Pregnancy is one of life’s greatest miracles; trying to conceive can be an exciting, fun and also frustrating process.
For some it happens overnight but many couples struggle with conceiving as infertility can be cause of many factors.
Today we’re talking with Michelle Nwabudike, certified nurse practitioner specializing in obstetrics and gynecology at Allina Health Bandana Square Clinic, about planning for pregnancy and what you need to know about infertility.
Selected Podcast
Planning for Pregnancy
Featured Speaker:
Michelle Nwabudike, CNP - Obstetrics and Gynecology
Michelle Nwabudike is a board-certified women's health nurse practitoner specializing in obstetrics and gynecology and maternal-newborn care. I have professional interests in adolescent health, sexuality, preventive women's health care, abnormal PAPs, colposcopy and OB care. Transcription:
Planning for Pregnancy
Melanie Cole (Host): Pregnancy is one of life’s greatest miracles. Trying to conceive can be an exciting, fun time, but it can also be frustrating for many couples. And for some it happens overnight, but for some other couples, they struggle and they’re really not sure why. Today my guest is Michelle Nwabudike. She’s a certified nurse practitioner specializing in obstetrics and gynecology at Allina Health Bandana Square Clinic. Welcome to the show, Michelle. Talk a little bit about fertility and couples that are wanting to get pregnant. What do you think is the most important bit of information that you can give a couple that says to you, “We’re trying to get pregnant”?
Michelle Nwabudike (Guest): Well, Melanie, I think that the most important information that a couple can have at their hand is the idea that both of them are at their optimum health, that they truly are at the weight that they desire to be, that they’re both non-smokers, that they’re really taking good care of themselves up to the point of the decision and are going to continue taking care of themselves during the pregnancy as well as after so that they are there for their children.
Melanie: How important is diet and all that? Obviously you say being at their optimal weight and not smoking and making sure they’re as healthy as they can be before they start the process. How important is what we eat in that fertility process?
Michelle: The diet is extremely important. There are many foods that we have in the market these days that are processed, and some of the chemicals in the processing can be very harmful. They interfere with our hormones, particularly female hormones but also male hormones. For instance, soy interferes and starts to mimic estrogen and can be very upsetting to the normal female menstrual cycle. Also, some of our foods are higher in fats and different associated chemicals and things that are not healthy for us. Many of these things do mimic other hormones that are going to throw off the menstrual cycle.
Melanie: Do you want women considering getting pregnant to take certain supplements while they’re trying to conceive?
Michelle: Yes, we do recommend a general multivitamin, a prenatal vitamin if that’s what their goal is, to become pregnant. Within that prenatal vitamin, it has all of their minerals; additional calcium; vitamin D, which is also very important; omega-3 fatty acids—it helps to reduce inflammation, regulate menstrual cycle, and it helps to maintain a lot of our reproductive organs. Also, within a general prenatal vitamin, we’re going to have increased iron, which also helps with ovulation and making sure that there is good egg health for the woman. We also want a fair amount of folic acid, which a prenatal will provide, and that can be very helpful for preventing any congenital defects.
Melanie: If they’re looking at the label, how much folic acid would you like them -- because we see 400 mg, we see 800 mg. How much would you like them to see on that label?
Michelle: I think in general, prenatal is going to have in the neighborhood of 400. And in general if they’re taking a separate folic acid, 1 gram.
Melanie: Now, tell us about alcohol. And you mentioned smoking already, but what about drinking alcohol. Does that affect fertility?
Michelle: It absolutely does. Alcohol can affect sperm count; it decreases the sperm count. And it can increase birth defect if the mother is drinking prior to the knowledge of knowing she’s pregnant. Or just the effect that it has on inflammation. It can affect the egg health. Smoking and drinking are both things that need to be put on hold.
Melanie: Michelle, one of the things that I know: women trying to get pregnant, it’s a very stressful time. Does that stress work against itself? Can this be a vicious cycle? You’re so worried about getting pregnant and it’s not happening, and the stress itself is contributing to that? Is there any truth to that?
Michelle: Very much so. It’s important to really relax, and we can’t say it enough to these couples that it’s extremely stressful. They have one goal in mind, and that’s to have a baby. But during that time, they need to take time to be healthy, and in being healthy, we generally recommend exercise, which will reduce stress, and try meditating once a day, whether you do that through yoga or walking, sitting, breathing. Don’t forget to do your daily self-care. These are very important things: massage, facial, bath. Make sure that you’re getting the 30-minute walk or anything that you would normally do to decrease, stress or find a new hobby that’s going to help decrease stress and take your mind off the general goal here, becoming pregnant.
