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Drugs - (prescribed medication / over counter non prescribed)

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Drugs - (prescribed medication / over counter non prescribed)

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You can improve your chances of getting pregnant and having a healthy pregnancy by following the steps on this page.

Take a folic acid supplement

It's recommended that all women who could get pregnant should take a daily supplement of folic acid.

You should take a 400 microgram supplement of folic acid every day before you get pregnant, and every day afterwards, up until you're 12 weeks pregnant.

A microgram is 1,000 times smaller than a milligram (mg). The word microgram is sometimes written with the Greek symbol μ followed by the letter g (μg).

Folic acid reduces the risk of your baby having a neural tube defect, such as spina bifida.

A neural tube defect is when the foetus's spinal cord (part of the body's nervous system) does not form normally.

Some women are advised to take a higher dose supplement of 5 milligram (5mg) every day.

You may need to take a 5mg supplement of folic acid if:

you or the baby's biological father have a neural tube defect

you previously had a pregnancy affected by a neural tube defect

you or the baby's biological father have a family history of neural tube defects

you have diabetes

you take anti-epilepsy medicine

Talk to a GP if you think you need a 5mg dose of folic acid, as they can prescribe a higher dose.

You can get folic acid tablets at pharmacies, or talk to a GP about getting a prescription.

Do not worry if you get pregnant unexpectedly and were not taking a folic acid supplement at the time. Start taking them as soon as you find out, until you're past the first 12 weeks of pregnancy.

Stop smoking

Smoking during pregnancy has been linked to a variety of health problems, including:

You can find useful information on the dangers of smoking during pregnancy and advice on how to stop on the Smokefree website.

Quitting can be hard, no matter how much you want to, but support is available.

The NHS Smokefree helpline ( 0300 123 1044) is open 9am to 8pm Monday to Friday, and 11am to 4pm at weekends.

It offers free help, support and advice on stopping smoking, including when you're pregnant, and can give you details of local support services.

Smoke from other people's cigarettes can damage your baby, so ask your partner, friends and family not to smoke near you.
Find out more about smoking and pregnancy

Cut out alcohol

Do not drink alcohol if you're pregnant or trying to get pregnant. Alcohol can be passed to your unborn baby.

The Chief Medical Officers recommend that the safest approach is not to drink alcohol at all.

Drinking in pregnancy can lead to long-term harm to your baby, and the more you drink, the greater the risk.

Find out about alcohol and pregnancy, alcohol units and tips for cutting down.

Keep to a healthy weight

If you're overweight, you may have problems getting pregnant and fertility treatment is less likely to work.

Being overweight (having a BMI over 25) or obese (having a BMI over 30) also raises the risk of some pregnancy problems, such as high blood pressure, blood clots, miscarriage and gestational diabetes.

Before you get pregnant you can use the BMI healthy weight calculator to find out your BMI. But this may not be accurate once you're pregnant, so consult your midwife or doctor.

Having a healthy diet and doing moderate exercise are advised in pregnancy, and it's important not to gain too much weight.

You can keep to a healthy weight by having a balanced diet and doing regular exercise.

Find out about foods to avoid when you're pregnant.

Know which medicines you can take

Not all medicines are safe to take when you're pregnant or planning a pregnancy, whether they're on prescription or medicines you can buy in a pharmacy or shop.

If you take prescribed medicine and you're planning to get pregnant, talk to a doctor.

Do not stop taking your medicine without talking to a doctor.

Find out about medicines in pregnancy.

Get flu and whooping cough vaccinations

Some infections, such as rubella (German measles), can harm your baby if you catch them during pregnancy.

Most people in the UK are immune to rubella, thanks to the uptake of the measles, mumps and rubella (MMR) vaccination.

If you have not had 2 doses of the MMR vaccine, or you're not sure if you have, ask your GP surgery to check your vaccination history.

If you have not had both doses or there's no record available, you can have the vaccinations at your GP surgery.

You should avoid getting pregnant for 1 month after having the MMR vaccination, which means you'll need a reliable method of contraception.

Find out about other infections during pregnancy that can harm your baby and what you can do to reduce your risk of getting them, including cytomegalovirus (CMV), parvovirus (slapped cheek syndrome) and toxoplasmosis.

Talk to a doctor if you have a long-term condition

If you have a long-term condition, such as epilepsy or diabetes, it could affect the decisions you make about your pregnancy - for example, where you might want to give birth.

While there's usually no reason why you should not have a smooth pregnancy and a healthy baby, some health conditions do need careful management to minimise risks to both you and your baby.

Before you get pregnant, have a discussion with your specialist or a GP about getting pregnant.

If you're taking medicine for a condition, do not stop taking it without talking to a doctor.

