Fourth Week of Pregnancy

YOU ARE 3 WEEKS AND 1 DAY 
258 days to go...

YOUR BABY TODAY

This is a cross section of the ball of cells embedded in the uterus at this early stage of pregnancy. It contains fluid in the center and two areas of white cells with a darker streak of cells between them—these will form the embryo, now less than 0.5 mm long.

Pregnancy hormones are being produced, but it may be difficult to detect them accurately, so it’s best to wait before you do a test.

You might be eager to do a pregnancy test as you enter the fourth week of your cycle. Most women use over-the-counter home pregnancy tests. These are simple to use and work by detecting the levels of hCG in your urine—this is the hormone that is produced as soon as the embryo implants in the lining of the uterus. 

There are home pregnancy tests that claim to detect a pregnancy six days before your period is due. But if you use one of these and test this early, your hCG levels may not be high enough to give a positive result, even though you might be pregnant.

ASK A... DOCTOR

I’m worried about doing a pregnancy test because I think my partner is going to be disappointed if I’m not pregnant. Feeling pressured to conceive is stressful, and this can affect the hypothalamus the structure in your brain that governs your menstrual cycle. So your partner’s avid interest may actually be counterproductive. 

Be honest with your partner about how you feel. Explain to him that you share his enthusiasm for having a baby, but that you’re feeling pressured, and that you’re worried it will affect your ability to conceive. Conversely, if you aren’t entirely sure that you are ready for a baby, now is the time to discuss this, too. Pregnancy is a life-changing event, and both you and your partner need to be fully committed, and also aware that it can, in itself, be stressful. 

Have fun together and make sure the pressure to conceive doesn’t take the fun and spontaneity out of your lovemaking.

YOUR PREGNANCY DIARY 

Trying to get pregnant is an exciting experience, so why not keep a written record—it’s a good way to pass time in this interim period while you’re waiting to take a pregnancy test. Rather than just noting down the dates of your period and signs of ovulation, use it to record the highs and lows so far. 

Once you’re pregnant, you can continue to use the diary to record your feelings: for example, your emotions when you saw the positive symbol on the pregnancy testing kit; how you broke the news to your partner and his response; what your baby’s first kick felt like; the best and worst aspects of being pregnant. You may also find that letting off steam about your partner’s quirks or your mother-in-law’s idiosyncrasies is surprisingly therapeutic! 

Besides providing a unique record of your pregnancy, keeping a journal can also help you in subsequent pregnancies: for example, you may find it reassuring to look back and find that morning sickness was just a phase. 

YOU ARE 3 WEEKS AND 2 DAYS 
257 days to go... 

YOUR BABY TODAY

In this computer-generated image the entire blastocyst can be seen embedded in the lining of the uterus. The cells that will develop into the embryo are seen as the dark area in the 12 o’clock position.

Adopting a healthy lifestyle and improving your well-being are sensible measures now that you might be pregnant.

THE LOWDOWN

Cultural beliefs 

Here’s what some cultures believe: 

• Hindu fathers part the hair on their partner’s head three times upward from the front to the back to boost the development of the growing baby.
• In some countries, there is great emphasis placed on protecting the unborn baby. In Thailand, the pregnant woman’s abdomen may be painted to ward off evil spirits. It is also believed that giving gifts before the birth will attract evil spirits.

AS A MATTER OF FACT 

There are at least 30 chemicals in cigarette smoke that can adversely affect fertility

Because smoking reduces the rate at which cells replicate, it may cause most damage during the first days and weeks of pregnancy. In addition to causing fertility problems in women, smoking can have negative effects on sperm and reduce testosterone in men.

Once your pregnancy is confirmed in the next week or so, you’ll find you’re bombarded with more health information than ever. Is your diet well balanced? Could you cut back on the amount of salt, sugar, and fast food you eat? Are you eating plenty of fruit and vegetables, particularly leafy green vegetables, which are a good source of folic acid. Are you exercising enough and safely? Even though you don’t know you’re pregnant yet, it’s worth being aware of the recommended advice and making some basic dietary and lifestyle changes. Turn to the section on pages 14–29 for some up-todate information. It’s also worth being aware of the early signs of pregnancy so you know what’s normal. 

If you have a preexisting medical condition or are taking medication, seek medical advice.

FOCUS ON... YOUR HEALTH 

Lifestyle changes 

If you smoke, you should quit (so should your partner) for health reasons. Once you’re pregnant, not smoking will reduce the risk of miscarriage, stillbirth, premature birth, low birth weight, and sudden infant death. 

You should also stop drinking alcohol entirely. The current advice from the US Surgeon General is to avoid drinking alcohol completely while trying to get pregnant and once you are pregnant, since there is no known safe consumption level for pregnant women.

Get gentle exercise, such as walking or swimming, which are ideal before, during, and after pregnancy

YOU ARE 3 WEEKS AND 3 DAYS 
256 days to go...  

YOUR BABY TODAY

The embryo is implanted and is 10 days old. The entry point at which the embryo buried into the lining of the uterus is now covered by a clot, and this prevents blood loss and protects the embryo.

Try to stay busy to distract yourself from constantly wondering whether you’re pregnant, and think positively.

ASK A... DOCTOR 

I did an early pregnancy test and have failed to conceive again, for the sixth month. Could it be because I have irregular periods? Menstrual cycles that vary more than a few days in length from month to month are considered irregular. An irregular cycle can be troublesome when trying to conceive, but being aware of the signs of ovulation can help you determine when you are approaching your short window of fertility. 

Irregular ovulation and menstruation account for around 30–40 percent of fertility problems. Many factors determine how fertile a woman is, such as her age, whether her cervical fluid is wet enough to sustain sperm, or whether her fallopian tubes are open, but the most important factor is whether she ovulates regularly. 

Sometimes, a condition called anovulation occurs, in which there is irregular menstrual bleeding but no ovulation. If you don’t release an egg each month, you won’t have as many chances to conceive. You may be given medication to stimulate egg production and boost ovulation. 

Waiting for your period to start—or better yet, not start—can be quite stressful when you’re trying to conceive. If your menstrual cycle is irregular you may not know when your period is due and therefore may not know if you’re late and potentially pregnant or not. The uncertainty is likely to make you anxious and every time you go to the bathroom you dread seeing that your period has started. 

Whether or not you know you have fertility problems, the wait can be difficult. If you do get your period, the disappointment can be hard. The cycle of having your period, waiting for ovulation, hoping you’re pregnant, and then finding out you’re not can become very wearing month after month. 

If you have been trying to conceive for a year with no luck then you should go to your doctor for tests. Or go at six months if you are over 35 or know that you may have fertility problems, such as blocked fallopian tubes. Try confiding in a good friend about your problems so that you have someone to talk to, but try not to become obsessive and let it dominate all your relationships. 

If you’ve only just started trying, remember there is a only a one in four or five chance that you will conceive each month, so you’re unlikely to get pregnant in the first month of trying

If you’re over 35 and have been trying to conceive for six months, speak to your doctor about fertility tests. You should both be checked because your partner’s sperm will need to be tested too. You will be given blood tests.

AS A MATTER OF FACT 

Around half of pregnancies in the US could be accidental.

According to the US Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System, 49 percent of all US pregnancies, and 31 percent of US pregnancies resulting in a live birth, are unintended. Data collected is from 60 percent of US births in 31 states and one city

YOU ARE 3 WEEKS AND 4 DAYS 

255 days to go... 

