I am a mother of 8 kids. Yes I said 8! I know everything there is to know about parenthood and I can write the book of fertility. Please ask me any questions related to pregnancy or fertility or general women's health. I am however not a doctor and can't give you medical advice I am only a person who studies medical. But I can however give you my opinion on any womens health related questions. Below I have posted a few Q&A's for your viewing.

What is the best way to conceive a child?

Surprisingly there is no official research on this but it is commonly accepted that the missionary position is among the best for conceiving. However, any positions that allow deep penetration (such as on all fours or lying down spooning) are theoretically best as sperm is placed right by the cervix and so doesn't have too far to travel on its own!

Its also generally accepted that upright positions such as girl on top or standing up aren't as effective. Some recommended avoiding lubricants as these can impair the movement of sperm or affect the hostility of the cervical fluid.

Some believe that lying with your hips raised up on a pillow, or legs in the air, for 20 minutes to half an hour after sex increases your chances of conceiving by giving gravity a helping hand. Again, whether this works or not is an unknown but some swear by it. Obviously you should avoid doing this if you have been recommended to do so by your doctor for medical reasons.

While following this advice is all well and good, the best way to increase your chances of becoming pregnant is to have regular sex throughout your cycle (2-3 time a week) with more around your most fertile time - using fertility charting methods will help you to find out when this is. Most of all its important to just relax and have fun - making sex mechanical and just for the purpose of having a baby doesn't do anyone any good and will just end up making you stressed. Try to remember that trying for a baby is meant to be the fun part!

Diet and Fertility

Trying to get pregnant is an emotional and physically demanding time, and while timing may be seen as the important factor to think about, there are also several aspects to your diet that are important to monitor and address during this period.

Generally it is important to try and get close to your recommended weight whilst trying to conceive, as being over, or under, can hinder your chances of conceiving; to check your recommended weight it is best to consult your GP.

Whilst trying to conceive it is important to maintain a balanced diet, meaning a varied mix of all the main food groups, for example fruit and vegetables, aiming for the general five a day rule, carbohydrates, protein, diary foods to ensure calcium levels are high, and foods rich in iron such as red meat and pluses.

In terms of folic acid which is important during pregnancy, it is also recommended that women who are trying to conceive should also keep their levels high, taking a supplement of 0.4 milligrams daily, roughly from the time you stop using contraception, up until the 12th week of pregnancy.

While maintaining a balanced diet is the best way to keep your chances of fertility high, some women take vitamin supplements to ensure their diet is as nutritionally rich as possible. While over the counter vitamin supplements can be beneficial, it is sensible to switch to one specifically formulated for those trying to conceive, ensuring the right levels of the right vitamins are taken, again speak to your midwife or GP for further details on this.

While these are all things you should aim to be eating while trying to conceive, there are, of course, several that are best avoided to try and make conceiving that little bit easier. Try and avoid excess vitamin A, found in liver products and cut out any supplements containing this vitamin or fish liver oil; of course your do need some vitamin A, but excess could hinder your fertility.

Also, although there is no solid evidence that caffeine limits fertility and your chances of conception, this should also be monitored, as, since 2001, the recommendation is that pregnant women should limit their intake of caffeine to no more than 300 mg per day, as there are signs linking it to miscarriage and low birth weights.

There are, of course, lots of things to think about when starting, or already trying to conceive. Ensuring your diet is balanced, varied and nutritionally rich, means there is one more thing you can tick of the list.

Fertility Boosting Foods

While eating a healthy, balanced diet, drinking lots of water, exercising regularly and avoiding alcohol and cigarettes is the best way to get your body in shape for a baby there are certain foods which are said to boost (or at least optimise) your fertility. By including the following foods in your own and your partners diet you can help to ensure that you are getting all the important nutrients you need to make a baby.

Whole grains

Whole grains such as oats, brown rice, whole wheat and quinoa are complex carbohydrates and so not only give you lots of energy for baby-making by releasing sugar into your blood slowly and evenly, but also contain an abundance of B and E vitamins that are essential for cellular reproduction, hormonal balance and the production of healthy ova and sperm.

