Guide To Get Pregnant

For a better understanding as to how your pregnancy will begin, you should know about your menstrual cycle. Your menstrual cycle starts from the first day of your period and continues until the first day of your next coming period.

There are four phases in your menstrual cycle and its average length is 3 days to one week.

Menstruation or bleeding phase: This phase includes draining of thickened uterine lining i.e. endometrium in the form of menstrual blood through your vagina. Components of menstrual fluid are blood, uterine lining cells, and mucus.

Follicular phase: This starts on the first day of menstruation and stops with ovulation. Follicle-stimulating hormone FSH is produced in this phase which causes the ovaries to release 5 to 20 follicles and each has an immature egg. At around the 10th day of the 28 day-long cycles, only one follicle will get matured into an egg. The uterine lining is also thickened in preparation for pregnancy.

Ovulation: Estrogen hormone level is raised during the follicular phase and this results in releasing of luteinizing hormone LH. This LH starts your ovulation when a mature egg is released which then passes down the fallopian tube towards the uterus to meet the sperm. This is the time you can get pregnant by noticing your signs of ovulation. You will ovulate in the middle of your cycle, i.e on the 14th day [1] if you have a 28-day cycle and it lasts for 24 hours. If not fertilized with the sperm your egg will die or dissolved by your body.

Luteal phase: After releasing the egg, the follicle changes into corpus luteum which releases high levels of progesterone and estrogen. These hormones thicken the uterine lining for the implantation of fertilized eggs. If your egg is fertilized, human chorionic gonadotropin is detected in pregnancy tests that maintain corpus luteum and uterine lining. If your egg is not fertilized, the corpus luteum shrinks get reabsorbed leading to decreased estrogen and progesterone levels that result in the starting of your periods.

Now you have known that ovulation happens to release the egg and it meets sperm and this fertilized egg gets implanted in the uterus and pregnancy begins. For better estimation of your ovulation period and to have intercourse you should know about ovulation in detail.

Every month of your menstrual cycle, the mature egg is released by your ovaries and this is called ovulation. The time when a mature egg passes down through the fallopian tube to meet sperm and get fertilized is known as conception [2]. It results in embryo formation. This can later get implanted in the uterine lining and grows into a baby.

Best Time to Get Pregnant

You will have good chances of getting pregnant if you have sex within a day or so of your ovulation. If the length of your menstrual cycle is 28 days, then your ovulation usually occurs 14 days after the first day of your last period. After 12-24 hours of ovulation during your menstrual cycle, you can no longer get conceived because your egg is not present in the fallopian tube. For fertilization to occur the egg and sperm should combine together at the right time.

You may now have doubts as to how to know that your uterus is releasing a mature egg. There are few signs that are given by your body while you ovulate and tracking of these signs helps you for better planning.

Signs of Ovulation

You are most fertile around the time of your ovulation. This occurs at the mid-way of your menstrual cycle ie. on the 14th day if your average menstrual cycle length is 28 days. Your body shows some or all of the following signs of ovulation[3]:

• The positive result shown by ovulation Predictor Kit: This kit is mostly used as an at-home pregnancy test by many women. On dipping the test stick into your urine, two lines appear on the stick, the test line, and the coloured line. If the test line is thicker and dark-coloured than the control line, then you are about to ovulate.
• Fertile Cervical Mucus: On you reach your ovulation, your cervical secretion turns as wet and egg-white like indicating the best time to get pregnant.
• Increased feel to have sex: There is an increased desire for women to have sexual intercourse just before she ovulates.
• A slight increase in basal body temperature: You can notice a slight increase in your body temperature just after your ovulation. This is due to the progesterone hormone that is released after ovulation.
• Cervical position checking: if your cervix is high, softer, and opened, it means that you are in a fertile state. While a low, firm and closed is a non-fertile state of your cervix indicating that you already ovulated or not yet ovulated.
• Tender breast: The hormones that are produced by your body after ovulation makes your breast feel tender to touch. You can notice this change as an indication that ovulation has occurred.
• Ferning saliva pattern showing fertile period: This is uncommon and difficult to identify. This method of tracking ovulation is done by using special microscopes and so not much preferred. You can imagine this ferning pattern of saliva like the image of frost or snowflake on a glass window.
• Pain in abdomen: A general or localized pain on one side of the abdomen is seen in some of the women during their ovulation. This is known as “Mittelschmerz” or “middle pain” or “pain in the middle of the month” [4].
• Symptoms of pre-menstruation: Few times, premenstrual symptoms like the tenderness of breasts, breast enlargement, bloating of the abdomen, and mood swings are seen in association with ovulation.