YOUR BABY TODAY

To embed itself in the lining of the uterus, the embryo-to-be needs the help of progesterone, secreted after ovulation by the empty egg follicle, the corpus luteum. Progesterone helps the lining thicken.

Do you feel different? You’ll find yourself analyzing every twinge in your body as you look for signs that you’re pregnant.

FOCUS ON... NUTRITION 

Diet ban 

If you were dieting before you conceived, it can be tempting to continue once you find out you’re pregnant. Don’t: diet, your baby may become undernourished and is more likely to be premature and underweight at birth. Do, however, eat a healthy, balanced diet. Don’t eat junk food when you’re pregnant since this can increase the risk of your baby developing weight problems. 

If you are overweight or obese, your doctor may recommend that you gain less weight than other pregnant women. The recommended weight gain for overweight women is 15–25 pounds. And for obese women, the recommended weight gain is at least 15 pounds. (By contrast, normal-weight women should gain 25–35 pounds during pregnancy.) 

In an ideal world, you should lose excess weight before conceiving, because obesity makes you more prone to diabetes and high blood pressure and means you’re more likely to need a cesarean. 

It’s still very early and you’re unlikely to have pregnancy symptoms yet—although you may have some light spotting (see opposite). Some women claim to “feel” pregnant, even before changes to their breasts are noticeable or before they start feeling sick. Some women say that they just “know.” You may be very in tune with your body and may notice that your body is changing even before you are able to take a test. Unfortunately, sometimes our minds can play tricks on us: you may want to be pregnant so much that you can sometimes convince yourself that you’re feeling different. If you don’t feel any different, don’t worry, this is also completely normal. 

Either way the only definitive way to know whether or not you are pregnant is to take a pregnancy test. You don’t need to go to your doctor to confirm your pregnancy since the tests that they use are the same as those bought over the counter. If the test is positive, you’re pregnant! 

ASK A... NUTRITIONIST 

Should I give up coffee in case I’m pregnant? The March of Dimes advises pregnant women or those trying to become pregnant to drink no more than 200 mg of caffeine a day (that’s a 12-ounce cup of coffee). Going without your caffeine fix is a good thing when you’re pregnant, since research shows that, in high doses, it can increase the risk of miscarriage. 

One study discovered that pregnant women who consumed two or more cups of coffee (or a caffeine-rich equivalent) were twice as likely to miscarry as those who gave up caffeine. Before switching to decaff, be aware that decaffeinated drinks may raise cholesterol. The good news is that many women find they naturally stop wanting coffee in early pregnancy 

YOU ARE 3 WEEKS AND 5 DAYS 
254 days to go...

YOUR BABY TODAY 

The first stage of placental development—your baby’s life support system—is shown here. The image shows nuclei (blue) within a continuous network of cells that will become the placental villi. At first the tiny villi are solid; later, they will contain blood vessels.

As the fertilized egg becomes completely embedded in your uterus, it may cause some light bleeding.  

This computer-generated image shows the ball of cells—the blastocyst—as it appears situated within the uterus. The outer ring of interconnected cells that will eventually form the placenta are clearly seen.

The ball of cells, known as the blastocyst, that will form the embryo has now completely embedded within the lining of the uterus and the lining has regenerated over it. 

Unfortunately, in the complex process of conception, only about half of all fertilized eggs progress to become a blastocyst and only about half of these go on to become successfully implanted in the uterus.

 When the blastocyst embeds, there may be some bleeding, known as “spotting.” This often leads to confusion regarding the dating of the pregnancy, not least because it can occur around the time that you would normally start your period. 

The color of the blood can vary. In most cases it is pinkish, although bright red blood (fresh blood) can occur, as can brownish, old blood. As long as it is not profuse, the color really doesn’t matter. If the bleeding lasts for a short period, and you don’t experience discomfort, it’s likely that things are just fine, but do see your doctor for a checkup. 

Around 25 percent of women will experience some bleeding in early pregnancy, but most go on to full term. However, in some cases, bleeding does mean a miscarriage is occurring so always report the fact that you’ve bled to your doctor. 

AS A MATTER OF FACT

It is thought that around 50 percent of pregnancies might miscarry before implantation. 

Up to a third of pregnancies miscarry up to the fifth week and around a quarter will end in miscarriage between the fifth and seventh week. Thankfully, the risk of miscarriage becomes much lower as the weeks go by, decreasing dramatically after the 12th week of pregnancy.

DOUBLING UP

As with many parents, you probably thought long and hard about trying to conceive your second child. There’s no ideal age gap between children, but consider: 

The pros: 

• You are in “baby mode” and will be used to the routine and all aspects of baby care. You will have all the equipment you need from bottles to a carriage and crib. 
• A two-year-old might find it easier to accept his new sibling than a four-year-old who is much more conscious of having the sole attention of his parents. 
• There will always be squabbles, but children close in age tend to play better together. 

The cons: 

• It’s tiring caring for a one- or two-year-old while pregnant. 
• It can put a strain on your body to have pregnancies close together. 
• If you have a second baby before the first one can walk, you could be doing a lot of carrying, increasing the chance of backaches. 
• You won’t have as much time to get to know your first child before your second is on the scene. 

YOU ARE 3 WEEKS AND 6 DAYS 
253 days to go... 

YOUR BABY TODAY

This microscope view of an embedded blastocyst shows the amniotic cavity (semcircular white area at top), with the cells that will develop into the baby just below (dark oval at the 12 o’clock position). The yolk sac is the pink area below.

Complex changes are taking place inside your uterus to create a safe and nourishing environment for your unborn baby

The ball of cells embedded in the uterus is already laying down the foundations for its future life as an embryo. At two layers thick, the germ cells form a flat disk that divides the fluid-filled inner part of the ball of cells into two chambers. 

The smaller of these fluid-filled chambers will become the amniotic sac. The larger chamber, lying closest to the future placenta, will become the yolk sac that supports the You’ll gain weight in the months to come but not necessarily an excessive amount. Try not to become obsessive about weighing yourself. early embryo. The umbilical cord will eventually develop close to the smaller chamber. The inner germ cells have been developing at a slower rate than the rapidly expanding outer cell layers. 

 At first the umbilical cord is a simple stalk, containing no blood vessels but simply anchoring the embryo to the future placenta, which will eventually become your unborn baby’s lifeline.

ASK A... NUTRITIONIST

I’m hoping I’m pregnant, but I’m already worrying about the amount of weight I might put on, and am scared I’ll never be slim again! These days, it is almost impossible to pass a newspaper stand without seeing the latest celebrity who has not only fit right back into her clothes after having her baby, but who actually weighs less than she did before pregnancy. However, this is concerning for health professionals, since a dramatic weight loss after the birth is not good for mother or baby. 

The recommended weight gain during pregnancy is 25–35 lb, if you have a Body Mass Index (BMI) within the normal range. Your baby and her support system will make up a good proportion of this, as will the increased pregnancy fluids, fats, and an enlarged uterus. Much of this extra weight will be lost as soon as your baby is born. Also, after the birth, some of this extra weight provides nutrients for breast-feeding, which uses up to 500 calories a day. 

The most sensible approach to controlling your weight during pregnancy is to eat a healthy diet and get gentle exercise to ensure that weight gain is not too dramatic. You should be aiming to eat around 2,100– 2,500 calories a day, increasing this by 200 calories in the last trimester of pregnancy—the equivalent of a banana and a glass of milk. 