Oily fish

Oily fish such as salmon, mackerel and sardines are the best source of essential fatty acids (EFAs) omega-3 and omega-6 which play an important role in regulating reproductive functioning, improving blood flow and enhancing sperm quality and mobility. Flaxseed oil is a good EFA alternative for those who don't eat fish.

Full fat dairy

Research has found that women who eat at least one portion of full fat dairy a day are significantly less likely to suffer from fertility problems that those who consistently go for low fat or non dairy options. Dairy products are also a great source of calcium which is important in the development and maintenance of the nervous system, bones and blood.

Garlic

Although not typically known as a food for romance, garlic contains an abundance of fertility boosting nutrients and can easily be neutralised with parsley. It's a great source of the mineral selenium which is thought to enhance male fertility and help prevent the chromosome breakage that may play a role in early miscarriage. Garlic also contains vitamin B6 which helps to regulate hormones and strengthens the immune system.

Lean red meat

Lean red meat is a great source of iron which helps to prevent anaemia, decreases the risk of ovulatory infertility and plays a role in the production and function of red blood cells. Red meat is also a good source of vitamin B12 which is essential in the maintenance and development of the nervous system.

Honey

Honey has been used to enhance fertility throughout history as it is incredibly rich in the minerals and amino acids that nourish the reproductive system and stimulate ovarian function. It's considered by many to be a fertility boosting super food.

Spinach

Spinach and other leafy greens are an excellent source of folic acid which is important in optimising sperm production, facilitating regular, healthy ova production and helping to prevent neural tube defects during early pregnancy. It is also a great source of iron and vitamin C which helps to enhance sperm quality by protecting the DNA stored within it from damage.

Oysters

It is the abundance of zinc found in this seafood delicacy that gives it its fertility boosting qualities. Zinc is often considered to be the most important fertility nutrient as it has been shown to help with both healthy sperm and egg production. If oysters aren't your thing, zinc can also be found in baked beans, eggs, nuts, whole grains and pumpkin seeds.

Chillies

These certainly 'spice' things up in the fertility department by increasing the flow of blood around the body, ensuring that the reproductive system gets a healthy supply. Chillies also stimulate endorphin production which means more fertility boosting, stress releasing, happy hormones circulate around your body and are also an excellent source of vitamin C which helps with iron absorption.

Avocado

Avocado provides a rich source of vitamin E which is a powerful antioxidant and an essential fertility nutrient for both men and women as it improves the viability of sperm and helps to regulate both ovulation and the production of cervical mucus. It is also an excellent source of unsaturated fats which are essential for healthy hormone functioning, olive oil is another good vegetable source.

In general when trying for a baby it pays to go for good quality, unprocessed foods as these are likely to be much richer in vitamins, minerals and nutrients and also freer from pesticides and added oestrogens that may disrupt reproductive functioning in both men and women. By supplementing a balanced diet and healthy lifestyle with the foods listed above you will help to ensure you have all the nutrients you need to ensure your reproductive system is in optimum condition.

Can you get pregnant during your period?

Although it is very unlikely that you will get pregnant while you are on your period, technically it is possible and has happened with many woman. This is largely because of the huge variation that can occur both in the length of your menstrual cycle and the timing of ovulation within it.

I will explain more....

How conception works

During the course of each menstrual cycle your ovaries develop an egg that will be released when you ovulate. While the 'average' menstrual cycle is considered to be 28 days in length, realistically it can vary between 25-35 days and still be considered 'normal'.

You're likely to find that the length of your menstrual cycle varies from month to month with some being shorter than the 'norm' and some longer.

Similarly, ovulation usually takes place around 14 days before the end of your cycle (or start of your next period). However, because of fluctuations in the balance of your reproductive hormones this can also vary from cycle to cycle, even for those with regular periods.

