Conception Q&A

Can smoking damage my husband’s sperm? Is it harder for overweight women to conceive? We answer these and other frequently-asked questions from mommies-to-be.

Q: I drink a cup of coffee in the morning and a diet soda in the afternoon. Can too much caffeine decrease my chances of becoming pregnant? And once I become pregnant, do I need to cut out caffeine altogether?

A: There hasn't been scientific confirmation that caffeine decreases your chances of becoming pregnant, or that it will harm your baby should you become pregnant. However, there is reason to be cautious. One study showed that drinking more than three cups of coffee a day during pregnancy was associated with inhibited absorption of iron and zinc. Another showed that moderate to heavy use of coffee and caffeine in pregnant women may result in smaller babies. More studies need to be conducted before a conclusion can be drawn about what the effects may be. In the meantime, to be on the more cautious side, try to avoid consuming caffeinated beverages. And don't overlook "hidden" sources of caffeine found in many sodas, including Mountain Dew, Root Beer, and Dr. Pepper.

Think you might need a little help? Learn more about Assistive Reproductive Technology

Q: I'm about 20 pounds overweight and I'm trying to become pregnant. Does my extra weight pose any health risks to me or my baby?

A: There's probably little chance of adverse effects in this degree of excess weight, but women who are overweight do have some increased risk of developing preeclampsia (a condition characterized by high blood pressure) or gestational diabetes. Since these conditions can increase the risk of complications for mother and baby, ideally it would be best to lose weight before conceiving.

Still not motivated to shed some extra pounds? Digest this: Obese or overweight women are more likely than average-weight women to have an infant with birth defects, according to a new study from the Centers for Disease Control (CDC) and Prevention. The study found that birth defects, such as spina bifida and heart disease, are more prevalent among babies born to overweight mothers.

However, if you do become pregnant while overweight, do not go on a calorie-cutting diet and deprive your body and the developing fetus of essential nutrients. "It is very important that you do not try to lose weight during pregnancy," warns CDC epidemiologist Margaret Watkins. "It's not the time; you could seriously jeopardize the health of your baby. Eat healthfully, don't starve yourself." 

Can I start trying to have a baby as soon as I take my last birth-control pill, or should I wait to clear the drug out of my system?

A: There are no known adverse effects in conceiving right after taking oral contraceptives. However, doing so can make it difficult to calculate your due date. A woman's menstrual cycle is often irregular immediately after she stops taking birth-control pills; in particular, the timing of ovulation during the first cycle is quite unpredictable. So if you were to conceive during that first cycle, the standard method of estimating the start of the pregnancy by pinpointing the first day of your last period would be unreliable. Ideally, after stopping the Pill, you should use barrier forms of contraception for two to three months before trying to conceive. If conception occurs within these first two or three months, it may be advisable to use some alternative method of estimating pregnancy, such as ultrasound.

Q: My husband smokes. Can tobacco damage his sperm?

A: While there is no evidence that smoking damages sperm, there are many other reasons to be concerned about having a smoker in the house. Secondhand smoke poses a real risk to both a pregnant woman and her unborn baby, since the smoke she inhales is only a little less than if she smoked herself. A pregnant woman exposed to tobacco smoke is at increased risk of premature delivery, as well as other complications. Then, after the baby is born, exposure to secondhand smoke can increase your child's risk of sudden infant death syndrome (SIDS), and can lead to infant and childhood respiratory illnesses. Finally, you need to be concerned about the adverse effects--including links to lung cancer and heart disease--that this habit has on your husband's health. For all these reasons, quitting smoking is the best thing he can do!

Q: I have stopped taking birth control pills after 10 years of use. But I haven't had a period. How can I become pregnant?

A: It sometimes takes the ovaries a little time to recover from the suppression of birth control pills, but function normally returns (indicated by a menstrual period) by the third month after you've stopped. If there hasn't been a period by three to four months, you should see a doctor who may want to do some testing and perhaps prescribe medication to stimulate ovulation.

Q: I don't know if I've ever had chicken pox. Should I consider getting the vaccine before trying to become pregnant?

A: Contracting chicken pox while pregnant is dangerous. During the first few months, it can cause abnormalities in the fetus, including limb malformations and mental retardation. In late pregnancy, it can lead to a very severe and potentially fatal form of pneumonia in the pregnant woman. A simple blood test can tell you whether or not you've had chicken pox. If the results show that you haven't had the disease, you should be immunized before becoming pregnant. Your doctor will probably advise waiting two months after getting the vaccination before trying to conceive. The vaccine includes a live virus, and while this doesn't pose the same risks as contracting chicken pox, doctors advise waiting just to be extra cautious.

Q: When is an ultrasound typically done during a pregnancy, and what is the technician looking for when it is done?

A: Timing of an ultrasound will depend on the reason it's being done. In the first two or three months of pregnancy, it can be used to confirm the existence of pregnancy or to count the number of babies in a multiple pregnancy. Halfway through a pregnancy, ultrasound can establish a baseline for later monitoring of fetal growth, to assess the baby's development. Toward the end, the doctor might want to check the position of the baby, the location of the placenta, or the amount of amniotic fluid.

Q: Should I see a doctor before attempting to conceive? How soon after becoming pregnant should I see the doctor?

A: It's a very good idea to see a doctor before conceiving. There may be some conditions that can be corrected, improving the chance of a good pregnancy outcome. Some of the things that might be done at a preconceptional visit include:


  • Going over your diet to make sure it is optimal

  • Reviewing any drugs or medications (including over the counter preparations) you are taking and perhaps modifying this list

  • Prescribing folic acid (which prevents a certain type of birth defect)

  • Checking your rubella status and immunizing you if you haven't had this disease

  • Providing an opportunity for you to get your questions answered

In general, you should see a doctor as soon as you are sure you are pregnant. Although if you have had a recent preconceptional visit, the doctor may suggest you wait until after you have missed your second period before visiting.

My first child was delivered by cesarean section because he never descended through the birth canal. What are the chances of my delivering vaginally with my next child?

A: In situations such as yours (first labor complicated by failure to progress), carefully supervised labor with the next pregnancy will result in a healthy baby being born vaginally to a healthy mother in 60 to 65 percent of cases. In the remaining 35 to 40 percent of cases, labor will not progress normally and it will be necessary to do another cesarean.

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