AS A MATTER OF FACT

Newborns are getting heavier.  

This is mostly due to improved diet and living standards. However, obesity in the mother is another factor—if the mother is overweight, there is an increased risk of diabetes, which can increase the baby’s weight.

You’ll gain weight in the months to come but not necessarily an excessive amount. Try not to become obsessive about weighing yourself

 YOU ARE 4 WEEKS EXACTLY 
252 days to go...

YOUR BABY TODAY 

This highly magnetized image shows that the embryo consists of two layers of cells— those of the upper, darker layer are more rectangular in shape and lie on the side of the amniotic cavity, and those on the lower layer lie on the side of the yolk sac.

Are you feeling irritable and tired, and are your breasts tender? Well, you might just be pregnant!

Nature has a strange way of working. You might feel low if you have your usual PMS symptoms and think it means that you haven’t conceived, but in fact, there are many similarities between the symptoms of premenstrual syndrome (PMS) and those of early pregnancy. This is because the hormones that cause PMS are raised in pregnancy and so can cause the same symptoms. In addition to this, you might be irritable and emotional even without having PMS, just due to the anxiety of wanting to be pregnant and waiting to see whether or not your period arrives. 

While you are in the middle of this storm of hormones and raging emotions it can be difficult to remain calm. Talk to your partner about your emotions and anxieties—just expressing that you’re finding things stressful can help you get through this tense time.

Alternatively, confide in a female relative or friend, who might be able to relate to how you’re feeling. 

Frustratingly, at this point it is still a waiting game; all you can do is try to be patient until you take your pregnancy test. If your period was due today—day 28 of your cycle— and hasn’t made an appearance, you can take a test as early as today or tomorrow. Good luck! 

FOCUS ON... YOUR BODY

Start squeezing! 

It’s never too early to start Kegel exercises and you’ll be glad you did once you become pregnant. The pelvic floor is a broad sling of muscles that stretches between your legs and extends from the pubic bone in front to the spine at the rear. It holds and supports your bladder, uterus, and bowel in place and controls the muscles which hold closed the anus, urethra, and vagina. 

Try these simple steps to tone your pelvic floor: 

• First try to locate your pelvic floor: sit on a chair and close your eyes—now visualize the sling of muscles stretching right across your body holding your uterus and bladder. 
• Next contract your pelvic floor muscles pulling inward and upward, hold for a count of five, then release. Repeat this exercise at least 10 times a day. 
• Test: if you’re having trouble identifying the muscles, imagine that you are trying to stop the flow of urine; the muscles you feel contracting are those of the pelvic floor. 

GO to The Fifth Week of Pregnancy from here

Read More

Third Week of Pregnancy

 Your 3rd Week

YOU ARE: 2 WEEKS AND 1 DAY 
265 days to go... 

WHAT’S HAPPENING INSIDE?

 Here the egg is shown surrounded by sperm. Although only one sperm will fertilize the egg, several hundred are thought to be necessary to break down its defensive layers and enable fertilization to take place.

Your newly released egg will only survive 24 hours, but hopefully in that time it will meet sperm and be fertilized.

You are likely to have ovulated and your unfertilized egg now begins its journey. Once it has been released by the ovary, the egg is swept up by one of your fallopian tubes and, moving in the direction of the uterus, comes to rest in the widest portion of the tube, awaiting fertilization. 

It is no exaggeration to say that for each sperm released the chance of even reaching the site of fertilization is in the order of one in a million. Around 300 sperm reach the tube but only one will fertilize the egg. 

Once the sperm has penetrated, it triggers a reaction that makes the surface impenetrable. Each sperm and egg contain 23 chromosomes, half of the total genetic material required. The egg will always contain an X chromosome but the sperm will carry either an X or Y chromosome and therefore determines the sex of the embryo. The sperm and egg chromosomes combine forming the “zygote” and fertilization is complete.

A few hundred sperm survive the journey and encounter the egg in the fallopian tube, but it is just one sperm that actually fertilizes the egg.

FOCUS ON... DADS

Fit but not fertile? 

If you want to become a dad, there are many reasons why you should ensure you’re in good shape, not least to support your partner as she prepares for pregnancy. However, while a couch potato lifestyle isn’t desirable for men who want to conceive, it seems that pulling out all the stops at the gym might not be the best course of action either. 

Researchers asked a group of fit young men to exercise intensively four times a week for two weeks. Afterward, their semen was tested and found to contain fewer sperm and lower levels of the hormones essential for conception. These hormonal changes were temporary and returned to near normal within a few days of the men resuming previous levels of activity. 

The concern is that recovery might not be so fast among older men, or in those who have poor sperm counts and/or low hormone levels. So stay in shape but don’t overdo it

AS A MATTER OF FACT 

The hormones responsible for the production of sperm are released every 60 to 90 minutes. So a man is constantly producing sperm cells

In theory, this means that a male is always fertile, but it takes sperm a 72-day period to fully develop. So leading an unhealthy lifestyle during that time will impinge on the quality. For this reason, if you’re trying to conceive, your partner should embark on a healthy lifestyle for three months to produce good sperm.

Genes and inheritance  

The genes that parents pass on to their children at least partly determine their children’s physical and mental characteristics. In some cases, an abnormal gene may be passed on, resulting in an inherited genetic disorder.

HOW GENES ARE PASSED ON

Through the generations 

Through each generation, genes are shuffled and re-shuffled. Half of a baby's genes come from its father and half from its mother. The baby's parents in turn inherited half each of their genes from each of their own parents. One quarter of each person's genes therefore come from the grandparents. So how does this happen? 

Instead of containing the full complement of 46 chromosomes, each egg and each sperm has just half, or 23, chromosomes each. When they meet at conception the chromosomes pair up to again make up the full complement that now forms the genetic blueprint for the new individual. One of the 23 pairs of chromosomes are sex chromosomes, so gender is also determined at conception. 

Each egg carries an X chromosome and each sperm either an X or Y. If two X chromosomes combine, the baby will be a girl; if an X and Y chromosome combine, the baby will be a boy (see right).

Genetic inheritance means that successive generations can share certain characteristics. 

 What are genes?

Genes are located on rodlike structures called chromosomes that are found in the nucleus of every cell in the body. Each gene occupies a specific position on a chromosome. Because genes provide instructions for making proteins, and proteins determine the structure and function of each cell in the body, it follows that genes are responsible for all the characteristics you inherit. 

The full genetic instructions for each person, known as the human genome, is carried by 23 pairs of chromosomes, and consists of around 20,000–25,000 genes.

How inheritance works 

At conception, the embryo receives 23 chromosomes from the mother’s egg and 23 chromosomes from the father’s sperm. These pair up to make a total of 46 chromosomes. Pairs 1 to 22 are identical or nearly identical; the 23rd pair consist of the sex chromosomes, which are either X or Y. 

Each egg and sperm contains a different combination of genes. This is because when egg and sperm cells form, chromosomes join together and randomly exchange genes between each other before the cell divides. This means that, with the exception of identical twins, each person has unique characteristics

How gender is determined Of the 23 pairs of chromosomes that are inherited, one pair determines gender. This pair is composed either of two X (female) chromosomes, in which case the baby will be a girl, or of one X and one Y (male ) chromosome, in which case the baby will be a boy.