Regardless of when it happens, once you ovulate, an egg will be released into one of your fallopian tubes and will begin its journey towards your womb. Provided their is a healthy supply of sperm available and under the right conditions it is here that fertilisation can take place.

There is a period of about 24 hours after ovulation during which conception can occur. If the egg is not fertilised during this time it will be shed during your next menstrual period. However, should conception occur, the zygote will continue towards the uterus where it will embed itself into your uterine lining and begin it's development into a baby.

How is it possible to get pregnant on your period

A very short menstrual cycle

Ovulation tends to occur around 14 days before the end of your cycle, irrespective of the cycle length. So, if you experience a very short cycle one month, it is possible that you will ovulate while you are still menstruating. If you had sex just before, or during your period, this in turn will make it possible for you to conceive .

For example, say your cycle is 21 days in length and you ovulate 14 days before your next period. Taking the first day of your last menstrual period as 'day 1', this would mean that you ovulate just 7 days into your cycle. Therefore, theoretically you may still be on your period or just finishing your period when you conceive.

Long-life sperm

Under normal conditions, sperm can survive in the female body for 3 - 4 days after intercourse. However, under 'optimum' conditions it can survive for 5 - 7 days and still be able to fertilise an egg during this time. For this reason, if you have sex during your period it is possible that healthy sperm will still be 'active' when you ovulate, making conception possible.

Extended menstruation

Most women menstruate for somewhere between 3-5 days each cycle, however anything between 2-7 days is considered 'normal'. Despite this, it is possible to experience a longer menstruation with bleeding continuing for up to 10 days. Consequently, if you have sex and then ovulate while you are still menstruating it is possible for conception to occur.

Ovulation spotting

Some women experience spotting when they ovulate as the ovarian follicle sometimes produces a little blood when it opens to release the egg. It is possible to mistake the appearance of this pink/brown discharge for a menstrual period, particularly if it occurs shortly after menstruation has finished. As you are most fertile just after ovulation, you are more likely to get pregnant at this time than any other in your cycle.

What does this mean for me?

Many women fall into the routine of religiously charting their cycle and only having sex just before or after ovulation when trying to conceive. However, the fact that it is possible to get pregnant during your period just shows that the best advice to follow is simply to have sex every couple of days throughout your cycle. Doing this will ensure that there is a plentiful supply of sperm available to fertilise an egg, whenever it is released.

Conception

Conception is the process of becoming pregnant. Most women ovulate each month, this is when an egg is released by the ovaries. For women with a 28-day menstrual cycle, ovulation typically occurs on day 14.

During intercourse the man will ejaculate and sperm will be passed from the testicles via the penis into the woman's vagina. If a sperm meets the egg, fertilisation may occur.

During a male ejaculation, there are anywhere between 60 million and 500 million sperm that have a go at the 'big race'. They cross the collar of the uterus pretty much within ten minutes. Only about 100 to 200 of the 'chosen ones' will arrive at the most strategic place.

The egg can be impregnated for approximately 24 hours from when it leaves the follicle. Once one sperm is successful and penetrates the egg it will lose it's tail and it's head will increase in size. This entrance creates an 'activation' in the egg and it too begins to enlarge.

If the egg has been fertilised (the process of the sperm fusing with the egg) it will move to the uterus and attach itself to the uterine lining, a process called implantation. The cells are called a zygote. The cells will begin to divide which will lead to the development of an embryo and hopefully produce a baby in nine months time!

A simple game of genetics will determine the sex of your baby. Every man and woman constitutes 22 pairs of chromosomes plus one pair that is the difference between them; these are the sexual chromosomes X and Y. Men have the chromosomes pairing of XY and women have the pairing of XX.

• Both the egg and the sperm have 23 chromosomes
• The egg is always the carrier of the X chromosome
• The sperm can carry either an X or a Y chromosome

This means that it is the male side that determines the sex of the baby.

Pre conception Health ChecIf you are planning on starting to try for a family, it is a good idea to visit your GP for a pre conception check up. During the check up your GP is likely to discuss both your own and your partners lifestyle habits and general state of health as well as any potential 'risk' factors that may affect your chances of conceiving and carrying a healthy pregnancy.

