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Want to Get Pregnant? Follow the 90-Day Guide

As with so many things in life, it pays to be prepared—and conception is no exception. At least 90 days before starting to try to conceive, both men and women should take steps to improve their diet and exercise routines, as well as fine-tune any medications they may be taking to make sure they are friendly to the developing fetus.

"If you optimize all those things, you'll improve your fertility, reduce the risk of miscarriage and enhance the outcome of pregnancy, meaning both mother and baby will be healthier," says Lisa C. Mazzullo, M.D., clinical assistant professor of obstetrics at Northwestern University Medical School in Chicago and co-author of Before Your Pregnancy: A 90-Day Guide for Couples on How to Prepare for a Healthy Conception.

For men, the 90 days before conception are crucial because that's the developmental life cycle of sperm.

"That's the time to eliminate things in a man's diet and lifestyle that can be a concern and improve upon things to increase the health of sperm," says Dr. Mazzullo.

For women, what they do during that 90-day period can increase their chances of becoming pregnant. They also can help reduce the risk for complications as long as they continue their good habits until delivery.

With this in mind, Dr. Mazzullo offers these suggestions for pregnancy preparedness.

Mind your meds

At least 90 days before trying to conceive, women with chronic conditions, such as asthma, high blood pressure, a seizure disorder, or diabetes, should see their doctor and obstetrician-gynecologist to make sure their conditions are stable and their medication regimens won't be harmful to a fetus.

If necessary, blood work may be needed to fine-tune your medication use. A preconception visit also can help your doctor troubleshoot for diseases or conditions you may not know you have that can prevent pregnancy or interfere with the healthy development of your baby.

In some cases, you may be advised to stop taking certain medications. If so, "a month or two in advance of conception is the time you'll need to get the medication out of your system," says Dr. Mazzullo.

If you're on psychiatric medication, you also should meet with your doctor or psychiatrist about weaning down to the lowest possible dose.

With medications for depression or anxiety, it's best to be on just one drug, if you can, instead of two or three, and to be on the lowest dose possible, says Dr. Mazzullo.

Whatever you do, don't stop these drugs on your own, just like you wouldn't stop taking diabetes or asthma medications.

"You won't be mentally at your best, which can affect how well you take care of yourself," cautions Dr. Mazzullo. "If you're depressed or anxious, for example, you may not eat right or exercise, which is important for conception, as well as fetal growth and development. You also may be at higher risk for postpartum depression after delivery."

If you're traveling abroad and need specific immunizations, get them three months before you try to conceive. "You'll need the vaccines that far ahead so it's safe to conceive," she says.

Certain medications also can affect sperm quality and sexual performance, which is why men who take medications also need to check in with their doctors if they're being treated for a chronic illness.

Take folic acid

It's important that women hoping to conceive get at least 400 mcg of folic acid daily at least one month before conception, particularly if their diet doesn’t contain adequate green leafy vegetables and other sources of folic acid.

"By getting adequate folic acid in advance, you can reduce the risk for neural-tube defects, such as spina bifida," says Dr. Mazzullo. The recommended dose for folic acid may be higher if a woman has a personal or family history of neural tube defects.

After you become pregnant, you most likely will need to switch to a prenatal vitamin, so talk to your health care provider.

Reduce alcohol, caffeine intake

Because alcohol exposure can increase the risk of miscarriage and affect fetal development (fetal alcohol syndrome or FAS), it's important for women trying to get pregnant to not drink any alcoholic beverages at least a month before trying to conceive.

Alcohol affects your ovulation pattern because it affects different enzymes in the liver.

"I often tell my patients if they want a glass of wine or a margarita, to have it during their periods. But in the second half of the month, when they could conceive, not to drink at all," she says.

Men also should moderate their alcohol intake. "If they drink more than two drinks a day, they may make fewer sperm or make what I call 'sloppy swimmers,'" says Dr. Mazzullo. "The sperm is developed, but it doesn't get the job done."

Likewise, men and women trying to conceive should reduce their caffeine intake to fewer than two caffeinated beverages a day to avoid impairing sperm motility and female fertility.

Smoking or using illegal drugs can have serious effects on the developing fetus. Smoking and other forms of tobacco use can lead to an infant who is underweight or with hindered intellectual or emotional development. Illegal drugs can cause birth defects, developmental disorders and respiratory problems. Children whose mothers used illegal drugs during pregnancy may be addicted to the drugs.

Get in the exercise habit

Women who exercise before pregnancy tend to be healthier during pregnancy.

"By preparing your body ahead of time, you're getting it in the best possible shape for the marathon of pregnancy," says Dr. Mazzullo.

Although exercise, per se, doesn't affect a man's fertility, what he wears during exercise can. Men who spend time a lot of time in a jock strap, for example, should limit wearing one as much as possible during the conception period because it can heat the testicles and lower sperm count. For the same reason, men also should limit their time in a hot tub, spa or steam room to 15 minutes twice a week.