Tips for couples who are trying to conceive and not pregnant yet

Don't be afraid to ask questions, urges Fertility NZ CEO Nicola Bitossi.

By Nicola Bitossi
A new year begins, and the horizon seems to open up before you. Will you get pregnant in 2019?
Do you have a plan for trying to conceive this year, or do you feel like a passenger on your journey? A sense of loss of control can be one of the most stressful aspects of infertility.
We live in a society where young women and men often feel pressured to do it all – get an education, start a successful career, find a life partner, travel, buy a home. Although most young New Zealanders plan to have children in their future, many delay baby-making until some of these things have been ticked off. This is a product of our society.
The first month or two of trying to conceive without success can come as a shock – especially if you were warned during your teenage years about the ease of 'falling pregnant'.
Infertility is a time-critical medical condition, and managing time, together with limited financial resources, can add pressure to an already stressful situation. Be proactive – seek out solid advice, arm yourself with the support you need and map out your options.

You’ve started trying, but it hasn’t happened yet

• See your GP if you've been trying for more than 12 months (9 months if the woman is over 35, and 6 months if she is over 40)
• Your GP should do initial testing – such as a semen analysis, and blood tests to confirm ovulation
• Don't be afraid to ask questions
• If you meet the criteria, your GP can refer you for a consultation with a specialist. Insist on this if you've been trying for over a year and have no answers from the initial testing. (You can also self-refer for a private fertility specialist consultation at any of the fertility clinics, and although you'd pay for this initial consultation, if you're eligible, you will still then be placed on the waiting list for publicly funded treatment).
• Optimise your chances of conception by improving your lifestyle
• Ensure you know when the fertile window is – this is your most powerful information when trying to get pregnant!

You need help or are undergoing treatment

• If you meet the criteria for publicly funded treatment, get on the waitlist as soon as possible. Even if you think you won't need it, it's best to keep your options open
• Seek out further information on your diagnosis or treatments from your specialist, clinic or Fertility NZ. Not Dr Google!
• Research consistently demonstrates the physiological and emotional benefits of in-person support. Meeting others 'in the same boat' can be incredibly powerful, particularly if you feel isolated by infertility
• A diagnosis of infertility is a life crisis. It may help to acknowledge the size of this challenge (probably one of your biggest in life) in order to deal with it pragmatically. Trying to keep a balance between your infertility and other aspects of your life can help you to feel a little less overwhelmed.
• Ask questions and take notes. Your specialist(s) will be familiar with the treatments, chances of success and options for your particular situation. If you need an additional appointment to explore options, this may well be worthwhile
• Fertility clinic counsellors are experienced at helping people navigate the options and challenges of a fertility journey
• Don't be afraid to ask for a second opinion, or to switch to a different specialist within the clinic
Wherever you are on your fertility journey, ensure that you define the things that are within your control and the factors outside your control.
You may not be able to change your diagnoses, age, or wait time for funded treatment. However, you can optimise your fertility through weight management, nutrition, moderate exercise, minimising testicular heat, and making positive lifestyle choices. For instance, cigarette smoking halves the chance of pregnancy, for both natural conception and treatment such as IVF.
Fact: 85 per cent of New Zealand women cannot identify ovulation, and this is incredibly important information when trying to conceive. If you are a clinic patient, have a clear plan of what your 'next steps' might be and don't be afraid to ask questions. Build the team that you need – medical professionals or clinicians that you trust and the support that's right for you. Involve your partner or support person in the process, options and challenges.
Prioritise self-care and self-compassion – if your emotional tank is topped up, it will help you build resilience and 'hang in there' along your journey. Be as kind to yourself as you'd be to your best friend if they were in your position! You may choose to take long walks, read a great novel, have a weekend away, book regular massages or declare a pyjama day!
Above all, consider what you need to feel in control of your fertility journey. Utilise the people and resources available – build a team and a plan and prioritise self-care.