An egg always contains one X chromosome, while a sperm can carry an X or a Y chromosome. Whether your baby is a boy or a girl will therefore always be determined by the father. If a sperm carrying an X chromosome fertilizes the egg, the resulting embryo will be a girl. 

If a sperm with a Y chromosome fertilizes the egg, the resulting embryo will be a boy. In the male, both the X and Y chromosomes are active. In females, however one of the two X chromosomes is deactivated early in development of the embryo in order to prevent duplicate instructions. This could be the X chromosome from either the mother or the father.

Gene variations Each gene within a cell exists in two versions, one inherited from each parent. Often these genes are identical. However, some paired genes occur in slightly different versions, called alleles. There may be two to several hundred alleles of a gene, although each person can only have two. This variation in alleles accounts for the differences between individuals, such as color of eyes or shape of ears. One allele may be dominant and “overpower” the other recessive one (see box, right).

Why genetic disorders occur 

Genes usually exist in a healthy form, but somtimes a gene is faulty. Genetic disorders arise either when an abnormal gene is inherited or when a gene changes, or mutates. Genetic disorders may follow a dominant or recessive pattern of inheritance (see right). They can also be passed on via the X chromosome. 

Such sex-linked disorders are usually recessive, which means that a woman can carry the faulty gene without being affected, because she has another healthy X chromosome to compensate. If a boy receives an affected X chromosome, he will be affected; a girl will be a healthy carrier like her mother. An affected male could pass on the affected gene only to his daughters. 

YOU ARE 2 WEEKS AND 2 DAYS
264 days to go... 

WHAT’S HAPPENING INSIDE ?

Here a human egg cell 24 hours after fertilization is artificially colored purple. Around the egg is a thick layer (yellow) that has now become impenetrable. The two red areas, or pro-nuclei, contain genetic material from the mother and father before it has fused.

When your egg has been fertilized, hormonal changes naturally occur to stop your normal menstrual cycle.

At this early stage following fertilization of your egg, the developing embryo will signal its existence to the pituitary gland in your brain and switch off your menstrual cycle. It does this by producing a new hormone, called human chorionic gonadotrophin (hCG). This hormone overrides your usual monthly cycle and maintains the high progesterone levels that are essential for your pregnancy. The hormone progesterone is essential to an embryo’s survival in the uterus, and therefore to your baby’s well-being and development before birth. 

Later, starting around weeks four to five, your embryo will make all the hormones needed to maintain its own life. Of course its nourishment and shelter come from you, but even in the very early weeks of pregnancy the embryo behaves like an independent human, at least as far as its hormones and genes are concerned.

ASK A... DOCTOR 

I’ve been doing ovulation tests, but they’ve all been negative. Does this mean I haven’t ovulated this month? Even if you don’t appear to have ovulated this month, you may still have. It’s possible to miss the LH surge just by chance. This is more likely if you don’t test at the same time each day, or you drink a lot of water. 

Remember too that ovulation tests are imperfect, and it’s possible to get a false negative. If you had other symptoms of ovulation, such as pain, or changes in your mucus, it’s likely that you ovulated anyway. However if you have gone two or three months with consistently negative tests, then you might not be ovulating regularly. In that case, it’s worth seeking medical advice.

HEALTHY CONCEPTION 

When you’re trying to conceive, you’ll find you are much more aware of your general health. As a rule, colds, flu, and other common infections are unlikely to affect your fertility or your unborn baby if you have conceived. Some infections and viruses, however, can have a more serious impact: 

• Shingles and chickenpox (both caused by the same virus) are best avoided around the time of conception if you haven’t had chickenpox before. 

• Food poisoning, for example caused by listeria bacteria, can be harmful. 

• Toxoplasmosis can be contracted from handling cat feces.

AS A MATTER OF FACT

Too much testosterone can affect a woman’s fertility.

Small quantities of testosterone are secreted from the adrenal gland and the ovaries. In low levels it may aid fertility, but too much can affect the menstrual cycle and lead to infertility

 YOU ARE 2 WEEKS AND 3 DAYS 
263 days to go...

WHAT’S HAPPENING INSIDE? 

When the two nuclei have pooled their genetic material to create a cell containing its full complement of 46 chromosomes—23 each from the mother and father—the cell can start dividing, shown here at the first division creating a two-celled body

Vital cell divisions are now taking place as the fertilized egg begins its journey toward implantation.

The chromosomes from the sperm and egg joined over 24 hours ago. It takes around 30 hours for the resulting zygote to complete its first cell division. The zygote, at only 0.1 mm in diameter goes on to divide into 16 cells, forming a compact ball. 

Cell division is such that the ball of cells is hardly any larger than the  original zygote. The ball of 16 cells, now known as a “morula” (as it resembles a mulberry), travels toward the uterus, entering on day three after fertilization. Every cell within the morula is totipotent, meaning it is able to form any type of cell. From this point onward the cells will lose this function as they start to specialize.

FOCUS ON... IVF 

From eggs to embryos

Egg collection will be scheduled (see right), following the first stage of IVF. Not all follicles that were stimulated will contain eggs. Two days after egg retrieval, you will be given progesterone to thicken the uterus lining. Two to five days after fertilization, the most promising embryos are chosen to be transferred. If you’re under 40, you’ll have one or two embryos transferred. 

If you’re over 40, you may have up to three or more transferred. The goal is to achieve a pregnancy, yet limit the risks of a multiple pregnancy. Any leftover embryos can be frozen for future treatment cycles. Recent research suggests that frozen embryos are better than fresh ones—this may be because only the best embryos are selected for freezing and survive the freezing and thawing process. 

The outcome of IVF depends to a great extent on the woman’s age, but on average each cycle has a 20 percent success rate.

ASK A... DOCTOR 

I’ve been doing ovulation tests. I’ve now ovulated so do my partner and I need to keep having sex to make sure I conceive? You can’t be sure that you’ve conceived already, so the usual advice would be to continue lovemaking. Even if you’ve been tracking your ovulation by monitoring your temperature or cervical mucus, or by using an ovulation kit, you can’t be sure exactly when it occurred. It won’t be possible for you to pinpoint the exact time of ovulation. 

Since the fertile window is several days, you may as well continue having sex for at least a couple of days after what you think is your most fertile time. 

Furthermore, since sex says “I love you” more strongly than most other means of communication, it’s good for both you and your partner to stay intimate at times you’re not trying to conceive. 

Remember also that abstention doesn’t usually have the hopedfor effect of banking up and improving the quantity and quality of sperm. In fact, the opposite may happen.

 YOU ARE 2 WEEKS AND 4 DAYS 
262 days to go...

WHAT’S HAPPENING INSIDE? 

This is an embryo at the 16-cell stage, when it has changed from a zygote into a morula. It is in the process of dividing into a hollow ball of cells—the blastocyst—which will eventually implant in the lining of the uterus.

Significant changes are taking place daily within your uterus and within just 72 hours from now, the fertilized egg will implant.

Around four days following fertilization, fluid begins to collect within the morula. This creates a separate outer cell layer, one cell thick that encapsulates an inner mass of cells. The inner layer will become the embryo, and the outer layer the placenta. The whole structure now consists of approximately 58 cells and is termed the “blastocyst.” 

The blastocyst spends several days within the cavity of the uterus before implanting. The morula had an impenetrable outer surface as it traveled, but this disappears as the blastocyst prepares for implantation.

