Preconception and Planning - TTC

The babyMed University&nbsp;Fertility&nbsp;Course,&nbsp;founded by <a style="font-size: 0.9em;" href="/about-dr-amos-grunebaum" target="_self">Dr. Amos Grunebaum</a> and his staff, will teach you about fertility, how to get pregnant, improve your pregnancy chances, and have a healthy baby!
<a href="/babymed-university-fertility-course-signup">Sign up now!</a>
<a href="fertility-course-fertility-class-guide" target="_blank">":"babyMed University Fertility Course Sign Up Now and get pregnant faster!","field_file_image_title_text":"babyMed University Fertility Course Sign Up"},"link_text":null,"type":"media","field_deltas":{"3":{"format":"media_original","field_file_image_alt_text":"babyMed University Fertility Course Sign Up Now and get pregnant faster!","field_file_image_title_text":"babyMed University Fertility Course Sign Up"}},"attributes":{"alt":"babyMed University Fertility Course Sign Up Now and get pregnant faster!","title":"babyMed University Fertility Course Sign Up","class":"media-element file-media-original","data-delta":"3"}}]]</a>The lessons in the babyMed University Fertility Course are&nbsp;not just&nbsp;a how-to guide. babyMed is&nbsp;a place to interact with other hopeful parents-to-be, share your excitement, frustrations, and ask questions. And when that special day comes, it's the place to come and spread the good news! We want to be the first to say, "Congratulations!"
The babyMed University Fertility&nbsp;Course consists of 10 lessons. It takes about 45-60&nbsp;minutes to go through these lessons. You can either do them all in one sitting or at your leisure.
<h2>The babyMed University Fertility Course:</h2>
<ul>
<li>Your very first step:&nbsp;<a href="/preconception-and-periconception-care-and-health">Preconception Health</a></li>
<li>Lesson 1:&nbsp;<a style="color: #336799; text-decoration: none;" href="/fertility-101-lesson-01-roadblocks-getting-pregnant">The Many Roadblocks To Getting Pregnant</a></li>
<li>Lesson 2:&nbsp;<a style="color: #336799; text-decoration: none;" href="/fertility-101-lesson-02-menstrual-cycle-and-period">The Menstrual Period</a></li>
<li>Lesson 3:&nbsp;<a style="color: #336799; text-decoration: none;" title="Big O Ovulation" href="/fertility-101-lesson-03-big-o-ovulation">It's All About The Big O: Ovulation!</a></li>
<li>Lesson 4:&nbsp;<a style="color: #336799; text-decoration: none;" title="Cervical Mucus" href="/fertility-101-cervical-mucus">Your Cervical Mucus&nbsp;</a></li>
<li>Lesson 5:&nbsp;<a style="color: #336799; text-decoration: none;" title="His Sperms" href="/fertility-101-lesson-05-his-sperms-are-your-friends-too">It's All About the Sperm</a></li>
<li>Lesson 6: <a href="/guide-to-fertility-awareness-and-natural-family-planning">Fertility Awareness and Natural Family Planning&nbsp;</a></li>
<li>Lesson 7:&nbsp;<a href="/infertility/why-cant-we-get-pregnant" target="_self">Overview of Infertility</a></li>
<li>Lesson 8:&nbsp;<a title="Fertility Specialist REI" href="/fertility-101-lesson-11-infertility-specialist">Do I Need an Infertility Specialist?</a></li>
<li>Lesson 9:&nbsp;<a title="Infertility testing" href="/getting-pregnant/fertility-and-infertility-tests-do-if-you-cant-get-pregnant">Infertility Testing for Him and Her</a></li>
<li>Lesson 10:&nbsp;<a title="Infertility Treatment Options" href="/fertility-101-lesson-12-infertility-treatment">Infertility Treatment Options</a></li>
</ul>

Dr. Amos Grunebaum offers vital lessons in the babyMed Fertility Course and teaches you everything you need to know to get pregnant now!