There are few tests that help you to know your ovulation phase and thus give you a better idea of planning sexual intercourse for determining your best time to get pregnant.

Women can do an ovulation test herself at home by making use of certain ovulation kits.

Cervix position during your Ovulation

You can check your cervical position as it helps to detect your ovulation and let you know when you are fertile.

Steps to be done: You can locate and record your cervical position by following simple steps:

• Make sure to wash hands properly: If you have any infection of your vagina, you should wait until it subsides before checking your cervix.
• Place yourself in a good position: You should position yourself so that you can easily reach your cervix. This is possible by putting one leg up on the chair or bathtub, squatting, or can sit on a toilet.
• Place your finger into the vagina: You can use either your index or middle finger and slowly slide in an upward direction to through vagina which is the first passage and then reaches the cervix.
• Find your cervix: Vagina gives you a soft and spongy feel and opens up to pressure given by fingers, while the cervix is firm, strong, and has dimples. If you are closer to ovulation or ovulating, you can't reach the cervix as it is shifted a little higher and is softer. If you are not nearing ovulation, then you can reach and find the cervix easily.
• Detect the fertile period by locating cervical position: Make a note of these changes to help you to understand the changes that are happening and help you to detect your fertile period.

Cervix is soft, high, opened and wet and it is popularly known as “SHOW”. This is the best time to have sex and to get conceived. When you are fertile with ovulation period nearing your cervix feels more like your lips than your nose. After ovulation, the cervix drops and gets firmer and gives a feeling like the tip of your nose.

Cervical Mucus Check

An increased mucus secretion with thin, slippery, and stretching texture is noticed before and during ovulation. It can be similar to raw egg white. Thin cervical mucus indicates that you are in your fertile phase and if you have sex at this time, you will get pregnant.

You can check the consistency of your cervical mucus in 3 ways:

1. Before you feel to urinate, try to wipe at your vaginal entrance with the help of a white toilet paper or tissue paper. Then have a look for the colour and feel the mucus.
2. You can also check the colour and texture of your cervical discharge that is sometimes present on your underwear.
3. Fingers can be used to feel your cervical mucus. Try to insert clean fingers into your vagina and take out the mucus from the lower opening of the vagina. Place this mucus between your thumb and index finger and tap both your fingers. When you try to separate or spread your thumb from the index finger, if the fluid stretches without breaking, this indicates that your ovulation is nearing [5].

Proper observation of your cervical mucus in terms of appearance, sensation, and categorizing it as follows helps to a better understanding of your fertile days.

Categories of cervical mucus

We can consider classifying the nature of mucus into 4 types:

• Type 1: This is simply of lowest fertility category. Here

To your eyes – shows nothing visible, To sense- makes you feel dry, rough and itchy at vaginal area

• Type 2: This is of low fertility level

To eyes- shows nothing, To sense- makes you feel damp

• Type 3: It can be said as an intermediate fertility stage

To eyes- you see mucus as thick, creamy-textured, white to yellowish in color, not stretchy or elastic, To sense- a feeling of dampness

• Type 4: This is the high fertility stage

To eyes- you can notice mucus of transparent type, stretching and elastic like a raw egg white, maybe liquid or watery too, To sense- mucus is slippery smooth and wet to touch.

(BBT) Basal Body Temperature Prediction Test

The temperature at which your body rests is known as your basal body temperature [6]. This is said to be a bit lower than your normal temperature. This basal body temperature increases a little during and after your ovulation.

Tracking the temperature for a few months gives you a better idea about your next ovulation period. There are some criteria for measuring this temperature like:

• It should be noted immediately after you wake up from your morning sleep
• It should be taken at the same time every day.
• A basal thermometer that is most accurate is needed

It is a little hard to measure temperature in this way and also you may have the risk of inaccurate readings. Your body temperature is altered when you have a fever, or stressed, taking alcohol, had a night of disturbed sleep, change in room temperature, change in the climate of that day, and the time at which you wake up.

