Recently, I have been seeing patients that wish to start a family. 

For parents who have never had a child or pregnancy before, there are some basic questions that should be considered, first from the female:

woman wanting to conceive

1. “How long do we wait after stopping the birth control pill?:    

Once you stop taking the birth control pills in your package, a normal period will occur within a couple of days.  That’s how long it takes for blood levels of the pill to go back to zero.  After this normal period is done, pregnancy can begin during the very next cycle.  There is no need to “wait for a few cycles” to “clear out” the last of the pill’s hormones. 

2.     “Do I need to avoid certain exercises like horseback riding or running?”

In answering this, I remind patients that the best favor they can do for their obstetrician (or midwife) is to be in the peak of physical condition as they reach term.  The old advice of resting, or avoiding strenuous activities was well intentioned, but bogus unless you have uterine bleeding, or have a n incompetent cervix (with habitual miscarriages).  Now, falling is not brilliant, so learning how to ride a horse or a cross-country motor bike is probably best left until the pregnancy is over.  However, if one is already an accomplished rider, there is no reason to avoid reasonable use of these activities.  As for the rest of the gym or sporting menu, go for it!

3.     “When is the best time to get pregnant?”

Ovulation occurs two weeks before one’s next period, irrespective of whenever the last period took place. 

ovulation chart

For women with regular 28 day cycles, then day 14 is pretty simple to figure out.  Also, some women will have a tiny cramp at the time of ovulation, helping them to know their timing.

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But for those who have irregular cycles, or want to optimize their chances,

ovulation test

there are kits available at the drug store for daily (basal) oral temperature recording, or for (vaginal) cervical mucous assessment.

ovulation kit

4.     “Must we try daily?”

No. There can be such a thing as “trying too hard”.   Daily ejaculations can actually reduce the effective sperm count, reducing chances.  In the old days doctors would suggest trying “every other day” leading up to the ovulation, which certainly seems to make sense.

5.     “Are Hot-tubs OK?”

Not for men.  When testicles are exposed to body temperature or higher, they will not produce useable sperm.  That’s why they descend from the abdomen into the scrotum during fetal development. And hot tubs are often set well above body temperature.  For the same reason, tight pants in the summertime could also produce the same effect. 

For more information, consult your doctor.  A full physical examination (including blood work) would be a good starting point for both parents.

In addition, as we discussed in another post, acupuncture could also be very helpful as an adjunct, as could occasional week-end breaks for a change of pace.


Remember, not everything happens as fast as you want it.  Infertility doctors usually do not get involved until at least a couple of years of trying to conceive.  So unless the clock is really ticking (ie if you are almost entering the menopause), take the pressure off yourself.

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