ASK A... MOM 

Why are people so interested in whether I’ve conceived? I certainly found that once I’d told people I was trying to have a baby, they were inordinately interested in the process. It was difficult, especially in the week when I was waiting to find out if I’d conceived. The best way to deal with it is to respond by saying that you’ll let people know if there’s news. If you’re struggling to conceive, telling people you’re having difficulties should help stop them from asking.

FOCUS ON... HEALTH 

Fertility: the alternative approach 

If you’re having difficulty conceiving, or just want to improve your chances, consider using a complementary therapy. Always inform the practitioner that you might be pregnant

Reflexology works by manipulating pressure points in the feet to improve energy flow to specific parts of the body. While there is plenty of anecdotal evidence that reflexology helps conception, this isn’t currently backed up by scientific research. However, it may help relieve stress, which can be a factor in couples who have problems conceiving. 

Acupuncture works on the principle that problems such as infertility are caused by blockages in the body’s energy flow or “qi.” By inserting tiny needles into energy points that are linked to the reproductive organs, the flow is restored. In 2008, after reviewing seven studies of more than 1,300 women having fertility treatment, researchers concluded that acupuncture given around the time of embryo transfer increases the chances of pregnancy. 

It’s not as clear whether acupuncture can improve fertility in couples not undergoing treatment, but it is thought to improve male fertility by improving sperm health and reducing stress, a factor that can impede the chances of conception. 

YOU ARE 2 WEEKS AND 5 DAYS 
261 days to go...

WHAT’S HAPPENING INSIDE?

This is an embryo at the blastocyst stage, five days after fertilization. It is seen hatching from the shell that originally surrounded the unfertilized egg. At this stage, the blastocyst has moved into the uterus and is preparing to implant.

While playing the waiting game, you may want to consider how you’d feel if there are two fertilized embryos waiting to implant!

Have you conceived, and might it be twins? Twins can be nonidentical or identical and each type of twins is conceived differently. 

Nonidentical (dizygotic) twins are the result of two separate eggs being fertilized by separate sperm. They may also occur as a result of IVF if two embryos are placed in the uterus. 

Identical (monozygotic) twins occur when a single egg is fertilized by a single sperm and divides into two embryos. This split can occur at any stage up to nine days after fertilization and its timing is critical to the way the placenta(s) and amniotic sac(s) are formed. If the zygote splits within the first three days, two separate placentas and amniotic sacs develop. If the split occurs at blastocyst stage (see opposite), four to nine days after fertilization, the fetuses will share a placenta but have separate sacs; when the split occurs after day nine, the fetuses will share a placenta and a sac. 

Having nonidentical (fraternal) twins, which come from two separate fertilized eggs, depends a lot on family history. It’s often said that twins skip a generation, which isn’t quite true. In fact, your chances of having twins are simply higher if you have a close relative with twins, but twins never become inevitable, however many members of your family have them. 

Family history is most relevant with nonidentical twins, and when the twins are on the mother’s side. This makes sense because this kind of twin relies on a woman releasing two eggs in any one cycle, which may be hereditary. However, for reasons that aren’t clear, a family history of twins on the father’s side can be important too. It may be that the male of the species can carry a gene which makes his daughter release more than one egg at a time when she ovulates.

The lining of the uterus, when fertilization occurs, becomes secretory to nourish an embryo. The lining prepares itself in the same way, no matter how many embryos implant. 

THE LOST TWIN 

Twin conceptions may be more common than they appear. Without knowing it, some women miscarry one twin in early pregnancy. It is sometimes possible to have symptoms of a miscarriage, yet, confusingly, the pregnancy then appears to continue until term, culminating in the birth of a completely normal singleton baby. 

Nobody is quite sure how often this happens, or why. While one in every 31 births in the US today is a twin birth, research using scans in very early pregnancy suggests that at conception the figure is much higher. Some experts believe that 15 percent of all births may start off as twins. Their loss could simply be nature’s way of dealing with imperfections. 

AS A MATTER OF FACT 

The odds of having identical twins are about 3.5 in 1000.

Some estimate that the chances of having twins after fertility-enhancing treatment is as high as 1 in 38.

YOU ARE 2 WEEKS AND 6 DAYS 
260 days to go...

WHAT’S HAPPENING INSIDE?

The blastocyst prepares to embed itself in the lining of the uterus—the endometrium. Once it is completely implanted—usually around seven days after fertilization— the pregnancy wlll become established.

Your reproductive organs undergo complex processes that will enable your body to maintain the pregnancy.  

 If you have conceived, the ball of cells known as the blastocyst that ` will eventually form the fetus will now be preparing to embed in the lining of your uterus, and the placenta will be starting to form.

 Before this happens, however, there is another important change going on. After you ovulate, the empty ovarian follicle develops into a structure called the corpus luteum (which means, literally, “yellow body”). This small, fluid-filled sac becomes increasingly “vascular,” developing blood vessels and beginning to produce the hormone progesterone. This is required to create mucus to allow your fertilized egg to survive, and build up the lining of your uterus, in which the blastocyst will soon imbed (see opposite). 

The corpus luteum also produces a little estrogen. By about 8–12 weeks of pregnancy, your placenta will take over the production of progesterone, but the corpus luteum continues to play a small role in hormone production until about six months, when it usually shrinks away.

THE MIRACLE OF CONCEPTION 

When you consider the multitude of events that have to fall neatly into place before a baby is conceived, it’s hard to believe that anyone can become pregnant. No wonder they talk about the miracle of life! 

To become pregnant the following have to happen: 

• Your hormone balance must be correct for the egg to develop. 
• Ovulation must take place: if you don’t release an egg, there is no way for fertilization to occur. 
• You need to have sex at the right time in your menstrual cycle; sperm can last about three days in healthy cervical mucus, but if your timing is off, egg and sperm are unlikely to meet. In some cases there may be only two or three days each month when you can conceive. 
• Your partner needs to produce plenty of good, healthy sperm that can penetrate your cervical mucus to reach the egg. 
• When the egg has been fertilized, the blastocyst has to implant securely in the lining of the uterus.
• The right levels of the hormone progesterone must be produced by the corpus luteum to maintain the pregnancy.

ASK A... DOCTOR

Should I stop taking medication in case I’ve conceived? Many medicines are safe to take, but some are not, or have not been fully evaluated. This last group includes many antihistamines for allergies, over-the-counter sleeping pills, and many analgesics. 

If you’ve accidentally taken an over-the-counter remedy that’s not considered appropriate for use in pregnancy, you’re unlikely to have done any harm with just one dose. However, seek medical advice if you’re concerned. 

If you need to continue using a medicine in pregnancy, ask if it’s safe to do so. While pharmacists are well-informed on all medicines, your doctor is the best person to consult on prescription-only drugs. 

YOU ARE 3 WEEKS EXACTLY 
259 days to go...

WHAT’S HAPPENING INSIDE? 

The blastocyst is firmly embedded in the lining of the uterus. Once this has happened, the placenta (the temporary organ that supplies the growing embryo with oxygen and nutrients) will begin to develop.

It’s a week since the egg was fertilized and it now implants in your uterus, where it will soon develop into an embryo.

Around seven days after fertilization, the blastocyst implants in the lining of the uterus. The outer cell layer, no longer protected, is able to attach to the lining of the uterus. The lining is now more receptive and has undergone changes that make it more “sticky” to aid attachment. The blastocyst erodes cells to sink beneath the surface. 