Find out more about:

Testing for sickle cell and thalassaemia

Sickle cell disease (SCD) and thalassaemia are inherited blood disorders that mainly affect people whose ancestors come from Africa, the Caribbean, the Mediterranean, India, Pakistan, south and Southeast Asia, and the Middle East.

Pregnant women in England are offered screening tests for these disorders, but you do not have to wait until you're pregnant before you have a test.

If you or your partner are concerned you may be a carrier for 1 of these disorders, perhaps because someone in your family has a blood disorder or is a carrier, it's a good idea to get tested before starting a family.

You can ask for a free blood test from either a GP or a local sickle cell and thalassaemia centre.

Find out more about screening for sickle cell and thalassaemia in pregnancy

More about having a healthy pregnancy

You can also get information and advice from:
Find health services near you

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You can improve your chances of getting pregnant and having a healthy pregnancy by following the steps on this page. It's recommended that all women who could get pregnant should take a daily supplement of folic acid. You should take a 400 microgram supplement of folic acid every day before you get pregnant, and every day afterwards, up until you're 12 weeks pregnant.

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Being active and spending less time sitting down (known as being sedentary) can help with getting pregnant, pregnancy and mental wellbeing.

On this page

Exercise/physical activity and fertility

Exercise/being active can boost your fertility (the ability to get pregnant). Women who do regular, moderate exercise get pregnant quicker than women who don't exercise regularly.

It doesn't have to be an exercise class in the gym, it means any activity that will

raise your heart rate

make you breathe faster

make you feel warmer.

You should still be able to talk without pausing for breath. Walking briskly, for example, counts as moderate activity.

If you have a high BMI and are not getting pregnant as soon as you expected, intense exercise may improve your fertility as it will help you lose weight.

If you regularly do intense vigorous exercise, read more here.

Exercise/physical activity and pregnancy

Being active by doing regular moderate exercise before and after you get pregnant will help you have a healthy pregnancy and birth. Research has shown that being active before and during early pregnancy can reduce your risk of having problems in pregnancy, such as gestational diabetes or pre-eclampsia

Staying strong and ready for labour

Pregnancy puts strain on the body. You may find it easier to cope with if you are fit, strong and flexible. It has also been shown that labour is easier for women who are active during pregnancy.

Reduced stress and anxiety

Planning to have a baby can be very exciting. It can also be an anxious time for both parents-to-be. You're making plans for a huge change in your life. Mental health problems such as anxiety and depression can be common in pregnancy.

Staying active can help to boost your mood and lessen your risk of stress and depression.

Health benefits for baby

Staying active will also benefit your child's long-term health. Women who are active are more likely to have children who are active too. It may help for you and your partner to think about becoming active as part of your preparing to be parents.

Think about what kind of activity you'd like to do when you become pregnant and when your baby arrives and start doing it now. For example, it could be walking in the park or going swimming.

You don't have to join expensive gyms or follow a strict exercise plan. It's about focusing on ways to make activity part of everyday life.

How much exercise should I be doing?

If you have always been moderately active

For most women, if you have always been active, continuing to exercise at the same level before (and during) pregnancy is safe and healthy.

If you exercise vigorously on most days of the week

A small amount of women who exercise vigorously on most days of the week, such as competitive athletes, may be advised to cut their exercise to a moderate level if they are having problems getting pregnant.

If you have not been active before

If you have not been active before, start to build up your level of activity now. The advice is to build up to:

at least 150 minutes of moderate aerobic activity a week and

strength exercises on two or more days a week that work all the major muscles

or:

75 minutes of vigorous activity a week and

strength exercises on two or more days a week that work all the major muscles

or:

a mix of moderate and vigorous aerobic exercise a week and

strength exercises on two or more days a week that work all the major muscles

Moderate activity means any exercise that will raise your heart rate, make you breathe faster and feel warmer. You should still be able to talk without pausing for breath.

Good examples include:

Vigorous activity means any exercise that makes you breathe hard and fast. If you're working at this level, you won't be able to say more than a few words without pausing for breath.

Good examples include:

race walking, jogging or running

aerobics

singles tennis.

Examples of muscle-strengthening exercises include:

lifting weights

working with resistance bands

push ups or sit ups

yoga

pilates.

To get the health benefits from strength exercises you should do them until you get to the point where you struggle to do any more.

5 Tips for being active

1 Avoid sitting down as much as possible

Cut down the amount of time you spend sitting down (being sedentary). You could try:

walking or cycling to work

standing on the bus or train, or getting off a stop earlier

walking to a co-workers desk instead of emailing or calling

setting a reminder on your phone to stand up regularly

taking the stairs instead of the lift or escalator.