Melanie: Should you have a lot of sex when you’re trying to get pregnant? Should you keep track of your ovulation schedules? Can you have too much sex trying to get pregnant?
Michelle: Absolutely. There are so many good tracking devices on smartphones, and many of the patients that I see in the clinic day to day already have a tracking device on their cell phones that track their menstrual cycles, their ovulation predictors. These can all be very helpful. It can also be very helpful to identify that perhaps you’re not ovulating and this would be a good thing to bring to the clinic. Patients often want to know whether having intercourse through the whole cycle is important, and no, it’s not. It’s not going to decrease your chances by having intercourse the entire time during the cycle every day, but it’s also not going to increase your chance of having a pregnancy by having intercourse every day.
Melanie: Can a man have too much intercourse and lower their sperm count? Is there any truth to that?
Michelle: No, not necessarily. Men actually do continue to make sperm. Previously, the thought was to have intercourse every other day from the time that you’re fertile, say from day 10 through day 18, and a lot of that is you need some downtime and you don’t want to change the acidity of the vagina that keeps it healthy, too, and to make it so that it’s not in the forefront of your mind every day.
Melanie: What about positions? Are you supposed to lay there with your legs up in the air afterwards? Is there any truth to the positional, helping to increase your fertility?
Michelle: No. That is not true. The myth comes from the idea that gravity will help to keep that sperm deep down in the vagina. Yes, a woman can stay in bed and relax for 10 to 15 minutes after intercourse so she’s not up to the bathroom and expelling all of the semen afterwards, but she doesn’t need to sit with her legs straight up in the air or on her head afterwards. Mother Nature has really taken care of that for us. The cervix will -- with orgasm, it’s probably more important that orgasm takes place so that the vagina makes a little pouch underneath the cervix, in which the sperm pools, and then the cervix will dip down into that in kind of a contractive manner and drink up the sperm in that little pouch. So position doesn’t make any difference.
Melanie: When is it time? How long do you try to get pregnant before you start meeting with medical providers and discussing treatment?
Michelle: Well, the majority of women, 85 percent will become pregnant within trying within one year. As long as you are a healthy individual and you’re under the age of 35, we do give you one year and recommend some of these things that we talked about in order to become pregnant. If that’s not happening in a year’s time or you’re finding that your periods are very irregular, there’s any changes in your menstrual cycle, or you have any other health concerns, that’s the time to see professional health. And if you are over the age of 35, then we generally recommend seeing somebody after six months of trying.
Melanie: In just the last minute, Michelle, your best advice for those couples out there trying to get pregnant.
Michelle: Relax, have fun, be healthy, stay healthy.
Melanie: That’s great advice. Really, really great advice. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.
Planning for Pregnancy
Melanie Cole (Host): Pregnancy is one of life’s greatest miracles. Trying to conceive can be an exciting, fun time, but it can also be frustrating for many couples. And for some it happens overnight, but for some other couples, they struggle and they’re really not sure why. Today my guest is Michelle Nwabudike. She’s a certified nurse practitioner specializing in obstetrics and gynecology at Allina Health Bandana Square Clinic. Welcome to the show, Michelle. Talk a little bit about fertility and couples that are wanting to get pregnant. What do you think is the most important bit of information that you can give a couple that says to you, “We’re trying to get pregnant”?
Michelle Nwabudike (Guest): Well, Melanie, I think that the most important information that a couple can have at their hand is the idea that both of them are at their optimum health, that they truly are at the weight that they desire to be, that they’re both non-smokers, that they’re really taking good care of themselves up to the point of the decision and are going to continue taking care of themselves during the pregnancy as well as after so that they are there for their children.
Melanie: How important is diet and all that? Obviously you say being at their optimal weight and not smoking and making sure they’re as healthy as they can be before they start the process. How important is what we eat in that fertility process?
Michelle: The diet is extremely important. There are many foods that we have in the market these days that are processed, and some of the chemicals in the processing can be very harmful. They interfere with our hormones, particularly female hormones but also male hormones. For instance, soy interferes and starts to mimic estrogen and can be very upsetting to the normal female menstrual cycle. Also, some of our foods are higher in fats and different associated chemicals and things that are not healthy for us. Many of these things do mimic other hormones that are going to throw off the menstrual cycle.
Melanie: Do you want women considering getting pregnant to take certain supplements while they’re trying to conceive?