What was originally a single outer layer of cells now transforms into two layers. The outermost layer of cells creates space by eroding the lining, and it secretes hormones. These hormones inform your body that you’re pregnant and stimulate the uterus to support the pregnancy rather than shed its lining in what would normally be your period. The innermost cell layer will become the placenta and the amniotic sac that encloses the embryo. Within the blastocyst there is an inner cell mass that will form the embryo. 

STRETCH AND UNWIND 

It can help to relax in this interim period, before you do a pregnancy test. Fill some time by getting in shape with these simple stretches. Getting into the habit of doing these exercises now will help your body deal with the increased demands once you know you’re pregnant. Stretch before and after exercising to prevent muscle strain.

 

 

GO to The Fourth Week of Pregnancy from here

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Second Week of Pregnancy

 

Your 2nd week

THIS IS DAY 8 OF YOUR MENSTRUAL CYCLE 
272 days to go...

WHAT’S HAPPENING INSIDE ?

Here, three developing ovarian follicles can be seen in white. The inner circle of each is the egg. Of the follicles shown, it is likely that only one will fully mature at ovulation (see p.49) and release an egg.

By the end of this week you’re likely to have ovulated. It’s a good idea to know the signs that indicate you’re at your most fertile.

This is week two of your cycle. You will probably ovulateby the end of this week and will therefore be fertile. However, the fertile window can be from 5 days before ovulation to 12–24 hours after as sperm can survive for 5 days inside you. If your periods are regular, ovulation can be easier to track, but you may want to use other methods, such as looking out for natural signs (see box, right) or using an ovulation kit. Remember, however, the best way to conceive is to have sex regularly. 

While they are useful, testing kits are expensive and can be counterproductive because they make sex more clinical and less enjoyable. They work by testing the urine to detect a surge in LH, the hormone that triggers egg release. 

Always follow the instructions given. Testing between 10 am and 8 pm should be fine, but try to aim for roughly the same time every day. After a positive test, you should ovulate 12–36 hours later. Results are about 99 percent accurate but occasionally the result is a false positive. Results can occasionally give a false negative, especially if you’ve drunk a lot of water. If your test was negative, do another one the next day. Once you have a positive result, you can stop testing for that month. 

ARE YOU OVULATING? 

This week, look out for: 

• Lower abdominal pain at ovulation, called mittelschmerz (the German for “pain in the middle”). 
• Basal body temperature (your temperature when you first wake in the morning) rising slightly. 
• Cervical mucus—the cervix produces secretions, which become wetter, clearer in color, and stretchy, resembling raw egg white, just before ovulation. This indicates the start of your fertile phase. 

THIS IS DAY 9 OF YOUR MENSTRUAL CYCLE 

271 days to go... 

WHAT’S HAPPENING INSIDE?

In your partner’s body, sperm is constantly being produced. Here the sperm cells can be seen: they consist of a head (green), which contains the genetic material, and fertilizes the egg, and a tail (blue), which propels the sperm along.

While you wait to ovulate, fascinating changes are occurring in your ovaries as your follicles mature to release an egg.

In the time leading up to ovulation, which will happen later this week, the most advanced follicle moves to the surface of the ovary, ready to release its precious cargo. While you were having your period, around 15–20 follicles were developing in your ovaries. 

Both of your ovaries contribute to follicle growth, but usually only one ovary brings a follicle to ovulation. Which ovary it is seems to depend on chance since ovaries are not on a strict rotation. As the follicles grow, they enlarge greatly, filling with fluid secreted inside the follicle. Some women release more than one egg some months and if both are fertilized, it will mean nonidentical twins are conceived. 

By the time of ovulation, the follicle will be about 1 in (2 cm) in diameter, while the egg is just about visible without a microscope. 

To mature, follicles need FSH (folliclestimulating hormone) produced by the brain’s pituitary gland, but their early growth doesn’t appear to rely on it. It may, however, depend on other hormones and chemicals.

FOCUS ON... DADS

Dads: your diet counts too 

It’s never too late to start eating well if you want to become a dad. But because sperm take some weeks to mature, ideally start eating a healthy diet at least three months before conception. There are supplements, but most vitamins and minerals work better in the form of real food. 

• Antioxidants A diet rich in antioxidants, including vitamins A, C, and E, selenium, and zinc, helps prevent damage to sperm DNA. 

• Selenium may also help sperm penetrate the outer layer of the egg. Eat tuna, wheatgerm, whole grains, and sesame seeds. 

• Zinc is present in large amounts in semen. Eat fish, lean meat, shellfish, turkey, chicken, eggs, whole grains, rye, and oats. 

• Manganese is another element that could help male fertility. Eat leafy vegetables (including broccoli) carrots, eggs, whole grains, and ginger. 

• Essential fatty acids may improve sperm motility. Eat oily fish, such as mackerel, salmon, and sardines, flaxseed and linseed, and kiwi fruit. 

SPECIALIZED MEDICAL ADVICE 

If you have any ongoing medical problems, go to see your doctor before you start trying to conceive. Conditions such as diabetes, asthma, high blood pressure, heart trouble, a previous bout of deep vein thrombosis (DVT), thyroid conditions, sickle-cell disease, and epilepsy can all impact a pregnancy. 

The effect will depend on the individual condition and a specialist’s advice and care will be needed. If you’re in any doubt about how your own medical history may affect a pregnancy, check with your doctor before you start trying to conceive 

THIS IS DAY 10 OF YOUR MENSTRUAL CYCLE 
270 days to go...

WHAT’S HAPPENING INSIDE ?

As ovulation approaches, more cervical mucus is produced. Here it has crystallized to form a “fern leaf” pattern. Around the time of ovulation the mucus becomes clear, slippery, and stretchy, which makes it easier for sperm to swim through.

You may not care whether you have a boy or a girl, but according to some theories you can influence gender.

Conceiving is all about having sex at the right time this week, but if you’re hoping to have a child of a specific gender, the timing could be even more important. Some experts claim there is a link between when you have sex and the baby’s gender (see below). 

Recent research suggests that women who have a high calorie intake (especially if they eat that most phallic of fruit, the banana) are marginally more likely to bear a boy. Those who skip breakfast or have a low calorie intake are more likely to have a girl. One reason for this is thought to be that the extra calories consumed affect vaginal secretions and help to give the Y sperm that makes baby boys a vital boost.

 AS A MATTER OF FACT

If you already have two same-sex children, you’re 75 percent more likely to conceive a child of that sex again.

Although the sex of the baby conceived is random, conceiving children of the same sex could be due to the fact that some men produce better quality X sperm, which makes baby girls, or Y sperm, which makes baby boys. 

Statistically, couples who have two children of different sexes are less likely to try for a third child

MAKING BABIES... BOYS AND GIRLS

The Shettles method, devised by Dr. Landrum Shettles, is based on the fact that Y sperm (for boys) are smaller, faster, and less resilient than X sperm (for girls), and are less able to withstand an acidic environment in the vagina

To conceive a boy, the Shettles method advises: 

• Timing sex as close to ovulation as possible and adopting positions such as rear-entry that promote deep penetration. 

• The woman should orgasm, ideally at the same time as the man to make the vagina less acidic and favor Y sperm. 

• Drinking a cup or two or strong coffee just before sex to give Y-sperm an added kick.

