Birth Control and Fertility Care

While so much of our lives can’t be planned for, many aspects of conception can be. And your right to choose whether or not you want children—and when—is a fundamental one. We’re here to support that choice with information and options.

Preventing Pregnancy
Contraception is the foundation of reproductive autonomy, giving you the freedom to have sex without the constant worry of an unplanned pregnancy–along with many other health-related benefits. It is currently cheap or often free with most health insurance plans. From hormonal and nonhormonal methods, to long-acting and permanent solutions, your provider can help you choose an option that works for your life and future goals.

• Hormonal birth control options (pills, IUD, patch, ring, implant)
• Non-hormonal birth control options (copper IUD, condoms, diaphram, sponge)
• Long-acting birth control options (IUDs and implant)
• Emergency contraception (if you’ve had unprotected sex or your method failed)
• Permanent birth control (salpingectomy and vasectomy)

If you’re on birth control now but hope to get pregnant in the future, know the truth behind this one pervasive myth: birth control does not cause infertility, even if you’ve been on it for most of your adolescent or adult life. With the exception, of course, of salpingectomy/permanent birth control.

Preparing for Pregnancy
Preconception care is a way to ensure your reproductive and physical health are in the best possible shape before trying to conceive, both to help with conception itself and to have a healthy pregnancy. During a preconception checkup with your provider, we’ll discuss some basic, but beneficial, lifestyle habits.

The direct impact of diet and nutrition on fertility varies, but it’s always a good idea to think about both for your overall health—so prioritize that over any “pro-fertility” diet regimes. Similarly, daily movement and stress management can influence certain aspects of the fertility cycle, but not majorly. Since stress specifically is not the main cause of any fertility issues, don’t stress about it! A tangible thing you can do during the trying to conceive stage is to take a daily prenatal vitamin that contains folic acid. This helps prevent neural tube defects for when you do become pregnant.

If you were on hormonal birth control before trying to get pregnant, it can take several months for your period to return to its natural rhythm. That doesn’t mean you can’t get pregnant right after stopping it. It just means ovulation might be more of a moving target than a predictable one. So track your cycle during this time with a calendar and ovulation tests. This information will help guide you on when to have sex to increase your pregnancy odds. The most fertile time, often called the ‘fertile window,’ includes the five days before ovulation and the day of ovulation itself. Conception is most likely when intercourse occurs in the two to three days immediately preceding ovulation. It’s up to you (and your partner) if you want to have sex every day or every other. Data doesn’t support either option as “better.”

Trouble Getting Pregnant
If you’re trying to conceive without success, it can feel frustrating—and isolating. Knowing when to see a fertility specialist can ease uncertainty. Since 80-90% of couples will conceive within the first year of trying, providers usually recommend waiting 12 months (or 6 months if the person who will carry the baby is over the age of 35) before scheduling an appointment to take a closer look at potential fertility challenges.

What causes infertility can vary: lifestyle factors (smoking, eating disorders, extremes of weight), medications (chemotherapy or radiation), female factors (usually related to ovulatory dysfunction) and male factors (abnormal sperm movement or count). Most frustratingly, 25% of infertility cases are for no known reason

WHA’s family planning services and preconception care visits are tailored to your needs. Regardless of what those may be, we’ll likely want to chat about your health history, menstrual cycle, current medications and lifestyle habits when you come in for an appointment. From there, your provider will guide the conversation based on what you need right now.

Preventing pregnancy? We’ll talk through all of your birth control options and their side effects, alongside your past experiences with specific methods to help you get started on one, or make a switch to another.

Planning to conceive soon? Schedule a preconception checkup or wellness visit with your provider to:

• Review your health history and menstrual cycles
• Discuss any conditions that can impact fertility or pregnancy, such as polycystic ovary syndrome (PCOS), endometriosis, diabetes or hypertension
• Confirm you’re up to date on all health screenings and pap smears
• Receive guidance on lifestyle habits like nutrition, exercise, sleep and substance use

Trying to get pregnant but it’s not happening? We’ll explore the most common fertility testing options, starting with a detailed menstrual history and performing a physical exam. From there, most of the initial infertility workup can be done by your OB-GYN and could include:

• Blood tests to check hormone levels and ovulation patterns
• An ultrasound to evaluate the uterus and ovaries
• A Hysterosalpingogram (HSG) to check the endometrial cavity (inside of the uterus) and the fallopian tubes for any abnormality
• Laparoscopy surgery to help treat any potential causes of infertility, usually due to endometriosis, adhesions or tubal damage

Based on the information we collect, we’ll talk through when it makes sense to involve a fertility specialist. (Oh, and since male factors typically account for approximately 25% of cases of infertility, your provider will likely recommend a male partner undergo a simple semen analysis to evaluate sperm count, motility and morphology, which is done at an infertility lab.)

If you have any questions or concerns about your ability to conceive, or are thinking about getting pregnant, contact WHA to schedule an appointment.