Once you ovulate, you can notice an increase in your body temperature which will stay higher for the rest of your ovulation cycle. There is a fall in body temperature once your ovulation cycle ends. There is less than 1 degree of the temperature difference between these two phases [7]. It only tells you that you have ovulated and does not tell you when your fertile phase will begin.

Make a chart of your basal body temperature at the same time daily and note down your temperature. When you notice your complete cycle on the chart, you can be able to spot a point at which the temperature reaches higher when compared to the first part of your cycle. There is about 0.2 degrees or more hike of temperature when compared to that of the previous 6 days.

Now as you have an idea of a mild increase in your body temperature indicating your ovulation phase, you should now focus to know about tools that help to measure your BBT.

Tools that you need to measure basal body temperature

You can make use of your regular thermometer or get basal body thermometers that are easily available in pharmacies. Experts say that your change in body temperature is very slight and needs to use a special type of thermometer.

Basal thermometer: This is designed to show your temperature in tenths of a degree that will help you to notice very tiny changes in body heat. As these types of thermometers show you the decimal readings, they are more beneficial in terms of accuracy for those having an irregular and short or long menstrual cycle. This thermometer is proved to be faster and gives an accurate reading than a regular thermometer [8].

Basal thermometers can store your temperature readings. This helps you to wake up, note temperature and again sleep. Later, in the day when you are active, you can note down the readings.

Types of basal thermometers

There are various types of basal thermometers that are available in all shapes and sizes. Some of them are high-tech expensive while others are cost-efficient.

Below are a few different types:

1. Digital: These are the ones that have an on and off button with a small display that shows the readings.
2. Glass: They are easy to use and don’t need a battery. Experts say that glass mercury-free basal thermometers will give accurate results.
3. Smart basal Thermometers: They are expensive and are new in the market. They don’t have a look of conventional thermometers and often provide you a basal thermometer along with a compatible app.

If you want the best and accurate results, you should buy a thermometer that is more sensitive and effective in showing the results.

Which BBT thermometer to buy?

Specially designed Digital BBT thermometers have all the features like memory recalling to store the latest reading, beeping to indicate that temperature recording is finished and accuracy to 1/10th of a degree that is sufficient for charting purposes. There are some pros and cons of these Digital BBT thermometers that are to be considered.

Pros are:

• Digital BBT thermometers need less caring and are easy to be handled.
• It won’t break down into pieces if it falls on the floor.
• No need to shake it before using it.

Cons are:

• If using daily, there is a need to change their batteries.
• When batteries get weaker, it may show inaccurate readings
• They stop working suddenly with no reason after a year or after a few months of use.

When you have purchased a BBT thermometer you should be able to make a chart of your BBT. Let us now discuss in detail the process of charting BBT.

How to use a Basal Thermometer to track ovulation?

Having a recorded BBT is a pretty useful method to track your ovulation period. You can easily determine your fertile days by tracking BBT.

Steps to follow when charting BBT

• Step 1: Buy a handy digital thermometer of your choice from the drug store as they contain a memory recall feature. You can even buy a non-digital thermometer like a glass thermometer.
• Step 2: Keep the thermometer by your bedside so that you can reach it while still lying in bed. This is to make an accurate record of temperature at your body resting before you start moving. Any kind of moving, stretching can give a false BBT so place it beside your bed to be handy. If using a glass thermometer make sure that you shake it the night before to keep it ready for the next morning.
• Step 3: Record temperature at the same time every day and make sure to have at least five to six hours of continuous sleep before measuring BBT to get an accurate reading.
• Step 4: Place the thermometer in the mouth for several seconds in the same location every day to get an accurate reading. If you wish to place the thermometer vaginally or rectally, make sure that you place it in the same spot at the same depth for the rest of your cycle.

Making a chart of BBT

BBT charting: This is a chart done for several months to track the changes or fluctuations in your BBT that happens during your cycle. A mild change or increase in BBT indicates that you passed the ovulation phase. Having information of this temperature changes over time helps to know when you can likely get pregnant.

Steps to be followed to chart BBT are:

• Step 1: Note down your readings in the morning. You can also mark your readings on a journal or your phone that has a tracking app. There are apps available on phones to mark your readings on a chart or graph.