The babyMed University Fertility Course 

Can I get pregnant while breastfeeding? Having sex only once? Without an orgasm? Read on and find out the answers to those looming questions: Can I Get Pregnant if...?
<h2>Can I get pregnant if I am breastfeeding?</h2>
Yes, you can get pregnant while breastfeeding. While breastfeeding tends to postpone ovulation, this is not a guarantee, and it only does it for a couple of months at most. <a href="/breastfeeding/can-i-conceive-while-breastfeeding">Ovulation can occur even when you are breastfeeding</a> and before you have a period. If you want to avoid pregnancy, use birth control.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if I haven’t had a period?</h2>
Yes, you can get pregnant even without having a period. Ovulation can occur even if you do not have a period.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant If I douche after sex?</h2>
Yes, you can get pregnant even if you douche. Douching is a very ineffective method of birth control.&nbsp;Sperm moves up into the cervix and the uterus within seconds, and it is impossible to douche fast enough to keep sperm away from entering the uterus and fertilizing an egg. Even if you douche immediately after sex, it’s too late already.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant If I urinate or take a bath after sex? </h2>
Yes, you can get pregnant if you urinate or take a bath after sex. Neither will wash sperm out. Also, deodorant vaginal suppositories or sprays do not work either and can be harmful.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if I have sex when I have my period?</h2>
Yes, you can get pregnant when you have sex during your period. As long as you have sex within 5-6 days before you ovulate, it is possible to get pregnant during your menstrual period. Sperm can live inside a woman's body for up to 5 days, so if you ovulate anytime within 5-6 days of having unprotected sex, you could become pregnant.&nbsp;
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if I have no orgasm?</h2>
Yes, you can get pregnant without an orgasm. While the man must ejaculate to release sperm, it is not necessary for the woman to have an orgasm to get pregnant. A woman of childbearing age releases an egg each month as part of her regular menstrual cycle. This occurs whether or not the woman has sex or an orgasm.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if we only have sex during the "safe" time?</h2>
You can get pregnant potentially anytime during your cycle because ovulation can happen anytime. While your cycle may be more or less regular at most times, the balance of hormones responsible for ovulation can be disrupted by various factors, including age, stress, and medicines. So, pinpointing the time of ovulation and predicting any "safe" days can be difficult.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if we have sex standing up or if the woman is on top?</h2>
Yes, you can get pregnant even standing up or if the woman on top. Some people believe that having sex in certain positions, such as standing up, will force the sperm out of the woman’s vagina. In truth, positions during sex have nothing to do with whether or not fertilization occurs. When a man ejaculates, the sperm is deposited well into the vagina. The sperm will naturally begin to move up through the cervical canal immediately after ejaculation, no matter in what position they got there.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if the condom fits him very tightly?</h2>
This is a misconception based on the belief that the tighter the condom, the less likely sperm will seep out or that the condom will slip off during sex. However, a condom that is too tight is more likely to break during intercourse. When using a condom, it is also important to leave some space near the tip to safely catch the ejaculate; this prevents the condom from being over-stretched once the man ejaculates.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if he pulls out before he ejaculates from precum?</h2>
Yes, <a href="/can-you-get-pregnant-with-precum-pre-ejaculation-fluid">you can get pregnant even if he withdraws</a> because pulling out before the man ejaculates is not a foolproof method. Some ejaculate (fluid that contains sperm also known as precum) might be released before the man actually begins to climax. In addition, some men might not have the willpower or be able to withdraw in time.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if I have sex right after starting the pill?</h2>
There is actually some truth to this. As soon as you start taking the pill, it starts to work. But just to make sure, use additional contraception for the first month.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if I have sex the very first time?</h2>
Yes, you can get pregnant the very first (or second or third) time you have sex. A woman's chances of getting pregnant are always the same, about 1 out of 5, even if it is her first time.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if I am using saran wrap (or a balloon) instead of a condom?</h2>
Yes, you can get pregnant using saran wrap. If you do not have a reliable birth control method handy, do not use plastic sandwich wrap around a penis as a way to prevent pregnancy. It is no substitute for a condom and does not work (neither does using a balloon, so don't try that either!).
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if I use toothpaste as a spermicide?</h2>
Yes, you can get pregnant. Never use toothpaste in place of a spermicide. It does not kill sperm, nor does anything else besides, well, spermicide.
<h2 style="margin: 0.1pt 0in;">Can I get pregnant if I jump up and down after sex?</h2>
Yes! Sneezing, coughing, and jumping up and down after sex will not dislodge sperm. Sperm is too quick and too tiny for any of these methods to work.
Learn more about other birth control methods in our <a href="/contraception">Birth Control Guide</a>!