Factors your GP may look at include;

• Contraception - If you are currently using a hormonal form of contraception such as the pill, your doctor will provide you with information about switching to a non-hormonal method until your natural menstrual cycle is re-established.
• Smoking - Smoking serious affects your chance of conceiving and carrying a healthy pregnancy to term. It also increases the likelihood of premature birth and low birth weight so it is important that you and your partner stop smoking before trying to conceive. Your doctor will be able to provide you with all of the advice and support you need to help you quit.
• Weight - If you or your partner are significantly under or over weight your chances of conceiving may be adversely affected and risk of pregnancy and birth complications increased. Your doctor will be able to recommend a healthy pre pregnancy weight and provide you with suitable diet information to help you achieve this.
• Diet -Your diet will have a big impact on your chances of conceiving a healthy pregnancy. Your doctor will provide you with information on the foods that you should be eating and the supplements you should take to encourage the healthy development of a fetus (i.e folic acid).
• Exercise - Exercise is an important part of a healthy lifestyle. While exercising to excess may reduce fertility, participating in moderate exercise is likely to boost your physical health, energy levels and chance of conceiving. Current NHS recommendations suggest that you should try to walk for at least 30 minutes 5 times a week and participate in aerobic exercise for at least 20 minutes 3 times a week. Brisk walking, swimming, jogging or yoga are good options and can be continued throughout pregnancy. Your doctor will be able to advise you on your current exercise habits and on starting and building an exercise regime.
• Alcohol - Whilst trying to conceive both you and your partner should reduce the amount of alcohol that you consume as it can reduce fertility and also pose a developmental risk to a fetus once conception has occurred. You GP will provide you with information on the effects of alcohol on fertility and pregnancy and make a recommendation as to how much and how often it is safe for you to drink.
• Medication - Your doctor will want to discuss any medication you or your partner are currently taking, whether prescription or otherwise (this includes vitamins and herbal diet supplements) to check whether they are compatible with conception and pregnancy.
• Vaccinations - Your doctor will make sure that you are up to date with your vaccinations as many cannot be given during pregnancy. It is particularly important that you have been immunised against Rubella as if contracted during pregnancy the effects on the fetus can be potentially fatal.
• Medical History - During your pre conception check up your doctor will discuss your own and your partners medical history including any hereditary or genetic diseases known to be in your family and any other factors that may affect the conception and development of a healthy pregnancy.
• Physical - Your doctor may also carry out a physical examination of you and your partner to check your immediate health. This may include screening for blood pressure, cholesterol, diabetes and a cervical smear.
• Fertility - Your doctor will also be able to provide you with information and advice on monitoring and maximising your fertility.

Research has suggested that attending a pre conception check up with your GP can help increase your chance of conceiving a health pregnancy with fewer complications. This is thought to be because any potential problems that may affect you or your partners fertility can be identified early on so that treatment or lifestyle alterations can be made. This helps to ensure that you and your partner are in the best of health when you start trying to conceive and so gives your baby the best possible start in life.

Folic Acid for Pregnancy

Folic Acid (also known as 'Folate') is a naturally occurring B vitamin (B9) that can be found mostly in leafy green vegetable, orange juice and enriched grains. It is important in the manufacturing of DNA and red blood cells.

Taken daily before conception and very early in pregnancy when the neural tube is developing, it helps prevent babies being born with a serious neural tube defect. Women who get 400 micrograms (0.4 milligrams) daily can reduce this risk by up to 70%.

A neural tube defect is a birth defect of the brain and spinal cord. The most common neural tube defects are spina bifida (an incomplete closure of the spinal cord and spinal column), anencephaly (severe underdevelopment of the brain), and encephalocele (when brain tissue protrudes out to the skin from an abnormal opening in the skull).

Neural tube defects occur during the first 28 days of pregnancy, which is usually before a woman even knows she's pregnant. Given that only 50% of pregnancies are planned, some would argue that all woman of childbearing age should take folic acid, and not just those who are tring to get pregnant.

