Dr. Jennifer Blake
CEO, Society of Obstetricians and Gynaecologists of Canada

Q: For someone who has never heard of peak fertility, how would you explain it?

A: An egg is released once a month for women, approximately in the middle of the menstrual cycle, while sperm has the ability to live in the body for a few days. Therefore, the best opportunity for fertility is when the egg has been released and the sperm are still active.

Q: How important is it for women to know their menstrual cycle?

A: Certainly by knowing your cycle you can decrease the length of time it would otherwise take to fall pregnant.

Q: What are some of the common misconceptions surrounding fertility and the menstrual cycle?

A: One of the common misconceptions is that when you’re trying to get pregnant you need to be having intercourse all the time. That is probably the number one misconception. The response to this is that if you have intercourse every other day that is quite adequate if this occurs during the women’s peak fertility. The window of opportunity lasts for a few days. Some couples feel more confident if they are having intercourse daily, but you don’t need to. In fact, if you have intercourse too often you can actually deplete the sperm count and the sperm quality.

Q: There is a common reference to “Day 14”—is this when women are the most fertile?

A: Every women is a little bit different. It’s approximately 14 days before you get your next period, which means that if the cycle is slightly different in length, it is difficult to judge. We do not know when we are getting our next period; we know when we got our last period. Ovulation detection kits are helpful for women whose cycle may not be regular.

Q: What types of tools or resources are available for couples that want to monitor peak fertility?

A: Certainly you can use the symptothermal method – some women track temperature and cervical mucus, but this does not work well if you have shift work or get up at different times of day. If you are using a basal body temperature method, it is very important that you use a basal body temperature thermometer, as these are properly calibrated. Again, the problem with these is that they tell you after the fact. You get an understanding of your cycle but it may not be helpful in the moment. There are also ovulation detection methods, and a literature that shows that they are helpful. These are costly however.

Q: How does basal body temperature monitoring detect fertility?

A: This is when you keep track of your temperature every morning before you get out of bed and it shows a rise in the second half of the cycle after you have ovulated—the temperature goes up.

Q: Does diet and nutrition play a role in maximizing your fertility?

A: Certainly. You really want to get yourself into good condition when contemplating a pregnancy. We know so much now about the importance of the women’s health during pregnancy, so this is a good time to start caring for yourself and really pay attention to what you eat. Eating regular meals and not skipping meals is important, as well as sticking to the Food Guide. Get your fruits, vegetables, and leafy greens. Build up your calcium. Many women decide to reduce calories by cutting out milk; if you’ve made that choice you have to understand where you are getting your calcium from, because you will need calcium. Make sure that your hemoglobin is good, so if you are a vegetarian you need to be thinking carefully about where you are getting your iron, so you are not going into pregnancy anemic. If you are overweight, you want to get yourself into an ideal weight range if you can, but you don’t want to be starving yourself or skipping meals to get there. Certainly you’ll want to be increasing your level of fitness as you go along to protect yourself from back troubles during pregnancy. It’s a great thing to look ahead to when you want to get pregnant and make the decision to take care of yourself now.

Q: What about weight gain? How should pregnant women approach this?

A: You will still need to gain weight in pregnancy for the baby, but the problem is that you don’t want to over gain weight because that will contribute to your problems afterwards losing the weight. You want to avoid this cycle. There are so many different tricks that we know that can help us in this regard —portion control, eating meals slowly, and slowing the whole process down so that we can eat what we need as opposed to what is being offered to us.

Q: What are your top 3 tips for couples trying to conceive?

A: First, this is a wonderful time. It is the beginning of an adventure and should be approached this way. That said, there always is some degree of uncertainty. The couple is going into this as a team and they must be able to support each other through those uncertain times. Having good communication and being on the same page is really going to be a huge support when you’re going through this. It is a good time for both individuals to learn more about their own health. It is important for mom to pay attention to her diet and fitness, and stopping smoking and cutting out alcohol if trying to get pregnant. Prenatal supplements, particularly folic acid, should be started before trying to get pregnant. These can be started in the three or four months before pregnancy. This is also a good time for dad to be focusing on his health—alcohol, tobacco, and cannabis are bad for sperm quality and should be limited.

Eleanor Dalhousie