Can I get pregnant while breastfeeding? Having sex only once? Without an orgasm?
Read on and find out those looming questions: "Can I Get Pregnant If....?"

Can I Get Pregnant If...?

&nbsp;
The corpus luteum (yellow body in latin) &nbsp;is the small structure in the ovary from which the egg emerges during ovulation. After ovulation, it normally produces progesterone to support implantation of the fertilized egg and maintain pregnancy until about the 10th or 11th week. Without pregnancy, the corpus luteum phase lasts from the time of ovulation until the time of the next menstrual period. A normal CL phase lasts 12-16 days. When the luteal phase is shorter than normal, implantation of a fertilized egg can be negatively affected, making it more difficult for the conceptus to implant and to be lost.

A luteal phase defect (LPD) is a medical condition associated with the failure of getting pregnant because the luteal phase is shorter than normal.

What Is A Luteal Phase Corpus Luteum Defect (LPD)

&nbsp;
One of the most frequently asked questions we get at BabyMed is: "When should I see the infertility specialist"? After 6 months of trying? 12 months? When I have irregular periods?
We usually suggest you see your general Ob Gyn for a Periconception visit as soon as you start TTC. But when should you see the infertility specialist, the Reproductive Endocrinologist (RE)?
<a title="Infertility RE specialist tool" href="tools/fertility-specialist">The BabyMed interactive "Infertility Specialist Tool" </a>guides you though some questions and then comes up with the right answer.

Interactively find out if and when you should see an infertility specialist when trying to conceive.

The BabyMed Interactive Infertility Specialist Tool

&nbsp;
There are essentially three causes of LPD:
<ol>
<li>poor follicle production</li>
<li>premature demise of the corpus luteum</li>
<li>failure of the uterine lining to respond to normal levels of progesterone</li>
</ol>
These problems can be found alone or in combination.
1. Poor follicle production has its origins in the first half of the cycle. The follicle ultimately becomes the corpus luteum. Poor follicle formation leads to poor corpus luteum quality. Inadequate follicle development may be caused by an abnormal level of FSH, or the ovaries not responding strongly to the FSH. A poor corpus luteum will produce inadequate progesterone, causing the uterine lining to be inadequately prepared for the implantation of a fertilized egg. Ultimately, progesterone levels may drop early and menses will arrive sooner than expected.
2. Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. For reasons not wholly understood, the corpus luteum sometimes does not persist as long as it should. Initial progesterone levels at 5-7 days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses.
3. Failure of the uterine lining to respond can occur even in the presence of adequate follicle development and a corpus luteum that persists for the appropriate length of time. In this condition, the uterine lining does not respond to normal levels of progesterone. Therefore, should an embryo arrive and try to implant, the lining will not be adequately prepared, and the implantation will likely fail.

There are three causes of LPD: poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone.

Causes of Luteal Phase Defect (LPD)

<h2>Could the hCG pregnancy hormone levels signify whether you may be having a boy or a girl?</h2>
According to a recent study, women who carried a female fetus had hCG levels significantly higher than women who carried a male fetus. This finding is consistent with that same conclusion identified by several other researchers.