The Whelan method, devised by Dr. Elizabeth Whelan, suggests that having sex earlier on in the cycle, some four to six days before ovulation, is more likely to result in a boy. Sex nearer the time of ovulation is more likely to result in a girl. Curiously, the Whelan way is more or less the opposite of the advice given by Shettles.

But what works? The mainstream medical view, supported by reports in journals such as the New England Journal of Medicine, is that the timing of sex has little or no bearing on gender. The possible exception is that having sex two days before ovulation may be slightly more likely to favor a girl.

 

THIS IS DAY 11 OF YOUR MENSTRUAL CYCLE 
269 days to go...

WHAT’S HAPPENING INSIDE?

The lining of the fallopian tube, seen here, has a moist mucous membrane. This contains cells (brown) that protect the tube’s surface. The hairlike cilia (blue) move the eggs along the tubes following ovulation.

If this isn’t the first month you’ve been trying to conceive, don’t be too disappointed. It’s normal for it to take some time.

Have you been trying for a baby for some time? It’s hard to face the fact that we don’t always conceive when we want to. This lack of success may be difficult to handle, especially if you’re someone who has achieved in other areas of your life. 

With reproduction, there’s a large element of chance. Even for young women at their peak of fertility, the odds of conceiving in any one cycle are 50–50. It’s not unusual to try for six months, or even 12 months, without success. Around 16 percent of couples take over a year to achieve a pregnancy. So plan for conception over a longer time frame, say 12 months, unless you have any specific reasons to be concerned about your fertility or your health in general. 

The main exception is if you are over 30. In this case, see your doctor after trying for about six months. The first step is likely to be a blood test for you, and a semen analysis for your partner. However, be reassured that if you are over 30, you may still get pregnant in the old-fashioned way. The average time taken for a 39-year-old woman to conceive is 15 months. But the snag is that if you do end up needing assisted fertility techniques, it all takes time. 

ASK A... NUTRITIONIST 

I’ve heard that green tea will help me conceive. Is this true? So far, studies on green tea and fertility aren’t conclusive one way or the other. Overall, it’s likely to benefit your health without affecting your fertility. However, although green tea has a host of health benefits, it contains small amounts of caffeine and tannic acid, both of which have (at least in large quantities) been linked to fertility problems and an increased risk of miscarriage. 

STOPPING CONTRACEPTION 

You can get pregnant as soon as you stop using some contraception. 

• IUD (coil): you can get pregnant if you have sex in the week before it’s removed since sperm can live 3–5 days. 
• Pill: assume you’re fertile immediately. Some women seem to be extra fertile after stopping the Pill. 
• Implants: fertility can return immediately after removal of the implant, but some women find it takes longer. Occasionally periods can take three to nine months to become regular. This suggests that the effects of the hormone are still lingering, but you may still conceive. 
• Injections: irregular bleeding can continue for months, and you may not be able to conceive for several months either. However, as with implants, it’s possible to get pregnant before your periods return properly. 
• IUD or IUS: you could get pregnant if you have sex in the week before removal of the IUS system, but because the system contains progesterone, conception is less likely than with a regular coil (see left). 

THIS IS DAY 12 OF YOUR MENSTRUAL CYCLE 
268 days to go...

WHAT’S HAPPENING INSIDE?

 This mature ovarian follicle contains a fluid-filled cavity (pale pink) known as the follicular antrum. At this stage, just prior to ovulation, one follicle has become much larger than the others, and it is this follicle that will rupture to release an egg.

As your hormone level rises around this stage of your cycle, so might your libido—it seems nature takes care of everything!

Estrogen levels are rising and reach their peak today, based on a 28-day menstrual cycle. The rise in estrogen from the follicles is what stimulates the release of the LH hormone, which surges about 24 hours before ovulation. FSH from the pituitary gland starts rising later this week. Progesterone levels are low. There’s no call for this hormone until the uterus lining needs to thicken. In fact, high levels would make the cervix hostile to sperm, so they would have trouble getting through to the uterus and the fallopian tubes to fertilize the egg. 

Women also produce the male hormone testosterone and this reaches a peak around ovulation. This hormone is responsible for libido in both sexes so, hopefully, you and your partner should find you’re both in the mood for making babies at this time.

ASK A... DOCTOR

I had a miscarriage four weeks ago. Is it safe to try for another baby right away? There is no exact advice on when you should try again following a miscarriage. As a general guide, wait until you’ve had one menstrual period. This will help to date the pregnancy should you conceive quickly. However, your doctor may advise otherwise, especially if your miscarriage was linked with an infection. If you are waiting for tests because you miscarried, it makes sense to have these first. 

You and your partner may need time to grieve for the lost pregnancy, so it is unwise to rush into trying to conceive again. Be reassured that the vast majority of women who had a single miscarriage go on to have a baby

AS A MATTER OF FACT 

Being stressed can affect your ability to conceive.

Perhaps it’s no surprise that nature makes it more difficult to conceive in stressful circumstances. One reason might be that it reduces the ovary’s response to the hormone surge at mid-cycle (see left). There is also a link between stress and the failure of fertility treatments, although the exact reason for this isn’t known.

It’s a good idea to talk about and work through your grief together before trying to get pregnant again. Miscarrying can be extremely tough and may put a strain on your relationship

THIS IS DAY 13 OF YOUR MENSTRUAL CYCLE 
267 days to go...

WHAT’S HAPPENING INSIDE ?

The sperm cell can be seen here inside the fallopian tube. Since sperm can stay active and alive inside you for up to 72 hours, it’s possible to get pregnant even if you don’t ovulate for two to three days from now

This is an optimum time to conceive, but try not to think too much about when you might be ovulating and just enjoy sex! 

AS A MATTER OF FACT 

Having an orgasm could boost your chances of conception. 

One theory is that the female orgasm is an evolutionary device designed to convey semen into the cervix as the uterus contracts. If the woman climaxes up to a minute before her partner, or she doesn’t orgasm, she will retain less semen than if she comes at the same time or after him.

Use the time around ovulation to put some excitement and spontaneity back into your sex life. With all the recommendations and restrictions, not to mention old wives’ tales, that supposedly maximize conception rates, it’s easy to forget that sex is meant to be enjoyable. 

If you’re hell bent on conceiving, then the fun can get forgotten. You might want to try different positions, times, or places for sex. If you and your partner aren’t usually that adventurous, this is a good opportunity to try varying things a little. Try to have sex every 24–48 hours. 

If your partner ejaculates regularly, it will encourage the production of quality sperm. The benefits of abstaining have been greatly overstated in the past. 

It is true that not having sex for up to seven days can boost the number of sperm, but research now shows that abstinence can impair the motility (swimming ability) of sperm, especially if the sperm were already borderline. The longer the period of abstinence, the more marked the effect will be. 

So have fun and if you conceive that’s a bonus!

It may improve your chances of conception if you lie down for 15–20 minutes after having sex. Lying with your legs in the air will aid gravity further. 

SEXUAL POSITIONS 

It seems that how you have sex can help conception. Positions that maximize penetration, such as rear entry, may work best since sperm is then deposited as close to the cervix as possible—languishing too long in vaginal secretions can lead to a sperm’s early death. If the man is on top, the woman could try placing a pillow under her buttocks to raise her pelvis and aid the movement of sperm toward the cervix. Woman-on-top positions may lead to leakage of sperm. Avoid using lubricants because they can adversely affect sperm.

