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Getting pregnant AFTER the pill

So many of the young women I see at the clinic in their thirties have gone on the pill at fifteen, and don’t come off until they’re in their 30s and starting to try for a baby. It’s very easy for them to get quite panicked about their cycles and their fertility returning. So today, I want to answer the common questions that I get asked about coming off the pill.

As always, here is your cheat sheet so that you have all the information to hand

“I’m thinking about coming off the pill do I need to let it go out of my system for the next three months before I start trying for a baby?” The answer’s no. When you first come off the pill you should try for a baby as soon as you can, because some studies show that your fertility is better in the early months when you first come off the pill. Don’t waste time letting it go out of your system.

“How long will it take for my period and my cycle to return when I come off the pill?”  Although many women can get pregnant quite quickly, for others there are delays and it’s not unusual to have cycle disturbances for six to seven months, and cycle irregularities as well.

“Am I more likely to have polycystic ovaries when I come off the pill?” This is quite a difficult question to answer, because so many women have been on the pill for 10 to 15 years. When you’ve been on the pill that long, sometimes it can mask certain underlying factors that you don’t know that you’ve got. Some women may have polycystic ovaries when they come off the pill, because that would most likely be because they had it anyway but without realizing.

“If I’m trying to chart my fertility following the pill what can I expect?” When you’ve been on the pill for such a long time, a woman isn’t aware of what her nature cycles are. It does take time to get used to charting and noticing secretions and hormonal changes. Just get used to knowing your body and bear in mind it can take up to seven cycles for your ovulation to return to normal.

“When shall I come off the pill? I’m thinking of trying for a baby?”  If you’re in your mid-thirties and you’re thinking about baby, come off the pill straight-away and try, because on average, it can take eight to twelve months to conceive. A miscarriage isn’t uncommon. It’s really important that the minute you start thinking about having a baby you don’t put off coming off of the pill.

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when am I most fertile?

When Am I Most Fertile? Knowing Your Fertility Window

Most women know that they are most fertile during the days around ovulation but a lot of women remain lost in regards to when ovulation even occurs. One study carried out showed that while 92% of women accurately described ovulation, a third of them thought that it occurred during a period.

Menstrual Cycle

Eat for your monthly cycle

We often hear the word ‘regular’ with reference to a woman’s ideal cycle. Medically speaking regular is any cycle that varies in length by no more than seven days month to month. If the cycle fluctuates more than this then it is said to be irregular. Read more

Ovulation_egg

Ovulation facts

How much do you know about ovulation? We answer the most frequently asked questions from women trying to conceive.

Q. Can you ovulate twice in one month?
A. Yes. But this is fairly rare, and is what happens in the case of non-identical twins. If ovulation happens twice it is always within 24 hours. So your fertile time will still be over the same few days of your cycle.

Q. How long can the sperm survive?
A. Sperm can live for 2-3 days inside a woman’s body. However, during the optimum conditions which accompany the ovulation time it can survive for up to a week.

Q. How long am I fertile for each month?
A. The vast majority of pregnancies occur due to intercourse in the six day period before ovulation occurs. This fertile window will generally occur earlier in shorter cycles and later in longer cycles.

Q. I have regular periods. Does this prove my ovulation is normal?
A. Regular periods can occur even if ovulation has not occurred, so are not necessarily a sign you have ovulated during your cycle.

Q. How can be certain I have ovulated?
A. With great difficulty! Currently there are only three ways to confirm that ovulation is occurring: being pregnant; an ultrasound scan showing a collapsed follicle or a blood test showing a raised progesterone level.

Q. What is a progesterone test and should I have one?
A. A progesterone test can show ovulation has occurred, but needs to be taken on day 21 of a 28 day cycle. At this time raised progesterone levels will show that ovulation has occurred. Whilst the absence of raised levels will show if no ovulation has taken place.

Q. How accurate is temperature at indicating ovulation?
A. An accurately taken waking temperature can give some idea of the possible presence or absence of ovulation and any ovulatory problems, but temperature recordings are not conclusive and can be stressful so are not generally recommended.

Q. Should I use a predictor kit?
A. Some women find these useful, but they should be used alongside understanding of how your cervical secretions chance during fertiles times. An ovulation predictor kit tests for a surge in luteinising hormone. Ovulation normally follows within 36 hours of the LH surge, but a positive LH test does not always indicate that ovulation will follow.

Q. What should I be looking for in my cervical secretions?
A. During fertile times oestrogen changes cervical secretions to allow sperm to live longer in the woman’s body, and enter the womb more easily. Typically fertile secretions are wetter, slippery and more stretchy. To maximise the chance of conception, sex should occur on days with optimal mucus quality, regardless of the exact timing relative to ovulation.

Q. I’ve noticed as I get older I have less secretions – is this a problem?
A. Not necessarily. And plenty of water and good quality dietary fats can help. But it is very important to ascertain whether secretions have diminished due to age, or other factors such as hormonal imbalance or poor follicular development – this is where egg growth is not sufficiently stimulated in the ovaries.

Q. The time between ovulation and my period seems to have got shorter. Why is this?
A. As women age, ovulation becomes less frequent and the interval between ovulation and the next period (luteal phase) may be deficient or shortened. This may be a normal part of the ageing process or may have other causes. However, if there are less than 10 days from ovulation to the next period, there is not enough time for a fertilised egg to implant in the endometrium (womb lining).

Q. Which lifestyle factors most impact on ovulation?
A. Stress can have a large impact because it disrupts hormones associated with fertility. Weight fluctuations can also have an impact, and being underweight can be more detrimental to fertility than being slightly overweight. Other health issues such as anaemia and medications can have an impact. As can smoking, excess alcohol and poor diet.

Q. I think I might have a problem with my thyroid. Can that affect fertility?
A. The thyroid gland is like the body’s thermostat, releasing hormones to speed up your metabolism and burn more fuel, or slow down and conserve energy. Issues like stress and illness can affect the thyroid, disrupting its natural processes. And since your hormones are interrelated this can affect fertility.

Q. I’ve just come off the pill. How long will it take for my cycles to return?
A. This varies from person to person. The first month after you stop taking the pill is usually a particularly fertile cycle. After this ovulation can be disrupted for a few months in most women. For others it may take longer for ovulation to return to a normal pattern, despite regular periods.

Q. I’m breastfeeding. What affect does this have on my fertility?
A. Breast-feeding suppresses ovulation and it may take a while after stopping breast-feeding for a normal ovulatory pattern to return, despite seemingly normal periods.

Q. Can I time intercourse to affect the sex of the baby?
A. No. When you have sex makes no difference to the gender of the baby.

Q. How often should we be having sex?
A. Three to four times a week is ideal. This will ensure a healthy amount of active sperm is always present to fertilise the egg. Sex should also happen in enough time prior to ovulation for the sperm to ready themselves in the fallopian tubes.

For more information on ovulation, timing sex to conceive, investigations into ovulation problems or unusual patterns of cervical secretions, you may like to arrange a fertility awareness consultation with Jane Knight, fertility nurse specialist.

Contact our clinic to arrange a personal or, if preferred, Skype consultation.

Progesterone

Progesterone tests

So many women we see don’t do a progesterone test on the right day and wonder why it comes back low. This leads them to think that they are not ovulating, but the timing of the test is really important. The main test to check whether a woman is ovulating is by a blood test to check the level of the hormone progesterone which increases following ovulation. Read more