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Pre-Family Planning: Building a Foundation for Conception

Getting pregnant can sometimes be a challenge. Here’s how to be ready — physically and emotionally — for conception.

Remember all those years of wanting to not get pregnant? It’s one of life’s cruel little ironies that for many women, when they’re finally ready to have a baby — or a second or third — their bodies don’t cooperate.


“We conceived our son easily,” remembered one woman from West Chester, who asked not to be identified because of the sensitive topic.


She was ready for her family to grow when she started trying for a second, about a year after her son was born. She was having difficulty conceiving, so she went to a fertility specialist and learned she wasn’t ovulating.


She and her husband opted to try an egg donor, and six years later, she’s the mother of three children: two girls and a boy.


“There were some breaks in there, due to emotional well-being,” she said.

You’re Not Alone

While what she experienced was challenging and heartbreaking, her conception story is not unique. According to the Centers for Disease Control and Prevention, infertility — defined as not being able to get pregnant for a year or longer — affects about 6 percent of married women ages 15 to 44 each year.


Photograph by Casey Kallen

As a woman gets older, her chances of conceiving become more difficult. That’s mainly because women are born with a set number of eggs, while men make sperm all the time, said Dr. Isaac E. Sasson, a reproductive endocrinologist at Shady Grove Fertility, which has offices in Bala Cynwyd and Chesterbrook.


The quantity and quality of the eggs diminish with age.

How to Take Charge

Conception difficulties are very real, and they’re due to a variety of causes. Age is one of the most common, but not the only reason.


“People have given up all of their peak reproductive years,” Sasson said. “Baby number one may not be hard at 29 years of age, but baby number two at 33 and baby number three at 36, when our parents would have been done building their family already, now we’re struggling.”


A generation ago, the average age of first pregnancy was 21 years old, he said.


But we all know age is a factor, and we can’t turn back the hands of time. So what can you do to improve your odds? Women can influence conception — the process of becoming pregnant involving fertilization or implantation of the embryo — by educating themselves and being proactive.


Take these empowering steps to get your body as healthy as it can be:


Photograph by Jean Goins

Fertility awareness: Get to know your cycle, and your body’s timing. “The biggest myth is that you ovulate on day 14, which is just not the case,” said Diana Spalding, a nurse midwife and owner of Gathered Birth, a women’s wellness center in Media.


“Maybe you do, but it also may be on day 20 or day 12. Be aware of your (menstrual) cycle.”


Stop smoking: It’s hard to believe with smoking bans and warnings from the Surgeon General, but plenty of women — even those trying to get pregnant — still smoke. Yes, it’s hard to stop, but quitting really affects your fertility.


“Women who smoke are putting their eggs in an ashtray,” Sasson said. “Women who are going through IVF and smoke, their fertilization success rate is half of what it would be if they didn’t smoke.”


It’s bad for the baby, too. So stop before you start trying to conceive.


Get your body ready for success: Women who are overweight (with a body mass index over 25) take much longer to conceive, Sasson said. Being at a healthy weight will make it easier for your body to handle the stresses of pregnancy as well, including healthy weight gain that’s an essential part of carrying a child.


And it’s not just your body that counts: Healthy sperm cells are just as important as healthy eggs. Spalding said roughly 40 percent of fertility issues are due to a problem with the father, which is why specialists test the male first (it’s less invasive).


A healthy weight matters for men, too: A 2012 study found obesity negatively impacts fertility through changes in hormone levels and sperm function. Researchers also found that overweight men could pass those tendencies on to their offspring.


Simple diet and exercise changes can make a big difference, for both of you. Just consider walking your foreplay.

What If It Doesn’t Happen Right Away?

For a woman younger than 35, it can take up to a year to get pregnant, Spalding said. Most women will get pregnant in that year, but in any given month, most people do not get pregnant the first month they try.


If those months stretch on and you do seek help from a fertility specialist, there’s so much those experts can do. But while you know your body is in good hands, it’s important to consider your emotional state.


Even if you’re not experiencing side effects from some of the first-line fertility treatments, trying and failing to conceive can be wrenching — especially when you’re around friends and family who don’t have a fertility issue. Suddenly, a social media post about a friend’s new pregnancy can trigger a torrent of emotions.


“Be gentle with yourself,” Spalding said. Try yoga or “something you can do to alleviate the stress.”


If your baby picture-filled Instagram feed is making things worse, take a break. The same goes for online TTC groups.


“Get involved in activities you love,” said a 36-year old mother from Pottstown, who asked not to be identified. She had her 9-year-old without difficulty, miscarried once, and recently had her second child.


“Don’t spend your time waiting for something to happen,” she said.


Photograph by Abbe Forman

Be sure to take time for your partner, too —  trying to get pregnant can take over your life, and it’s easy to feel like you’re two cogs in a transactional wheel. Whether it’s a night out, a weekend away, or just cuddling without worrying about your basal temperature, spend some time together that’s not about conceiving.


If it takes a while to conceive, the journey can be long and lonely. The supportive connections with friends, family, and health care providers can carry you through the process.


Consider sharing what you’re going through with your close friends. You may be surprised to find out that one or more of them has been through the same thing.


And finally, try to keep perspective, as hard as that can be.


“Your value isn’t based on whether or not you can give birth,” said the Pottstown mom.


While you’re waiting for a child, pay it forward. It’s a great way to help others, she said.


“If you have a desire to nurture, find some other outlets to share that gift, such as volunteering, sponsoring a child, providing resources to underserved children, and encouraging people around you.”

If You Need Help

According to Dr. Isaac E. Sasson, of Shady Grove Fertility in Chesterbrook and Bala Cynwyd, one in six couples will struggle to build their family. “We look to support patients for all of their needs in helping them conceive,” he said.


Get to Know Your Body

For some women, conception is as easy as learning to predict when you ovulate, or release an egg from the ovaries that can be fertilized. According to The American Pregnancy Association, some women can feel ovulation, “a bit of pain or aching near the ovaries called mittelschmerz,” German for “middle pain.” The group recommends the ebook The Essential Guide to Getting Pregnant to learn more about ovulation.


Assisted Reproductive Therapy

In vitro fertilization (IVF), one of the most common and successful approaches, may be your family-building intervention. Using your own eggs or donor eggs, eggs are extracted and combined with sperm and manually fertilized in the laboratory to create an embryo, which is implanted in the uterus.



Often called third-party donors, sperm, egg, or gestational carriers may be empowering choices to build a family. An egg, sperm, and fallopian tube and uterus are the necessary pieces needed to build a family. “If one of those isn’t working or is unavailable, there’s an opportunity to replace that,” Sasson said.


“It’s not plan A, but if you can’t have plan A, what’s plan B? You may not want to use an egg donor, but they are your choices.”



Lead photograph by Abbe Forman. 


This article originally appeared in Main Line Parent and Philadelphia Family magazine. Want to get our next issue? Become a Supporting Member or subscribe today!

Contributing Writer


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