2 Try an app, such as Couch to 5k or Active 10
These NHS apps help thousands of people who never thought they could be active to start on the road to fitness.
3 Head to the park in your lunch break

If there is one near you. If not, have a walk. Don't spend your lunchtime sitting down at your desk if possible.

4 If you have other children, walk them to school, nursery or toddler group if it's not too far

Turning something that happens every day into a physical activity is a brilliant way to get more active. And it will keep your children fit too.

5 Get a step-counting app on your phone

By counting your steps and giving little rewards they show you how much you are doing and help with motivation.

Exercise and infertility

Exercise and low BMI

If your BMI is below 18.5 your weight may be too low. There are many reasons why a person may be underweight. One reason could be exercising too often or too vigorously and not taking in enough calories to replace energy used in exercise.

Vigorous activity means any exercise that makes you breathe hard and fast. If you're working at this level, you won't be able to say more than a few words without pausing for breath.

Losing too much body fat through vigorous exercise may stop you ovulating (releasing eggs) and this could cause fertility problems. There are also health risks during pregnancy of having a low BMI.

If you have been struggling get pregnant and/or do not have regular periods it may help to bring down your level of activity to a moderate level as well as making sure you eat enough food to replace the energy used during exercise.

Vigorous exercise and fertility

Most women who are used to vigorous, intense exercise are not affected by infertility and are fine to continue their level of exercise through getting pregnant, pregnancy and beyond. However, a few women who have a low or healthy BMI and do vigorous, intense exercise on most days, such as elite athletes, are affected by infertility. This is more likely to be the case if you are not not having regular periods.

This may be because the stress that intense physical activity places on the body can affect the hormones responsible for your periods. This can cause:

irregular periods (also known as oligomenorrhoea)

stopped or missed periods (also known as amenorrhoea).

If you exercise at vigorous intensity and have been struggling to get pregnant and/or do not have regular periods it may help to bring down your level of activity to a moderate level as well as making sure you eat enough to replace the energy used during exercise.

Talk to your GP if you have been trying for a year, or six months if you are not having periods. You may be referred to a specialist if you need any tests or treatment.

When to see your GP about exercise and fertility

Talk to your GP if you want to have a baby but are concerned about exercise and the effects on your menstrual cycle or your fertility.

Exercise and IVF

IVF is a type of fertility treatment. Generally the exercise advice for those having IVF treatment is the same as that for those trying to conceive without treatment.

Physical activity at a moderate level is safe and healthy and has not been shown to increase infertility. If you are having IVF treatment because you have problems with ovulation and you exercise at an intense or vigorous level your consultant may suggest cutting down to a moderate level instead during your treatment.

Men and exercise

There is not enough evidence to show that lots of exercise causes male infertility. If your partner is concerned about fertility, he may be advised to do less exercise if he is extremely active but there are probably other factors that are more likely to be behind the problem.

It's still important that your partner exercises regularly. Anyone who isn't active is more likely to be overweight. In men, being overweight can affect the quality and quantity of their sperm.

You and your partner may both find it helpful to support each other to lead a healthier lifestyle as you prepare to have a baby together.
Find out more about men and pre-conception health. Are you ready to conceive? Use our tool to find out.

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The benefits of exercising/being active when trying to conceive

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Being active and spending less time sitting down (known as being sedentary) can help with getting pregnant, pregnancy and mental wellbeing. Exercise/being active can boost your fertility (the ability to get pregnant). Women who do regular, moderate exercise get pregnant quicker than women who don't exercise regularly.

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Men and women who smoke take longer to get pregnant than non-smokers. Second-hand smoke is almost as damaging as smoking and women who are exposed to second-hand smoke take longer to conceive than women who are not. The chemicals in cigarettes can cause damage to eggs and sperm which affects a future child's health.

Why? Because smoking affects every stage of the reproduction process - in both men and women.

Smoking affects:

the DNA (genetic material) in eggs and sperm

men's and women's hormone production

the fertilised egg's ability to reach the uterus

the environment inside the uterus, where the baby grows.

Research shows that smokers are more likely to experience infertility than non-smokers.

Quitting at least three months before trying for a baby is important to make sure the sperm is healthy when the baby is conceived.

Fatherhood begins before conception

Professor Rob McLachlan from Andrology Australia explains how smoking damages sperm and affects a future baby's health.

The good news

A healthy baby starts with healthy sperm and healthy eggs. The good news is that the effects of smoking on eggs and sperm and fertility are reversible. Whether it's the male or the female (or both) who smokes, quitting will increase the chance of conceiving and having a healthy baby.
If men quit:
It doesn't matter how long a man has smoked for. As soon as he stops smoking, his sperm will become healthier.