Folic acid is found naturally in the following foods (although this is by no means an exhaustive list):

• Fortified Breakfast Cereals
• Orange juice (from concentrate is best)
• Broccoli
• Asparagus
• Spinach
• Lentils
• Black beans
• Strawberrys
• Enriched breads and pasta
• Peanuts

It can be difficult to get 400 micrograms of folic acid every day from your diet, so the best way to ensure you get enough is to take a vitamin supplement with 400 micrograms of folic acid. It is also important to eat a healthy diet including those foods that contain folate on a regular basis.

Remember, folic acid only works if taken before and during the first few weeks of pregnancy. Therefore, you should be taking folic acid supplements on a daily basis while you are trying to get pregnant, as well as for the first couple of months of your pregnancy.

Coping with not conceiving

If you're at a point in your life when the one thing that's missing is a baby it can be incredibly frustrating to keep trying month after month with no success. In a sense we all take the ability to have a child for granted, especially after years of trying not to get pregnant, and it can often come as quite a shock if you don't manage to conceive right away.

If it is taking a little longer than expected it may come as a reassurance to know that only 30% of couples conceive within their first 3 months of trying however, over 85% conceive within 12 months and over 95% within 24 months, so in all likelihood by this time next year you will have a little bambino of your own to cherish. Having said this statistics take on very little meaning when you're coping with the endless highs and lows of not conceiving each month. So what can you do to make the bumpy ride to baby easier?

Relax -

The first thing everyone always says is 'relax and it'll happen'; the phrase 'easier said than done' springs to mind in reply. While it is almost impossible to relax when you're counting days and looking for signs that this could be the month you get a positive there is a lot to be said for a bit of 'r and r'. In fact some research has found that lowering your levels of stress can help with your chances of conceiving so taking some time out to pamper yourself is no bad thing. At the very least going shopping, watching a comedy or even going to an exercise class at the gym will help to take your mind off things for a couple of hours.

Don't feel guilty -

It can be very easy to blame yourself or your partner for not having yet conceived but remember it's no one's fault. The most healthy couple only have a 20 - 25% chance of conceiving each cycle so realistically its just nature doing its thing. On the same note try not to feel to angry or frustrated with your partner if they aren't reacting to the situation in the same way as you. We all deal with things differently and while some of us like to vent, others like to hide their upset. Just because they aren't showing it, it doesn't mean that they're not feeling the disappointment.

Share the load -

Trying for a baby can be a very isolating experience especially if your friends have children  or are falling pregnant around you. The most positive thing you can do for your own well being is to share your feelings with others; talk to your partner, parents, friends or anyone that you feel comfortable with. Even if you don't feel you can offload to anyone you personally know it can be good to chat to others in a similar situation as this provides a whole nother level of support. Chat rooms or forums are a great place to vent and because of the anonymity they give you freedom to say what you really feel.

Take a break -

While charting your fertility and pinpointing when you ovulate does help you to maximise your chances of doing the baby dance at the right time it does put both you and your partner under a lot of stress to perform. This is being recognised to such an extend that some experts are now recommending that rather that rigorously monitoring your fertility you should simply focus on having regular sex throughout your cycle. Even if you're not willing to give it up completely, taking a break can be good for putting the zing back in your sex life and helping you to relax - both of which are only going to help your chances of conceiving.

Don't set goal posts -

Once you start trying to conceive its very easy to set yourself goalposts but unfortunately mother nature doesn't always have the same plans. Rather than thinking 'I'll be pregnant by Christmas' or 'I'm going to have a baby by my next birthday' it's much better to just to relax and try and enjoy the ride no matter how bumpy it feels.

Keep busy -

It sounds cliched but one of the most effective ways to cope with not conceiving is to keep busy. Its so easy to put life on hold and not do things because you're hoping to have a baby soon; this only puts added pressure on you and your partner and means that you miss out on life's wonderful opportunities. So, book that holiday, take a new class or learn to play the guitar, you never know sod's law may just come into its own!

