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Pregnancy Planner

If you're serious about getting pregnant--or if you're already trying--you may be sorting through a whole lot of unsolicited advice. What's really important?

One year before

Get a physical
You might imagine that your ob-gyn should be the first to hear about your pregnancy plans, but talk with your primary care physician to find out how your health may affect your ability to conceive and carry a baby to term. Make sure that you address:

Blood pressure Ideally, it should be below 120/80. Borderline hypertension (120-139/80-89) or high blood pressure (140/90) predisposes you to preeclampsia, a pregnancy-related high-blood-pressure disorder that can decrease blood flow to the fetus and increase the risk of premature birth; it can also raise your odds of stroke, heart attack, and kidney disease down the line. If your blood pressure is high, cut back on sodium, up your exercise level, and/or take medication (many are safe, even during pregnancy).
Blood sugar If you have diabetes, a family history of the disease, or certain risk factors such as extra weight or irregular periods, request a hemoglobin A1c test--it'll reveal your average glucose levels for the past three months. High levels could mean your body is producing extra insulin, which can interfere with ovulation and as a result, pregnancy. It also ups your risk for gestational diabetes, which affects up to 7 percent of pregnant women.
Medications Effective treatment of certain conditions like asthma, thyroid problems, diabetes, and depression is key. But some drugs (including acne and seizure medications) could pose a grave risk to a developing fetus. Ask your doctor if your prescriptions may be linked to birth defects and whether there are safer alternatives for you to take.
Vaccinations If you get measles, rubella (German measles), or chicken pox while pregnant, you have an increased risk of miscarriage and birth defects. Most American women were inoculated at a young age (or may have chicken pox immunity because they had the disease as a child), but some of these vaccinations require booster shots.

Assess your stress level
When you're under pressure, your body pumps out adrenaline and cortisol to boost your strength, focus, and reflexes. But an overabundance of these stress hormones can lead to depression, irregular menstrual cycles (which can make getting pregnant difficult), and even pregnancy complications. If you notice stress manifesting itself in physical symptoms, make lifestyle changes now. Aim for eight hours of sleep per night, and seek out ways to relax. Even small things, like deep breathing or visualizing a calming image, can make a difference.

Six months before

See your gynecologist
Discuss anything you might otherwise dismiss--irregular bleeding, abnormal discharge, or pelvic pain. These may be signs of hormonal problems that can lead to infertility. In addition to your Pap smear and breast exam, ask for a full STD screening--even if you've been with the same guy for years. Finally, ask about a prescription for prenatal vitamins. These contain supplemental iron, calcium, and other nutrients that can ease you into your first trimester; many doctors suggest women start taking them three months before conception.

Have your teeth checked
More than 80 percent of Americans have some form of gum disease, according to the National Institutes of Health. "Among pregnant women, it's closer to 100 percent," says Karla Damus, Ph.D., a senior research associate with the March of Dimes. Hormonal changes make the mouth more hospitable to bacterial growth. Severe gum infections can release bacteria into the bloodstream that travel to the uterus and cause infections that could complicate pregnancy. The American Academy of Periodontology estimates that women with periodontal disease are seven times more likely to deliver a preterm or low-birth-weight baby.

Three months before

Watch what you eat
Eating for two should mean being twice as careful about food. Start making choices that boost your metabolism and optimize your hormone levels. Complex carbohydrates (fruits, vegetables, and whole grains) contain fiber that slows digestion and stabilizes your glucose levels. Protein builds a healthy placenta and produces red blood cells; one great source, fish, is also rich in omega-3 fatty acids, which will help your growing baby's brain and nervous system.

Think before you drink
Alcohol raises the risk of physical and mental disabilities, so cut out drinking once you're actively trying to conceive. Heavy drinking--2 or more drinks a day--may increase your estrogen levels, which can cause irregular menstrual cycles and deplete your body of folic acid (the vitamin that protects the fetus from neural-tube defects).

Cut back on caffeine
A study published in The American Journal of Epidemiology found that women who consumed 300 milligrams or more of caffeine a day (equal to three 8-ounce cups of coffee) had twice as much trouble conceiving as those who didn't have any. Yet, most experts say a cup a day is safe.

Consider going organic
Certain environmental toxins may stay in your system and endanger your developing baby. To avoid pesticides, buy organic produce or make sure to wash fruits and vegetables with mild soap. Inhaling certain solvents, paints, and household cleaners has also been shown to cause birth defects and increase miscarriage risk, so make sure your home and workplace are well ventilated.

Four things he needs to do

1. Quit smoking. Cigarettes hurt sperm motility and sperm count.

2. Cut back on drinking. More than one daily drink may affect sperm production.

3. Get down to a reasonable weight. A 20-pound increase raises his odds of infertility by 10 percent.

4. Avoid hot tubs and saunas. Heat may hinder his ability to produce healthy, motile sperm.