Ensure that your chart has a vertical line for marking the day, month, and date of your cycle. Note your body temperature on the horizontal line starting from 990 Fahrenheit to 960 Fahrenheit. Average BBT of a woman before her ovulation ranges between 970 Fahrenheit (36.10C) and 97.50 Fahrenheit (36.40C). Whereas after ovulation it is increased to 97.60 (36.40 C) to 98.60 (370C) Fahrenheit. You can download an online BBT chart and see it for reference.

• Step 2: See for any changes that may be noted in the chart after recording for two cycles. This gives an accurate picture of your fertile days. You should be able to take notice of any temperature rise or fall at the same time for both the cycles. Ovulation signs are indicated if you notice a hike of the temperature of at least 0.4 degrees within 48 hours on your chart. This hike of temperature should be more than the highest temperatures that are recorded for the previous six days. BBT Basal Body Temperature of 960 to 980 Fahrenheit is seen in most women before one to days of ovulation.
• Step 3: Most fertile time or ovulating time is two days before the increase of BBT for most women. Remember that sperm can live only for 5 days in your reproductive tract and if you want to get pregnant then you should have sex two days before your ovulation. After your ovulation, if your BBT remains increased for more than 18 days, then you should go for pregnancy testing.

There are ovulation home kits available to test ovulation at home. They work as personal testing tools.

Ovulation Predictor Kits (OPKs)

Many ovulation kits are available from chemists and are very simple to use. This kit helps to know your ovulation time if you have irregular periods. It works to predict your ovulation by measuring the concentration of a hormone known as Luteinizing hormone LH that is present in your urine. The level of this LH hormone is said to increase about 24 to 36 hours before ovulation starts. Another method of predicting ovulation using an OPK is by noticing changes in your saliva, however, kits using this method are hardly available in India and are hardly used for prediction [9].

OPKs are used by women who are undertaking infertility treatment but can't visit gynecologists, and busy women working at odd hours and want to know about their pregnancy and women who wish to avoid pregnancy.

The ovulation kit has two lines in common. One is the control line which tells that kit is working and the other is the test line. You can know that LH concentration is increased in urine, if the test line is similar in colour or if it becomes darker than the control line.

How to use the ovulation kit?

Before you start to test, you should calculate your average menstrual cycle length. For your understanding, if your normal menstrual cycle length is 28 days, then you should start testing on the 11th day ( i.e. 11th day after your period has started). If you have a different cycle length, then talk to your doctor about the timing to do testing. Generally, it is good to do testing 3 to 5 days prior to the expected date of ovulation.

The kit has 5 to 7 sticks. You can directly urinate on the stick or place the stick in the sterile container that is filled with urine. The test stick will show a certain colour or displays a positive result if the increased LH level is detected. If you get a positive result it means that you will ovulate in the next 24 to 36 hours, and this will differ from woman to woman [10].

If you have an irregular cycle, you may face problems to detect LH surge. Also if you forget testing for a day, then you may miss the LH surge.

Preparing for the test: Do take more amounts of fluids or water before testing. Few drugs cause increased or decreased LH levels, such medicines should not be taken before testing. LH levels are reduced by estrogens, progesterone which are the main components of birth control pills. LH is increased by Clomid, which is used to stimulate ovulation.

Popularly used OPK in India

There are many OPK in the Indian markets today, which are used to predict ovulation by detecting the increased Luteinizing hormone LH level in your urine. OPKs are also called as ovulation kits and here we consider 5 popular OPKs:

1. i-Known ovulation test kit: This gives 99.9% accurate results of ovulation and available at medical stores or online.
2. Homecheck Instant ovulation test kit: This is proved to give fast results within 3 minutes and the accuracy rate is >99%.
3. First response: This digital responding test has an accuracy rate of up to 99% and shows results in terms of words like “yes” for positive results and “no” for negative results.
4. Pregaplan: This is easy and convenient to use a single-step OPK kit. It offers 99% accuracy and is popularized as the most advanced ovulation test kit in India.
5. Wondfo Ovulation test kit: Giving results in 5 minutes with an accuracy of 99%, this kit helps women with regular and irregular periods to plan for pregnancy.

