How do I know that WHEN I want to get pregnant, I can?

Gunce • Head of research at Glow. Unwilling infertility expert. 2 kids after 6 IVF treatments.

“I have no interest in getting pregnant anytime soon – but how do I know when I want to, I can?”

My friend, a successful Wall Street gal, who knew of my fertility challenges, asked me that loaded question the other day while we were devouring our limited-time pumpkin lattes.

How, indeed?

The truth of the matter is – there really is no way to know for sure.

Having a baby is one of those rare things that you only know that you can do, once you’ve already done it. Like climbing Mount Everest. Or walking out of Target having only purchased that one thing you walked into purchase.

But there are certain clues along the way that can put your mind at ease. That’s not to say that you should panic if you cannot check ‘Yes’ to every box below. However, I would suggest that you have a little less to worry about if all the following hold true for you:

You have regular cycle. And by regular, I mean you have your period once every 24 to 35 days. Having a regular period is one the clearest signs that everything is working as it should. What’s more, your periods should not be too heavy or too light. And you want them to last somewhere between 3 to 7 days. Deviation from these norms could indicate a problem like Polycystic Ovarian Syndrome or Endometriosis, and those conditions can make becoming pregnant more difficult.

“Well, that’s no good,” my friend interrupted. “I’ve been on birth control since college. I have no idea what my real cycle is. No idea if my real flow is heavy or light. That does not help me. What’s next?”

I insist that this is the most important piece of the puzzle and I suggest that she go off birth control for a few months to check if she is ovulating. You can do so with the help of Clearblue’s fertility monitors (and obviously, Glow). She shrugs. “I’ll think about it. What’s next?”

You have lots of eggs. There is a simple blood test that now measures your Anti-Mullerian Hormone (AMH) levels. This hormone is produced by specific cells, called Granulosa cells, which surround each and every egg in a woman’s ovary. So obviously, the more eggs, the more granulosa cells. And the more granulosa cells, the more AMH produced. By takings this test, you can determine your ovarian reserve. And the more, the better. But you have to remember this test shows you the quantity of the eggs you have left, but not necessarily the quality. Nonetheless it can be an important indicator. And you can do the test even if you are on birth control. However, check on costs. Your insurance may or may not cover it.

She jots the name down on her phone. “Okay. What’s next?”

I rattle of the next few in one breath:

You have not had any unchecked STDs. Diseases such as chlamydia and gonorrhea can cause pelvic inflammatory disease (PID) where the disease spreads to the reproductive organs. The infection causes scar tissues to build up in the fallopian tubes, ovaries and other organs and prevents both ovulation and the ability to conceive.

You do not smoke. It should surprise exactly no one that smoking can seriously delay your chances of conceiving and increase your chances of miscarriage. While we are it, heavy drinking and recreational drug use might also result in fertility problems.

You are neither significantly overweight nor underweight. The American Society of Reproductive Medicine (ASRM) has said that having a BMI of over 35 or less than 19 can affect how long it takes for you to become pregnant.

I pause before I drop the last tidbit:

You have a fertile partner. Be it a donor’s or your partner’s, you need viable sperm to fertilize your eggs. And the fact of the matter is almost 40% of all fertility related issues arise from the male partner. So you could be going through fertility treatments even if you yourself are completely fertile.

“Ugh!” She rolls her eyes at me. I empathize. This is an area of our lives that we mostly don’t want to think about, much less talk about.

I mean, how often have you heard the phrase “When it’s meant to be, it will be” in reference to making babies?

Well, I hate that phrase.

Here is one that I like better: “The more you know about your reproductive health, the better equipped you will be to make the right choices for you!”

Sure, it’s not as catchy. But it is smart. And ultimately, that’s what counts.