Don't worry, things may have changed a lot over the last few years in Obstetrics, but they haven't changed that much. This is just another way of saying that, if possible, a pregnancy should be planned at least three months in advance. This philosophy covers many of the most frequently asked questions I get from my patients about planning future pregnancy.

BCPs create a thin uterine lining that is unfavorable for pregnancy. Also, when coming off the pill, cycles are frequently irregular and this makes planning the timing of sexual activity more difficult. I generally say to start trying in the third cycle that you are off the pill.

Should I see a doctor before getting pregnant?

Yes, there are several problems that are difficult to treat in pregnancy, such as an abnormal pap smear. Also, some illnesses, if found, can be treated prior to having an adverse effect on a forming pregnancy. I recommend at least being seen within the last year unless you have a specific illness that needs closer observation, such as diabetes or hypertension.

Should I start taking prenatal vitamins before I get pregnant?

Yes, there have been studies that link improved nutrition to fewer miscarriages.

How long does it take medicines to get out of my system?

Almost all drugs are out of one's system completely in just a few days. The pre-conception period is an excellent time to stop smoking and alcohol consumption. This head start will hopefully make it easier to remain off these during the pregnancy. This commitment is best made with the father's involvement as well.

Does the father need to see a doctor?

Not in general. If there is a pre-conception problem, where there is risk to the mother or a significant risk of abnormality in the baby, the husband should be involved in any decision to have or not have a pregnancy.

When is the best time for sexual activity and should I use temperature charts?

I recommend not getting too intense about getting pregnant. Just plan some time together around your ovulation. This occurs 14 days before your period, and in most women is around mid-cycle. Temperature charts can establish your ovulatory pattern. They do not help much on a month to month basis though, because the best time to have intercourse is right before your temperature goes up. Urinary ovulation predicting kits can tell you just when to have sex, if you can afford them and want to go through the trouble. The reason one might do this is if you are coming off BCPs with a history of endometriosis or you have some other pressing reason to get pregnant as quickly as possible.

How accurate are those home pregnancy tests?

Quite accurate. They can diagnose a pregnancy once you have missed your period, if you use your first morning urine. Later in the day the urine may be too dilute to use.

When should we come in if w e can't get pregnant?

There is about a 25 % chance of pregnancy each month. Infertility is not diagnosed until after a year of trying. Of course, if there is a known problem or if one is approaching the end of their reproductive life, an evaluation may be started much sooner to save time.

How long should I wait before coming in to see you, if I think I'm pregnant?

The fetus is most sensitive to injury between the 17th and 56th day after conception, when the organs are forming. I like to see my patients soon after they are diagnosed as pregnant.

These are some of the more frequent questions I am asked. I have more information at my office that I would be happy to share with you. "Am I ready?" is the big question, and it is best answered by yourself and the prospective father.