THIS IS DAY 14 OF YOUR MENSTRUAL CYCLE 
266 days to go...

WHAT’S HAPPENING INSIDE ?

The ovary can can be seen here at the end of the fallopian tube. At around this time of the menstrual cycle, a follicle at the surface of the ovary releases an egg, which is swept down the tube by clearly visible fingerlike projections called fimbriae.

You’re highly likely to ovulate today, if you haven’t already, and if egg meets sperm you may soon be pregnant.

Typically ovulation occurs around day 14 but it can occur earlier or later. Ovulation is when an egg is released from your ovaries (sometimes two eggs are released—see box, below). LH rises thanks to estrogen output from the growing follicles, and it is this rise that triggers the events that now take place in the follicle. 

LH makes the egg inside the follicle become fully mature, ready for release and fertilization. This is the point at which the egg reduces its number of chromosomes from 46 to 23. The follicle is rich with fluid by now. Just before ovulation, it is some 1 in (2 cm) or more in diameter. In position, it lies just below the surface of the ovary. If you could see the follicle, it would look like a blister about to burst. 

Next the follicle produces enzymes that digest its outer layer, releasing the egg on to the surface of the ovary. Once the egg is released from the follicle, it’s soon swept into the nearest fallopian tube by the fingerlike projections that form the end of the tube, where it will hopefully be fertilized.

At ovulation, the follicle ruptures and the egg breaks through the surface of the ovary. Sometimes two follicles mature to this point, both releasing an egg.

AS A MATTER OF FACT 

If you’ve had nonidentical twins already, your chance of having another set quadruples. 

Nonidentical twins occur when more than one follicle ripens completely and the two eggs released at ovulation are both fertilized. The increased chance of having another set of twins is because most women who conceive nonidentical twins (without fertility drugs) showa pattern of releasing more than one egg per cycle. Your chance of having a second set of twins is about 1 in 3000.

 FOCUS ON... RELATIONSHIPS

Pressure to conceive

If you’re trying to conceive, you may have little else on your mind and this can put a strain on your relationship. With the goal of pregnancy in mind, it’s easy to become clinical about sex. At this point, you and your partner may be regarding each other not so much as sex objects, but as components of a baby-making machine. Enjoyment can so easily get lost. 

Understandably, you may find that your partner becomes aggrieved if he feels pressure to provide sperm; the distress may have an adverse effect on a man’s willingness and even ability to have sex. If this happens, it can lead to a downward spiral, which naturally makes conception less likely, and may cause discord. 

Make an effort to be loving and work together rather than against each other. Consider taking a break; couples often conceive when they’re away on vacation and more relaxed. Make sure you also enjoy some stress-free sex outside of your fertile window. 

Conception

Pregnancy begins with conception, a complex process that involves the release of one or more eggs from the ovary, successful fertilization by a sperm in a fallopian tube, and implantation in the lining of the uterus.

The release of an egg 

Each woman is born with her full quota of follicles that contain immature eggs, some of which will mature and be released in her lifetime. Every month, follicle stimulating hormone (FSH), released from the pituitary gland, encourages a number of the follicles to ripen. These follicles in turn produce the hormone estrogen, rising levels of which encourage the uterus to thicken to prepare for the implantation of a fertilized egg. As the eggs mature, the level of estrogen rises and the pituitary gland receives a message to produce luteinizing hormone (LH). Every month, this surge in LH triggers one follicle (and sometimes more than one) to release a mature egg—the moment of ovulation. 

Once the egg leaves the ovary, it enters the fallopian tube, which lies close by, and starts to travel through the tube to the uterus. The fallopian tube is just 4 in (10 cm) long and its lining has many tiny fronds that literally brush the egg in the direction of the uterus. Even so, the journey takes five days or more. In the course of this voyage, the fertilization of the egg takes place. 

The journey of the sperm During sex, the man releases an abundance of sperm—around 250 million at each ejaculation—into the vagina. Each sperm has a long tail to propel it, so it’s well equipped to swim up to the fallopian tube, where fertilization of the egg takes place. 

The whole distance, from the vagina through the uterus and up into the fallopian tube can be accomplished in hours. However, the sperm can survive in the vagina and the uterus for 3–5 days, meaning there is a window of around 6 days in which fertilization can take place (an egg lives 12–24 hours after ovulation). 

Not all of the millions of sperm make it as far as the fallopian tube; in fact, most of them die, seep out of the vagina, or get lost along the way. Around just 200 sperm, only a tiny fraction of the number originally released, arrive at the site of the egg. 

 

The moment of fertilization 

Although many sperm cluster around the egg and try to penetrate its outer layer, only one of them will manage to burrow its way through the surface and fertilize the egg. Once this happens, the egg’s outer layer thickens quickly to keep out other competing sperm, so that each egg can be fertilized by only one sperm. . 

Implantation in the uterus 

By the time the fertilized egg reaches the uterus, it has grown from a single cell into a compact cluster of cells, called a blastocyst. This cluster attaches to the uterine lining very loosely at first, then more deeply and permanently. At this early stage, the blob of cells, which is more than just a fertilized egg, but not quite an embryo, is sometimes referred to as a “conceptus.” Although its sex is already determined, it’s not remotely baby-shaped yet. The cells produce enzymes that allow it to digest its way into the uterus lining, and lie snugly below the surface. 

Assisting conception 

Some couples find that conception takes longer than anticipated. If you haven’t become pregnant after two years of trying, your doctor may suggest fertility testing to identify if your fertility or that of your partner is suboptimal. If this is the case, you may want to embark on fertility treatment to assist conception. The most popular treatment is in vitro fertilization, or IVF. 

This involves taking fertility drugs to help you produce more eggs. The eggs are harvested and fertilized with your partner’s sperm in a laboratory (hence the term “test-tube baby”), and you’re given hormone treatment to prepare the uterus to receive the fertilized eggs. 

If the quality of sperm is poor, a procedure called intracytoplasmic sperm injection, or ICSI may be used, whereby a single sperm is injected directly into an egg and the fertilized egg is transferred to the uterus. Intrauterine insemination, or IUI, involves putting sperm that have been selected for viability directly into the uterus. This is used where sperm has poor motility, or there are problems with ovulation.

TWINS
How twins are conceived

Today in the US, one in every 31 births is a twin birth. Twins are conceived in two ways that result in either identical or nonidentical twins. 

Identical twins occur when one fertilized egg splits into two separate cells. This type of twin is half as common as nonidentical twins. Identical twins have the same genes and are the same sex, so they are very alike, although subtle differences in their environment can mean they’re not always identical in every way. Identical twins are known as “monozygotic” twins, since they come from one “zygote," or fertilized egg. 

Triplets, quads, and higher multiples can be monozygotic too. However, triplets and more can arise from more TWINS complex combinations. For example, there may have been two fertilized eggs, one of which split into two. 

Nonidentical twins occur when two eggs are released at ovulation. Each twin’s genes comes from the parents, but the twins don’t share the same mix of genes. Nonidentical twins are also called “fraternal” twins, since they’re no more alike than other siblings and can be of a different sex. 

They’re also referred to as “dizygotic” twins, because they come from two separate “zygotes,” or fertilized eggs. Nonidentical triplets arise when three eggs are released instead of one. This is more likely to occur when ovulation is induced with drugs during fertility treatment.

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