In a study published by Yaron Y et al in Human Reproduction, the authors studied 1,325 pregnant women with singleton pregnancies at 10-13 weeks and compared different hormone levels including the <a href="/normal-hcg-blood-level-by-week-during-pregnancy" target="_self">pregnancy hormone human chorionic gonadotropin (hCG)</a>&nbsp;between women carrying a male and a female fetus.
These findings may have implications not only for <a href="/tools/down-syndrome-risk-calculator" target="_self">evaluating risks of Down syndrome</a> (women carrying female fetuses had a higher risk for Down syndrome) but also on the timing of a pregnancy test. If women carrying a male fetus have lower hCG levels then it may be possible that their first positive urine pregnancy test could be delayed.

hCG is an important hormone to keep an eye on during pregnancy.&nbsp;When it&nbsp;decreases early in pregnancy, it is clear that the&nbsp;pregnancy&nbsp;is not viable. However, after 10-11 weeks a decrease in hCG is not unusual in normal pregnancies. The management of cases with too low or decreasing hCG levels often consists of observation through blood testing and intervention when necessary.
It's worth noting that hCG changes from day to day so the timing of the blood matters. In general, hCG usually doubles every 48-72 hours very early in pregnancy and every 3-4 days later on until about 9-10 weeks of the pregnancy when it levels off. Consequently, there is no single <a href="/normal-hcg-blood-level-by-week-during-pregnancy" target="_self">"normal" hCG level during early pregnancy</a>. There are wide ranges of what constitutes normal levels so consulting your doctor on your specific situation is your best bet.

Could hCG levels signify whether you may be having a boy or a girl? A recent study says there is some evidence to support this idea.


hCG Levels and Sex of the Fetus

<h2>What is my fertile window?</h2>
Your fertile window also known as the&nbsp;fertility&nbsp;window consists of the 5-6 fertile days of your menstrual cycle 4-5 days before and the day of ovulation when intercourse is most likely to result in pregnancy.&nbsp;This fertile window starts 5 days before the day of ovulation until the day&nbsp;of ovulation. Your most fertile of these days are the 2 days before plus the day of ovulation.
Calculate: <a href="/when-am-i-fertile-today-calculator">Am I fertile today?</a>
Having sex 24+ hours after the day of established ovulation is unlikely to improve your chances of getting pregnant.