Michelle: Yes, we do recommend a general multivitamin, a prenatal vitamin if that’s what their goal is, to become pregnant. Within that prenatal vitamin, it has all of their minerals; additional calcium; vitamin D, which is also very important; omega-3 fatty acids—it helps to reduce inflammation, regulate menstrual cycle, and it helps to maintain a lot of our reproductive organs. Also, within a general prenatal vitamin, we’re going to have increased iron, which also helps with ovulation and making sure that there is good egg health for the woman. We also want a fair amount of folic acid, which a prenatal will provide, and that can be very helpful for preventing any congenital defects.
Melanie: If they’re looking at the label, how much folic acid would you like them -- because we see 400 mg, we see 800 mg. How much would you like them to see on that label?
Michelle: I think in general, prenatal is going to have in the neighborhood of 400. And in general if they’re taking a separate folic acid, 1 gram.
Melanie: Now, tell us about alcohol. And you mentioned smoking already, but what about drinking alcohol. Does that affect fertility?
Michelle: It absolutely does. Alcohol can affect sperm count; it decreases the sperm count. And it can increase birth defect if the mother is drinking prior to the knowledge of knowing she’s pregnant. Or just the effect that it has on inflammation. It can affect the egg health. Smoking and drinking are both things that need to be put on hold.
Melanie: Michelle, one of the things that I know: women trying to get pregnant, it’s a very stressful time. Does that stress work against itself? Can this be a vicious cycle? You’re so worried about getting pregnant and it’s not happening, and the stress itself is contributing to that? Is there any truth to that?
Michelle: Very much so. It’s important to really relax, and we can’t say it enough to these couples that it’s extremely stressful. They have one goal in mind, and that’s to have a baby. But during that time, they need to take time to be healthy, and in being healthy, we generally recommend exercise, which will reduce stress, and try meditating once a day, whether you do that through yoga or walking, sitting, breathing. Don’t forget to do your daily self-care. These are very important things: massage, facial, bath. Make sure that you’re getting the 30-minute walk or anything that you would normally do to decrease, stress or find a new hobby that’s going to help decrease stress and take your mind off the general goal here, becoming pregnant.
Melanie: Should you have a lot of sex when you’re trying to get pregnant? Should you keep track of your ovulation schedules? Can you have too much sex trying to get pregnant?
Michelle: Absolutely. There are so many good tracking devices on smartphones, and many of the patients that I see in the clinic day to day already have a tracking device on their cell phones that track their menstrual cycles, their ovulation predictors. These can all be very helpful. It can also be very helpful to identify that perhaps you’re not ovulating and this would be a good thing to bring to the clinic. Patients often want to know whether having intercourse through the whole cycle is important, and no, it’s not. It’s not going to decrease your chances by having intercourse the entire time during the cycle every day, but it’s also not going to increase your chance of having a pregnancy by having intercourse every day.
Melanie: Can a man have too much intercourse and lower their sperm count? Is there any truth to that?
Michelle: No, not necessarily. Men actually do continue to make sperm. Previously, the thought was to have intercourse every other day from the time that you’re fertile, say from day 10 through day 18, and a lot of that is you need some downtime and you don’t want to change the acidity of the vagina that keeps it healthy, too, and to make it so that it’s not in the forefront of your mind every day.
Melanie: What about positions? Are you supposed to lay there with your legs up in the air afterwards? Is there any truth to the positional, helping to increase your fertility?
Michelle: No. That is not true. The myth comes from the idea that gravity will help to keep that sperm deep down in the vagina. Yes, a woman can stay in bed and relax for 10 to 15 minutes after intercourse so she’s not up to the bathroom and expelling all of the semen afterwards, but she doesn’t need to sit with her legs straight up in the air or on her head afterwards. Mother Nature has really taken care of that for us. The cervix will -- with orgasm, it’s probably more important that orgasm takes place so that the vagina makes a little pouch underneath the cervix, in which the sperm pools, and then the cervix will dip down into that in kind of a contractive manner and drink up the sperm in that little pouch. So position doesn’t make any difference.
Melanie: When is it time? How long do you try to get pregnant before you start meeting with medical providers and discussing treatment?
Michelle: Well, the majority of women, 85 percent will become pregnant within trying within one year. As long as you are a healthy individual and you’re under the age of 35, we do give you one year and recommend some of these things that we talked about in order to become pregnant. If that’s not happening in a year’s time or you’re finding that your periods are very irregular, there’s any changes in your menstrual cycle, or you have any other health concerns, that’s the time to see professional health. And if you are over the age of 35, then we generally recommend seeing somebody after six months of trying.
Melanie: In just the last minute, Michelle, your best advice for those couples out there trying to get pregnant.
Michelle: Relax, have fun, be healthy, stay healthy.
Melanie: That’s great advice. Really, really great advice. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.