Consider your timeline. If you're positive you don't want to become pregnant right now but want to be a mom in your late 30s or early to mid-40s, look into freezing eggs or embryos for later use. "It's a spectacular option if you don't have a partner, you want to finish schooling or advance your career first, or you have an illness that prevents you from getting pregnant in the short term," says David Ryley, M.D., a reproductive endocrinologist at Boston IVF fertility clinic and clinical instructor at Harvard Medical School. "It would be far better if you pursue freezing in your 20s because the egg quality [is better] and the count is higher, but it can still be done up to age 40," Dr. Ryley explains. Freezing is not right for everybody -- it costs $10,000 to 15,000 out of pocket, plus up to $1,000 housing for eggs or embryos annually -- but it's an option for those who have a concrete reason for deferring motherhood.
Start tracking your periods. "Women's cycles can last [between] 25 and 40 days, so it's important to know exactly what physical changes to expect at specific times of the month so you can time your relations just right," says Kelly Pagidas, M.D., a fertility specialist with Women & Infants Center for Reproduction and Infertility in Providence. Keep a record in your datebook or use a site like My Mobile Fertility to track your cycles electronically for at least two months before you want to become pregnant.
Maximize your baby-making sex. "I'm constantly treating people who wait for the magical day of the month when they're ovulating and actually end up missing it," Dr. Pagidas says. Fertility experts say you should start getting it on well before ovulation, at least five days prior to egg release. You may also want to switch up the time of day to give your guy's swimmers their best shot. Studies show that sperm counts tend to be highest in the morning and early afternoon.
Get into a smarter pre- and post-sex routine. "I tell my patients to urinate just before intercourse and then avoid going again for at least 15 minutes after sex to make sure they're not unnecessarily flushing it out of their system, says Angela Chaudhari, M.D., a gynecologic surgeon and assistant professor in the Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine in Chicago. "Ideally, you shouldn't be upright for the first 30 minutes after sex so sperm has a better chance of going where it needs to be." But if you can't lounge in bed, it's no biggie. The majority of fertilization takes place within 90 seconds of ejaculation.
Stay hydrated. "Most women don't think about this, but you need to keep mucus membranes nice and moist to aid conception," says Jill Blakeway, a licensed acupuncturist and cofounder and Clinic Director of The YinOva Center fertility organization in New York City. Dehydration is common among women, especially if they're still cutting down diuretics like caffeine and alcohol. The eight-glasses-of-H2O prescription is largely a myth. "Simply drink enough caffeine-free liquid so your urine is a clear light yellow, and eat foods with high water content, such as lettuces and watermelon," advises Sarah Krieger, R.D., a nutritionist based in Kalamazoo, Michigan, and spokesperson for the Academy of Nutrition and Dietetics.
Eat cleaner. In addition to limiting processed and packaged foods, it's a good idea to center your diet on whole, fresh foods with a certain pH number. "There's evidence that alkaline foods, which help your body achieve its proper pH balance, may have improve the quality of your cervical mucus, making it easier to conceive," Blakeway says. Boosting your intake of leafy greens, cruciferous and root veggies, and lemon may help, as may avoiding acid-forming foods like dairy, sugar, meat, and wheat before ovulation.
Get help on your second time around. "I see quite a few moms who are shocked when they have trouble conceiving after their first child," says Alan Copperman, M.D., director of Reproductive Medicine Associates of New York and codirector of the Division of Reproductive Endocrinology and Infertility at The Mount Sinai Hospital in New York City. The causes of secondary infertility are myriad, including lifestyle (too exhausted from taking care of a toddler to have sex), medical (a C-section that hasn't fully healed), and even simply advanced age. Many of these are fixable, as long as you don't wait to seek assistance. "The first step is to evaluate the woman's uterus and tubes," Dr. Copperman says. "Then we make sure the guy doesn't have issues like taking certain blood pressure medications or experiencing erectile dysfunction."
Don't rule out donor eggs. For women over 40, using eggs from another woman (typically in her 20s or early 30s) is often a successful but bittersweet endeavor. "We know that women hesitate because they want to pass on their own DNA, but so much of the biological makeup of a child comes from growing inside the mother and other environmental factors," Dr. Ryley says. "Egg donation has a great rate of success -- up to 80 percent -- and the earlier you opt for it, the better your chances will be."
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