coffee per day.

Common Misconceptions About Increasing Your Fertility

When people find out you are trying to conceive or are having problems getting pregnant, you may get a lot of advice. People have good intentions but may have limited medical knowledge. It can get confusing sorting through all the health blogs, fertility forums, and more. It can also be painful when people think they have an easy solution to something that is so private and personal. Here are some common myths about getting pregnant and increasing fertility:

“Herbs, vitamins, teas and supplements will increase your fertility.” This is not necessarily true. Eat a healthy diet, take a prenatal vitamin, and exercise. Healthy women are more likely to have healthy pregnancies.
“This super food will increase your fertility.” There are many so-called fertility diets. If there was a super food that increased a woman’s chance of getting pregnant, everyone would use it! If a website endorses a specific food for fertility (like yams and pineapples), they are based on small, poorly done studies. They are full of antioxidants, however, which are great for overall health!
“Don’t worry, it’ll happen when you quit trying so hard.” First of all, I am sorry if anyone has said this to you. This statement simply adds guilt to the stress that infertility is already creating. At the most, the stress related to fertility troubles may slightly lengthen the amount of time it takes to get pregnant. Stress only affects your fertility if it prevents you from having intercourse or is affecting your menstrual cycle.
“Get in the right position.” Certain positions during sex, elevating your hips, lying flat for twenty minutes afterward do not increase the likelihood of conceiving.

If you come across any other advice that promises to be “the answer to all your fertility troubles,” be wary. Will it help you eat healthier? Does it encourage you to be active? Fertility is complex and there isn’t a right answer for everyone. Be sure the advice encourages healthy habits and listen to your doctor’s recommendations.

Focus on Your Health

One of the best things you can do to improve your chance of getting pregnant and have a healthy pregnancy is to optimize your own health. No matter what age you are, it is important to be cognizant of your weight. Eat a diet rich in vegetables, lean protein, whole grains, and healthy fats. Reduce your alcohol and caffeine consumption. Get regular exercise. Begin taking a prenatal vitamin right away. The healthier your body is when you are trying to conceive, the better your chances of having a healthy pregnancy.

The key point in all the fertility advice you may receive is this: be healthy, let us know if your menstrual cycle is abnormal, have timed intercourse, and see a doctor for a preconception visit if you have questions about your health before trying to conceive.

At Madison Women’s Health, we are here for you in your journey to pregnancy. We’re excited to be your partners as you grow your family! To make an appointment with one of our providers, call (608) 729-6300.

Dr. Ashley Durward has been providing healthcare to women in Madison since 2015 and joined Madison Women’s Health in 2019, specializing in high and low risk obstetrics, contraception and preconception counseling, management of abnormal uterine bleeding, pelvic floor disorders, and minimally invasive gynecologic surgery.

March 21, 2020/by Dr. Ashley Durward

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