Accuracy of ovulation kits: Yes, ovulation kits give accurate fertile dates when compared to calculator and temperature methods. If used properly, OPKs give 99% accurate results of the LH Luteinizing hormone surge that occurs before ovulation.

Reasons for a negative ovulation test using opk:

Many times you can resolve the problems that are causing negative test results. But for some reason, consultation with a doctor is needed.

Few causes for a negative ovulation test are:

1. Doing tests too early or too late in your cycle: sometimes LH tracking is missed, so doctors suggest doing testing twice a day with 10 hours apart before a few days of your ovulation, this helps you to pick up your LH surge.
2. Not aware of your menstrual cycle tracking: You should track your menstrual cycle for at least 6 months to identify your pattern. This 6 months of tracking helps to easily know when you are about to ovulate.
3. Improper test timings: You may get negative results if tested at inappropriate times. LH surge occurs during early afternoon hours. Experts suggest the best time to do testing is between 11 am and 3 pm or between 5 pm and 10 pm.
4. Presence of ovulation problem: hormonal problems and anxiety may cause ovulation disorders where you cannot have regular ovulation.

Ovulation calculator helps to know when you will be most fertile so that you can maximize your chances of making frequent sex for bringing sperm and egg together.

Ovulation Calculator or Calendar

This calculator helps you to know the days on which you are more likely to release an egg on a definite day of your menstrual cycle. The normal menstrual cycle lasts for 28 days and differs from woman to woman. You have 5 to 6 days during each menstrual cycle when you have good chances to conceive and get pregnant and these days are your fertile window days.

What is your Fertile window?

The days of your menstrual cycle when your pregnancy is possible is known as a fertile window period. This fertile window largely varies from woman to woman and depends on the length of her menstrual cycle.

This period tells about your most fertile days and you can have intercourse during those fertile days for achieving pregnancy.

Importance of ovulation calculation:

To stay healthy and wise, one should understand how one’s body works. Calculating your ovulation is essential for you if:

• You are planning and preparing yourself for pregnancy
• You are eager to know symptoms of ovulation like having tender breast, presence of light spotting, mild cramping and bloating of the abdomen, and an increased sexual urge.
• You wish to avoid or terminate a pregnancy.

Use of Ovulation Calculator: In the ovulation calculator, by entering the first day of your last menstrual period and the average length of your menstrual cycle, your ovulation and fertile dates are estimated [11].

Below is the calculation tip of your ovulation period.

• Step 1: Start by entering the date of the first day of your last menstrual period. For your understanding, if your last period began on the 12th of the month and lasted up to the 17th of the month, then the first day of your last period will be 12th.
• Step 2: Then, select your average menstrual cycle length. For this, you should calculate the number of days between the first day of your last to last period and the first day of your last period. For your understanding, let us consider that if your periods in March started on 12th and in April month your period started on 10th, then the number of days between these two dates is your average menstrual cycle length. Here the number of days between March 12th and April 10th is 30 days.
• For knowing better and accurate reading, you keep following the same process regularly for 4 to 5 months. Again for your example, let us consider that your average period cycle length across March to July is 30,29,27 and 30, then your average cycle length would be an average of 30,29,27 and 30, and that is 29.
• Step 3: Finally press on the “calculate button” to know your ovulation date and date of your next period.

It is to be remembered that these dates shown by the ovulation calculator are only the rough estimates and your dates may differ. This calculator method is beneficial when you combine it with other methods like basal body temperature and cervical mucus changes.

Fertility apps: There are few apps like fertility or ovulation apps that can help you in giving a more accurate ovulation calendar. They work with smartphones and take details of your basal body temperature and other fertility signs.

Benefits of fertility apps: These apps store your average cycle length for many months and tell your fertile days right on your phone. They help with your yearly consultation with a gynecologist and will store your period track. You can check for your last period just by looking at the phone.

Some of the apps are Clue, Glow and Ovia.

If you decide to start a family then you should find out options to give your pc a healthy start. The following are a few things you can do before trying for a baby that will help improve your and your baby’s health.

