In some senses, you are never “ready” to become a parent. There are so many things that you can’t adequately prepare for until they happen. It’s on-the-job-training in its truest form.
But, in other cases, you can anticipate, plan and prepare in advance.
If you were training for a marathon, you might ask yourself - have I trained enough? Am I ready for this race?
If you were applying to a job, you might ask yourself - am I qualified enough? Can I handle the demands of this job?
Similarly, when it comes to pregnancy, we can start asking ourselves - am I ready for this? Physically? Emotionally? Financially?
Let’s start this conversation by touching on the physical readiness point.
How do you know if your body is ready to conceive?
It’s hard to know exactly, but a state of hormonal balance is central.
Here are some good indicators of optimal readiness:
- A regular menstrual cycle with a relatively seamless period: Your period comes every 21-35 days and lasts for 2-7 days. You experience minimal PMS or period pain. PMS is common, but it's not normal (i.e., the way your body was designed to operate). If you have lots of period symptoms, that’s an indicator of an underlying hormonal imbalance. For example, breast tenderness or heavy clotting can indicate excess estrogen and spotting can indicate low progesterone. Both of these hormonal states can make it harder to become pregnant and would ideally be corrected before you start trying.
- Regular ovulation: Ovulation should be taking place ~12-14 days prior to menstruation each month. Just because you had a period does not mean that you ovulated. Using ovulation strips or progesterone strips is a good way to confirm.
- Any chronic conditions are optimally managed for pregnancy (e.g., thyroid disease, autoimmune disease, mood disorders): If you are managing a chronic health condition, it is important that you work with your doctor to confirm that all medications you are on are compatible with fertility and pregnancy. It is also important that your health condition is well-managed. For example, uncontrolled autoimmune disease can predispose you towards miscarriage. The same thing is true for a thyroid function that is not tightly managed (TSH, or thyroid-stimulating hormone, less than 2.5 mIU/L).
- Body mass index (or BMI) in the normal range between 18.5-24.9 or body fat between ~20-26%: BMI measurements are a crude tool, but it’s the most cited clinical measurement that we have to date. Our clinical advisory team generally prefers to use body fat measurements, since they are a more accurate reflection of body composition. Body composition matters because it affects hormone levels. Fat is not inert tissue; it is hormonally-active tissue. The more body fat you have, the more estrogen your body produces. Because of this, as I mentioned above, excess body fat can predispose you to a higher estrogenic state, which can interfere with ovulation. On the opposite end of the spectrum, having too low body fat indicates to your body that you are “starving” and your body then diverts resources from making your sex hormones to making stress hormones. This means you don’t have the raw materials to make adequate sex hormones and ovulation can be impacted as a result. We acknowledge that every body is different, but generally speaking, being higher or lower than the ranges listed above can interfere with ovulation.
- Balanced blood sugar: Hormones are all intimately connected and interdependent. Too much sugar leads to too much insulin. Too much insulin leads to too much cortisol and too much testosterone. Too much cortisol depletes estrogen and progesterone. Too much insulin and too much cortisol leads to excess body fat. Excess body fat leads to too much estrogen. And the cycle continues. If you know that you have diabetes or pre-diabetes, then it will be important to work with your doctor or a nutritionist to either manage or reverse your diabetes prior to getting pregnant. Other indicators of poor blood sugar management are constant sugar cravings, feeling irritable / lightheaded if you miss a meal, getting tired after eating and feeling weak or shaky often. If you suspect that you have issues with blood sugar, it’s definitely worth exploring further.
There are also lab tests (including our Plus package!) that can check some of these indicators to confirm, but your body gives you a lot of information if you know what to look for and listen to it.