Enjoy couple time -

You may not believe it now but once you do fall pregnant and baby arrives you'll look back on your days as a childless couple with a fondness that only someone who has been severely sleep deprived will understand. Enjoy the lie ins and romantic dinners or even just the opportunity to snuggle up and read a good book uninterrupted. Spending quality time as a couple will help to make the baby making process a whole lot more enjoyable for both of you.

Hold your head high -

Family events or even catching up with old friends can be stressful when you're trying to fall pregnant, being told that 'its about time you had children' or mentions of that 'ticking clock' are never particularly welcome when you're longing for a baby. In these situations remember that just because you aren't yet pregnant it doesn't make you a bad person; holding your head high and delivering a witty quip such as 'at the moment we're just having fun practicing' will help to silence these upsetting (no matter how well intended) enquiries.

Keep informed -

Things become a lot less scary when you understand them so reading up on getting pregnant and knowing what to expect can remove a lot of the stress and uncertainty from your journey but as always, if you need extra reassurance or advice visit your GP.

Implantation Bleeding all you need to know

What is implantation bleeding?

Implantation bleeding occurs when a fertilised egg attaches itself to the wall of the womb.

During implantation the tissue surrounding the fertilised egg burrows into the endometrium (the lining of the uterus), forming links with the mothers blood supply and body tissue that will gradually develop into the baby's lifeline for the next 9 months, the placenta. It is during the attachment process that a small amount of blood may be released.

What does implantation bleeding look like?

Most women report experiencing implantation bleeding as light spotting that's either light pink or brown in colour. Unlike menstruation it tends only to appear over a period of one - three days and is usually intermittent rather than a regular flow that becomes heavier over time.

When does it occur?

Implantation bleeding tends to occur before menstruation is expected, this is usually between six and twelve days after ovulation. Most women experience menstruation approximately 14 days after ovulation however this will depend on your individual cycle.

How common is implantation bleeding?

Contrary to popular belief, not all women experience implantation bleeding. In fact, it's thought that only a third of women experience this phenomenon. However, because of the similarity of implantation bleeding to the early stages of menstruation it is possible that some women simply miss its occurrence. That said, if you're trying for a baby it is also very easy to misread menstrual spotting as implantation bleeding. For this reason, while early spotting can be an indicator of pregnancy it's always best to wait to test until after the date your period was due.

How to spot implantation bleeding

While there is no way of being 100% sure whether spotting is an implantation bleed until you have missed a period there are a couple of useful indicators that can help you check.

• Appearance - Implantation bleeding tends to be a lighter pink/brown colour rather than the dark red that's usual for menstrual blood.
  
  
• Timing - If you conceive you will experience implantation bleeding before your period is due, usually around 9 days after you ovulate.
  
  
• Duration - Implantation bleeding tends only to last for a day or two and occurs intermittently.
  
  
• Heaviness - Unlike the progressively heavy flow of a menstrual period, implantation bleeding tends only to occur as light spotting or coloured discharge.

Bleeding between periods

When you're trying for a baby you tend to pay more attention to the variations in your menstrual cycle than usual. Bleeding or spotting between your periods can really throw off your timing - particularly if you're charting - and an unexpected symptom like this can can be a cause for concern and generally leave you wondering what's going on.

To help you understand what this menstrual symptom means we explain what causes bleeding between periods and what you should do if you experience it.

What causes bleeding between periods? -

There are a number of causes of spotting between periods, these include:

Ovulation spotting -
Some women regularly experience light spotting when they ovulate as ovarian follicles can release a little blood when they burst to free the egg. Ovulation spotting tends to occur 10 - 14 days into your menstrual cycle and, as a natural 'side effect' , is absolutely nothing to worry about.

It is, however, worth noting that spotting at ovulation is only considered a secondary sign of fertility as it is not experienced by all women and therefore not a reliable indicator of when you are at your most fertile.