<h2>On which days of my menstrual cycle am I more likely to get pregnant?</h2>
The 2 days before ovulation plus the day of ovulation have the highest chance of getting you pregnant if you have intercourse only once during the fertile window.
These 3 days are the best fertile window:
<img class="media-element file-media-original" title="Best Fertility Window" src="https://www.babymed.com/sites/default/files/Best%20Fertility%20Window.jpg" alt="Best Fertility Window" data-media-element="1" data-fid="69576" data-delta="1">
These percentages apply to intercourse for only one day:
<ul>
<li>6 days before ovulation (-6 dpo) : 0 %</li>
<li>5 days before ovulation (-5 dpo) : 8 %</li>
<li>4 days before ovulation&nbsp;(-4 dpo) : 17 %&nbsp;</li>
<li>3 days before ovulation&nbsp;(-3 dpo) : 8 %</li>
<li>2 days before ovulation&nbsp;(-2 dpo) : 36 %</li>
<li>1 day before ovulation&nbsp;(-1 dpo) : 34 %</li>
<li>The day of ovulation&nbsp;(dpo) : 36 %</li>
<li>Any day (24+ hours) after ovulation: (1+ dpo) : 0%</li>
</ul>
<a href="https://www.nejm.org/doi/full/10.1056/NEJM199512073332301">Adapted from Wilcox, AJ. et al. NEJM (1995)</a>
<a href="https://www.nejm.org/doi/full/10.1056/NEJM199906103402304">Wilcox NEJM 1999</a>
<h2>Probability of ovulation</h2>
Your probability of ovulation depends on long your cycle days are. The longer your menstrual cycle, the further down your cycle is your likely ovulation. We used to believe that in regular menstrual cycles, ovulation happens within a range of 2-3 days. However recent publications suggest that even in regular cycles ovulation can normally happen in a range of about a week or so. That is why it's essential when trying to get pregnant that you have sex over a range of days. We are helping you by having developed an <a href="/complete-fertile-window-and-ovulation-coverage-calculator">ovulation and fertile days calculator</a> which determines the range of likelihood of ovulation and fertile days. The table below follows a research study published in 2018 which calculated the chance of ovulation happening based on cycle day length. As you can see, even with a 28-day cycle, ovulation can happen in a wide range of days.&nbsp;
<img class="media-element file-media-original" title="Probability oif Ovulation based on cycle days length" src="https://www.babymed.com/sites/default/files/Screenshot%202019-10-08%2008.34.16.png" alt="Probability oif Ovulation based on cycle days length" data-media-element="1" data-fid="74116" data-delta="2">
Adapted from:&nbsp;Can apps and calendar methods predict ovulation with accuracy? Current Medical Research and Opinion, 34:9, 1587-1594
<h2>Why can I get pregnant from intercourse up to 5 days before ovulation?</h2>
Sperms can survive for up to 5-6 days inside a woman's uterus. Increasing amounts of estrogen in the cervical mucus and reproductive tract of a woman approaching ovulation generally allows the sperm to live for up to 6 days in the woman's uterus.
Because there is a wide range of days when ovulation can possibly occur based on menstrual cycle lengths, there is an even wider range of making sure you have sex no within 5 days prior to ovulation. Below is a table that shows you your chances to "cover" ovulation, to have sex, in anticipation of the possible ovulation day:
<h2>Sex ovulation and conception by cycle days</h2>
<img class="media-element file-media-original" title="When to have sex to cover possible ovulation" src="https://www.babymed.com/sites/default/files/When%20to%20have%20sex%20to%20cover%20possible%20ovulation.png" alt="When to have sex to cover possible ovulation" data-media-element="1" data-fid="74131" data-delta="3">
Instructions: In the left column move down to find your cycle days, then move to the right to find the cycle days to have sex to ensure you time sexual intercourse correctly. For example,&nbsp; if your menstrual cycles are 30 days long, then having sex on each cycle day between cycle days 10-20 covers each day an over 15% chance to not miss ovulation.&nbsp;
<h2>Does the timing of intercourse help?</h2>
Studies have shown that even in women with regular cycles, ovulation can possibly happen any time, so "timing" of intercourse has never been shown to improve your pregnancy chances. You are probably not improving your chances of getting pregnant if you wait for intercourse until the temperature goes up or the OPK has become positive. You may already have ovulated by that time, and sex after ovulation is unlikely to get you pregnant.
<h2>Every day or every other day intercourse?</h2>
Couples who tried to get pregnant were previously told to have sex once every other day during their fertile days. Recent studies have shown that the average couple who is trying to conceive should make love regularly 2-3 times a week, every week because you don't know exactly when ovulation happens.
In addition, you may improve your chances if you <a href="/when-am-i-fertile-today-calculator" target="_self">have sex once a day (as long as his sperm are OK) during the fertile 4-5 days prior to, and the day of, ovulation.</a> In those rare circumstances when the man does not have enough sperm (oligospermia), the old rule of once every other day still holds true.
<ul>
<li>Sex every day: 37% chance of pregnancy</li>
<li>Sex every other day: 33% &nbsp;chance of pregnancy</li>
<li>Sex once a week: 15% &nbsp;chance of pregnancy</li>
</ul>
From: "<a href="https://www.nejm.org/doi/full/10.1056/NEJM199512073332301">Timing of Sexual Intercourse in Relation to Ovulation -- Effects on the Probability of Conception, Survival of the Pregnancy, and Sex of the Baby</a>" was published in The New England Journal of Medicine (December 7, 1995 -- Vol. 333, No. 23). Allen J. Wilcox, Clarice R. Weinberg, Donna D. Bair.

You only have 5-6 fertile days in your cycle to get pregnant.

When Is Your Fertility Window?

<h2>Q: When can the embryo first be seen on ultrasound?</h2>
A: The embryo should first be seen on the ultrasound on or around cycle days 40-42, about 26-28 days after ovulation/fertilization (5w4d – 6w0d).