It takes about three months for sperm to mature. Men who quit at least three months before conception will have much healthier sperm with a greater chance of fertilising an egg, and creating a healthy baby.
If women quit:
Quitting improves the chance of getting pregnant.

Stopping smoking can improve natural fertility and some of the effects of smoking can be reversed within a year of quitting.

Women who quit smoking before conception or within the first three months of pregnancy reduce the risk of their baby being born prematurely to the same level of risk for non-smokers.

Women who stop smoking early in their pregnancy have babies with similar birth weights as babies born to non-smokers. Women who quit before their third trimester can avoid much of the effects smoking has on birth weight.

Quitting together

People find it harder to quit if their partner smokes. It's much easier to stop smoking if you do it with your partner or with another person. If you're in a relationship, deciding to quit together is best for everyone - parents and their future baby.

Clear the air for your baby

Dr. Raelia Lew, fertility specialist and gynaecologist explains how smoking affects your fertility and the child's health.

How can I quit smoking?

Quitting can be difficult but the benefits for parents-to-be and for the baby are enormous. You can talk to your doctor about what's available to help you stop smoking.

Visit Quit Victoria for more information about how smoking affects your health, and lots of practical tips and advice to help you kick the habit. You can also watch personal stories from ex-smokers and talk to someone who will help you quit.

Quit for fertility

Dr. Sarah White, Director of Quit Victoria shares her advice on how future parents can quit to improve their fertility and their future child's health.

References

Augood, et al. (1998). Smoking and female infertility: a systematic review and meta-analysis. Human Reproduction, 13(6), 1532-1539.

Day, J., et al. (2016). Influence of paternal preconception exposures on their offspring: through epigenetics to phenotype. American Journal of Stem Cells, 5(1), 11-18

Dechanet, C., et al. (2011). Effects of cigarette smoking on reproduction. Human Reproduction Update, 17(1), 76-95. doi: 10.1093/humupd/dmq033

Duckworth, A., & Azulay Chertok, I. (2012). Review of Perinatal partner-focused smoking cessation interventions. The American Journal of Maternal/Child Nursing, 37(3), 174-181.

Fakuda, M., et al. (2011). Paternal smoking habits affect the reproductive life span of daughters. Fertility and Sterility, 95(8), 2542-2544.

Fowler, P. A., et al. (2014). In utero exposure to cigarette smoke dysregulates human fetal ovarian developmental signalling. Human Reproduction. doi: 10.1093/humrep/deu117

Hackshaw, A., et al. (2011). Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update, 17(5), 589-604.

Hart, R. J. (2016). Physiological Aspects of Female Fertility: Role of the Environment, Modern Lifestyle, and Genetics. Physiological Reviews, 96(3), 873-909. doi: 10.1152/physrev.00023.2015

Hyland, A., et al. (2015). Associations between lifetime tobacco exposure with infertility and age at natural menopause: the Women's Health Initiative Observational Study. Tobacco Control. doi: 10.1136/tobaccocontrol-2015-052510

Jackson, et al. (2015). The influence of partner's behavior on health behavior change: The English longitudinal study of ageing. JAMA Internal Medicine, 175(3), 385-392. doi: 10.1001/jamainternmed.2014.7554

Lassi, Z., et al. (2014). Preconception care: caffeine, smoking, alcohol, drugs and other environmental chemical/radiation exposure. Reproductive Health, 11(Suppl 3), S6.

Milne, E., et al. (2011). Parental Prenatal Smoking and Risk of Childhood Acute Lymphoblastic Leukemia. American Journal of Epidemiology. doi: 10.1093/aje/kwr275

Mínguez-Alarcón, et al. (2018). Caffeine, alcohol, smoking, and reproductive outcomes among couples undergoing assisted reproductive technology treatments. Fertility and Sterility, 110(4), 587-592. https://doi.org/10.1016/j.fertnstert.2018.05.026

Mutsaerts, M. A. Q., et al. (2014). Effects of paternal and maternal lifestyle factors on pregnancy complications and perinatal outcome. A population-based birth-cohort study: the GECKO Drenthe cohort. Human Reproduction, 29(4), 824-834. doi: 10.1093/humrep/deu006

Sharma, R., et al. (2013). Lifestyle factors and reproductive health: taking control of your fertility. [Review]. Reprod Biol Endocrinol, 11(66), 1477-7827.

Sobinoff, A. P., et al. (2014). Damaging legacy: maternal cigarette smoking has long-term consequences for male offspring fertility. Human Reproduction. doi: 10.1093/humrep/deu235

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Men and women who smoke take longer to get pregnant than non-smokers. Second-hand smoke is almost as damaging as smoking and women who are exposed to second-hand smoke take longer to conceive than women who are not. The chemicals in cigarettes can cause damage to eggs and sperm which affects a future child's health.