Hormonal fluctuations -
Mid-cycle bleeding can be caused by fluctuations in your levels of reproductive hormones throughout the month as a response to stress, a change in diet or some other external factor.

Breakthrough bleeding -
While this is unlikely to apply if you are trying for a baby, women sometimes experience mid-cycle bleeding when they start taking a new brand of contraceptive pill. Known as breakthrough bleeding this tends to occur whilst you are taking the first couple of packets but then eases off thereafter.

Thrush -
Caused by a yeast infection, a severe bout of thrush can mean you experience bleeding between your periods in addition to some of the more well known symptoms such as itching and heavy discharge.

Pelvic Inflammatory Disease -
Known as PID for short, this is a inflammatory, bacterial infection of the upper reproductive tract that can affect the uterus, ovaries and fallopian tubes. It can cause bleeding between periods, pain in the lower abdomen, thick discharge, fever and vomiting and can eventually impact fertility if it is left untreated.

Endometriosis -

a condition where endometrial tissue (usually found in the womb) develops elsewhere in the reproductive system, lists bleeding between periods as one of its side effects and severe cases can ultimately cause problems with fertility.

Polycystic Ovary Syndrome -
Polycystic ovary syndrome (PCOS), a condition where multiple cysts develop on the ovaries, can sometimes cause irregular bleeding and spotting alongside symptoms such as weight gain, acne, excessive hair growth and problems with fertility.

Ectopic pregnancy -
 where an embryo implants outside of the uterus, can sometimes cause vaginal bleeding as a side effect along with severe abdominal pain on one size, tender breasts and dizziness.

Sexually transmitted infections -
Bleeding between periods and after intercourse can sometimes be indicative of a sexually transmitted infection and if left untreated could cause problems with fertility in the long term.

Bleeding between periods can occasionally be a symptom of a more serious condition such as cancer of the womb or cervix. However, this is only the case for a small minority of women.

What should I do if I experience spotting? -

If you experience bleeding between periods, whether on its own or after intercourse, you should book an appointment to see your doctor as soon as possible. More than likely the spotting will simply be due to fluctuations in your hormone levels and will be nothing to worry about. However, if there is an underlying condition that has the potential to impact your fertility, the sooner you get it checked out and treated the better.

During your appointment your doctor is likely to ask you about the symptoms you've been experiencing and will be able to carry out some blood tests and possibly an internal examination to find out why you're noticing bleeding between your periods.

Signs of Ovulation

'Officially' the best way to make a baby is by having regular (several times a week) sex throughout your menstrual cycle. Having said this, you are at your most fertile during the days leading up to ovulation as it is only once an egg is released that conception is possible (provided healthy sperm is present too!). You can maximise your chances of conceiving by learning to spot your body's signs of ovulation; this will enable you to time intercourse with your peak fertility so that there is plenty of sperm available to fertilise the egg each time you ovulate. We explain the signs to look for.....

Cycle Length

The most basic way to identify your time of peak fertility is by establishing the average length of your menstrual cycle. This can be used to predict ovulation as, for most women, the luteal phase (the time between ovulation and menstruation) tends to be fairly consistent in duration from month to month, generally lasting between 13 - 15 days. Therefore by monitoring your cycle  over several months you should be able to estimate the week during which ovulation is most likely to occur and consequently, you are most likely to conceive. While cycle length on its own this isn't an entirely reliable method for predicting ovulation, it can be a useful guide when used in conjunction with other predictive methods.

BBT

After you ovulate the elevated levels of progesterone in your body cause your temperature to rise. This increase is only very slight (approx 0.4deg) however by charting your BBT(basal body temperature) daily throughout your cycle you will be able to identify when exactly this increase, and therefore ovulation, occurred. While this is a retrospective sign of fertility, indicating when you have previously ovulated rather than predicting when you will, BBT can be incredibly helpful in establishing the most fertile phase of your cycle and also provides a very accurate estimate of the date of conception when you do fall pregnant.