Indian Diet And Food That Help In Improved Conception

Investing in modifying your diet plan will help in conception. The following Indian diet plan will help you with a healthy start:

• Vitamins and supplements: In your pregnancy your body is in need of more folic acid, iron, calcium, and vitamin D. certain birth defects are prevented by taking folic acid. To meet the folic acid requirement of 600mcg per day during and at breastfeeding you should take supplements containing folic acid. Iron plays a major role in the development of a baby’s brain. So for yourself and for the increased need for your baby, you should take 27mg of iron per day. Calcium is required for your baby’s bones and teeth. 600 IU of vitamin D helps to build up calcium in your baby.
• Healthy diet: Having good nutritious food during pregnancy includes eating:
• Whole grains like whole wheat chapati, oats, wholemeal bread, brown rice.
• Fresh vegetables of organic variety like spinach, ladyfinger and asparagus. Have protein sources like beans, pulses and nuts.
• Fresh fruits like oranges and lemons are citrus rich and full of vitamin C.
• Farm fresh eggs have vitamin D which improves female fertility.
• Dairy products containing low fat.

Indian Foods To Avoid While Planning Pregnancy

You should avoid the following foods while you are thinking of getting pregnant.

• Fish having higher levels of mercury
• Foods that have germs in them which can cause foodborne sickness like:
• Refrigerated meats, smoked seafood like salmon and mackerel.
• Milk that is not properly pasteurized
• Processed salads and cheese
• Avoid too much caffeine- as it may harm your baby.
• Deep-Fried and non-fried seafood.
• Juices that have added sugars and preservatives.
• Raw papaya has harmful components for pregnant ladies.
• Brinjal or eggplant is a big “no”, as it contains hormones that induce menstruation.
• Don't eat raw eggs, as they may contain dangers of infection with salmonella.

Lifestyle Changes for better fertility

Giving birth to a baby is quite exciting and you may also have many doubts like what you can do to make your baby grow healthy. For a healthy start of your pregnancy and for the normal growth of the baby, you should do the following.

• On-time visit to your doctor: you should have a regular prenatal checkup and testing that will help with your healthy pregnancy. If you have any health problems, your doctor will identify them as early as possible. Many problems can be cured and other problems can be prevented by getting appropriate treatment at the tight time.
• Your doctor wants to see you more often if you are above 35 years or if your pregnancy is at high risk due to your problems like high blood pressure or diabetes.
• Alcohol: It is good to avoid substances that harm you and your baby. Such substances include alcohol, tobacco, and drugs.
• Maintain a healthy weight: Proper amount of physical activity helps to stay active and keeps you strong, sleep better, and prepare your body for childbirth. You can discuss with your doctor about the activities that suit you better.
• Cautious about medicines: you should inform your doctor before you start taking or stop taking any kind of medicine. These medicines include over-the-counter medicine, herbal or dietary medicines

Exercise: You will notice many changes in your body with the growth of the baby inside. It is hard for you to know whether a new symptom is common during pregnancy or it may indicate a problem. So, keep regular contact with your doctor if you have something in particular that bothers you.

• Choosing the correct sexual position: You can consider the best sexual position that is comfortable for you and for your partner. Your partner should ejaculate inside your vagina and you should rest on your back after ejaculation to allow the sperms to swim up to the egg.
• Doing sex: Having sex regularly helps to keep your sperm healthy. You can have good hope of getting pregnant if you have sex twice or thrice a week rather than having it only once a week.
• Get enough sunlight: Studies say that getting enough sunlight increases vitamin D in both females and males. This vitamin D increases progesterone and estrogen levels. Sperm count is increased in males and the menstrual cycle is well regulated in females when the above hormones are normally produced.
• Get sound sleep: Improper and inadequate sleep for a long period of time affects overall health and causes low fertility rates. Hormonal imbalance results due to lack of good sleep which in turn affects fertility level.
• Be optimistic: Being positive helps you to deal with fertility issues. If you are open with an optimistic attitude you will have fair chances of increasing fertility. Belief in the experts, the treatments, and the medicines help to get the desired results.

Important Don'ts

Most of the couples use lubricants for comfortable sexual intercourse. But experts suggest that usage of such cosmetic lubricants may mess up the sperms and slow down their way to reach the egg. So, only use natural lubricants that are sperm-friendly.

Cut down on alcohol and smoking. You and your partner should quit alcohol and smoking before planning to get pregnant and even during it.