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March 21, 2010
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Pregnancy Planning (cont.)

How soon after stopping birth control can I become pregnant?

There is no evidence that there is increased risk of spontaneous abortion increases if a woman becomes pregnant in the first cycles after stopping oral contraceptive pills. Intrauterine devices (IUD's) are not harmful to the fetus. Women who get pregnant with an IUD that is still in place do not have higher change of congenital abnormalities in the fetus compared to other women. If the IUD of a woman in her 1st trimester is carefully removed by a doctor, or if it is expelled on its own in the 1st trimester, the chance of spontaneous miscarriage is not increased compared to other women.

When barrier methods such as condoms, diaphragms, cervical caps, and sponges are used, pregnancy can occur by simply discontinuing their use during a regular cycle. The same can be said for spermicidal gels and suppositories. For more information about birth control, please read the Birth Control article.

Medroxyprogesterone (Depo-Provera) is an injectable hormone used for contraception. The contraceptive effect of Depo-Provera may last as long as 18 months after the last injection. Normal menstrual cycles and pregnancy cannot occur until after the contraceptive effect wears off.

How do we maximize our chances of becoming pregnant?

For most couples, becoming pregnant occurs naturally. Some couples have difficulty conceiving, and ways to maximize chances of conception become important. Other parents may want to time the delivery of their babies during particular times of the year or space the birth of their babies according to a desired schedule.

The first step in maximizing the chances of conception is by estimating the time of ovulation. Ovulation is that time of the menstrual cycle wherein the egg is released from the ovary and travels towards the Fallopian tube. In women with regular menstrual cycles, ovulation usually occurs 12-14 days prior to the onset of the next menstrual flow. Simply counting back fourteen days from the expected date of the onset of next period should be the time of ovulation. The couple should have intercourse for several days before, day of, and day after the expected time of ovulation. There is usually some variation in the time of ovulation even in women with regular cycles, so a few extra days of intercourse before and after expected ovulation is advised.

If the cycles are irregular and unpredictable, estimating the time of ovulation becomes difficult, and professional assistance may be sought. Another option for a woman with irregular cycles is the use of ovulation predictor kits now available over-the-counter at most drug and grocery stores. These kits can be used to determine the approximate time of ovulation by detecting urinary hormone elevations that precede ovulation. Another approach is to have intercourse every other day throughout the menstrual cycle. This approach will take out the stress or anxiety involved in timing intercourse.

Basal body temperature timing is a technique of checking the body temperature every morning and charting the results. If the temperature rises by a certain amount and stays elevated, it can be assumed that ovulation occurred. The problems with this method are that it is tedious and only provides the woman with information about ovulation after it has occurred.

Ultrasound images of the ovaries can be performed to monitor the growth and collapse of the ovarian follicle during the cycle. The follicle is the fluid-filled structure that surrounds the egg, and it can easily be seen on ultrasound. This method is probably the most accurate in timing ovulation. It is also the most expensive and is usually reserved for selected couples who are experiencing difficulty in becoming pregnant.

It is important to remember that even though intercourse and ovulation coincide, pregnancy may still not be achieved in any given menstrual cycle or even after several consecutive menstrual cycles. In many situations, the failure to conceive after multiple attempts is not a reason for alarm. It is not uncommon for pregnancy to occur only after several months of consistent attempts. Couples who have experienced an inability to conceive after several cycles may consider seeking professional advice to determine if an infertility evaluation is necessary.



Next: Can I do something to help my chances of conceiving a boy or a girl? »

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