What every woman should know before they want kids

Our expert

Mary McAuliffe is the head of clinical services, a general nurse and midwife. She is a founding member of the Fertility Specialist Nursing Team at Waterstone Clinic.

Mary has a vast amount of knowledge in the field of Reproductive Medicine. She has been working at the Waterstone Clinic for seventeen years and is a certified fertility ultrasonographer (specialist course, University of Derby, UK). She is an active member of the Senior Infertility Nursing Group (SING, UK) and the Irish Fertility Society. She regularly mentors student midwives on female health placements at the clinic and has represented Irish fertility nurses on the management committee of Insights and at infertility nursing conferences in the UK.

Mary McAuliffe’s advice

First, it is important to know that a healthy period is, above all, a regular one. The average cycle is 28 days, but cycles can be shorter or longer, but what really matters is frequency. You should have regular, predictable cycles of approximately the same length (give or take a few days).

It is always good to track down your cycles and look at them over time. Do you always get menstrual periods? Are they unpredictable? Have they changed in the last six months and created a shorter or longer pattern? Do you have any irregular bleeding? If you notice any of these changes, it is best to discuss them with your doctor.

During a regular cycle, an egg is released from the ovary. The two questions you need answers to if you want to get pregnant are: is you ovulate, and when?

Ovulation occurs 14 days before your period should be. If you have a predictable cycle, it is likely that you are ovulating and that you can predict the day when it will happen. Knowing when you expect ovulation to occur is the first step, and knowing when to try to get pregnant is next. All you have to do to “try” is to have unprotected sex, but to get pregnant, you must try at the right timei.e. during your fertile window.

If you have a monthly cycle and ovulate, then you ovulate 12 times a year. This means there are a maximum of 12 opportunities for you to get pregnant in a year. It is easy to miss these opportunities if you are not aware of when you are ovulating or if you are trying outside the fertile window.

While this is contrary to what you might think, if you wait until you ovulate to try, you will be past the fertile window and you will have missed the opportunity. Trying in the days before ovulation (between four days before and until the day of) is when you have the best chance of getting pregnant. Once released from the ovary, an egg only survives in the body for about 12 hours. The possibility of becoming pregnant after this drops to zero.

If you are unsure when you might be ovulating, ovulation predictor sets can be helpful. Once the kit becomes positive, intercourse on that day and the next day should give you the best chance.

If you try unsuccessfully during your most fertile periods, the period regularity and your egg reserve are typically the first areas we will look at.

Some women have irregular cycles and can not predict when they will ovulate, which makes it very difficult to plan a pregnancy (although they often become pregnant spontaneously). Finding out why it is, whether it is because you have a large number of antral follicles and polycystic type ovaries, or if it is due to declining ovarian reserve, will help you understand what is happening and the help to get what you need to get pregnant.

You were born with all the eggs you will ever have and they are released through your reproductive life. The number of eggs in your ovaries is called your ovarian reserve, and it is determined with a simple AMH blood test and an ultrasound scan. AMH results should always be interpreted along with a transvaginal ultrasound scan by a fertility specialist to assess your ovaries.

The AMH test and scan will give you a good idea of ​​your fertility timeline. The results will tell you if you have a high, low or average amount of eggs for your age. The number of eggs we have decreases all the time and so fast after age 35. However, what is more important than the number of eggs is when you ovulate.

My greatest advice is always the same: knowledge is power in fertility. If you and your partner want to get pregnant, you need to do a fertility test. This will give you a wealth of information so you have the best chance of getting where you want to be.

Continue to follow us here to hear from Ireland’s leading experts in our IMAGE Talks Fertility Series in association with Waterstone Clinic.

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