Cervical Position

The position of your cervix (the part of the female reproductive system that separates the uterus from the vagina) changes throughout your menstrual cycle and can be a useful indicator of fertility. At the start of your cycle the cervix will feel firm to the touch (similar to the end of a nose), sit low in the vaginal canal and will be almost closed. As fertility increases throughout your cycle the cervix will begin to adopt a higher, more open position and will feel softer to the touch (more like the feel of your lips) - this peaks during ovulation and then returns to its low closed position, later on in your cycle.

Cervical Mucous

Cervical secretions also alter in line with fertility, being minimal at the start and end of the menstrual cycle, and abundant and egg-white-like (clear and stretchy) at ovulation. Charting the quantity, consistency and appearance of your cervical mocus  can really help you to predict when you are at your most fertile and consequently most likely to conceive. Although gaging your fertility using cervical mucous or position can seem a little awkward at first, once you become used to the fertility patterns of your body its much easier to interpret these signs of ovulation.

Mittleschmitz

Some women experience lower abdominal cramps or twinges just prior to ovulation, these tend to be focused on one side and may last anything from a few minutes to several hours. Tender breasts are sometimes experienced too and can be another useful indicator of the time at which you're most likely to conceive. It can be helpful to note down symptoms like this throughout your cycle as they will all help in building up a picture of your fertility.

Increased well being

Many women experience an increase in libido during the most fertile phase of their menstrual cycle, you may also notice that you feel more attractive and confident and have a greater feeling of well being at this time. When you think about it, in reproductive terms it really makes sense that you are going to feel most like 'mating' while you are at your most fertile and although this is not experienced by everyone, it can be used as a secondary indicator of fertility.

Luteinising hormone

If you find it difficult to monitor the natural fluctuations of your menstrual cycle it can be worth trying an ovulation kit  Although these come at a cost they are one of the most reliable means of predicting fertility as they measure levels of LH (luteinising hormone) in your body. This is possibly the most important sign of ovulation as it is responsible for stimulating ovarian egg release itself. Fertility-indicating LH surges can be detected up to 2 days prior to ovulation giving you plenty of warning as to when you are most likely to conceive.

Acupuncture and fertility Acupuncture has been used in Eastern medicine for thousands of years and works on a holistic approach to improve health. Practitioners believe that every part of the body is interconnected by the flow of Qi (energy) around the body. Qi consists of two equal and opposite forces, Yin and Yang, and when imbalance occurs in the body's energy, physical symptoms occur.

As part of their holistic approach, acupuncturists do not see symptoms as something to be treated, unlike Western medicine. Instead they believe that symptoms can lead them to the underling problem and by focusing treatment on this, balance and health will be restored to the body. By inserting fine needles into the channels through which Qi flows around the body, the body begins to heal itself.

Acupuncturists also focus on restoring general well being and so look at lifestyle, stress and diet as part of their consultation - they often use massage and herbal remedies as supplementary treatments.

Fertility

Fertility is an area in which acupuncture is becoming increasingly popular and with good reason too. Research has found that acupuncture therapy can have a positive effect on those trying for a baby and can actually aid the conception process.

Fertility focused acupuncture treatment has been found to increase blood flow to the reproductive organs, balance hormone levels, regulate the menstrual cycle and help improve the lining of the uterus and quality of eggs released. Additionally, conditions such as polycystic ovaries and endometriosis have also been shown to improve with this sort of treatment. Benefits to male fertility have also been found with positive effects on sperm count, morphology and mobility.

As trying to conceive can often be a stressful experience, many find that undergoing a course of acupuncture reduces associated problems such as anxiety, stress and insomnia and helps to improve the chances of pregnancy by improving well being in general.

IVF

As a testament to its positive effect on fertility recent research has found that combining IVF with acupuncture greatly enhances the chance of conceiving and carrying a healthy pregnancy. In one study women who underwent acupuncture throughout their IVF treatment were almost twice as likely to fall pregnant as those who went through IVF alone.

Again, findings of this nature could be due to a combination of enhanced function of the reproductive system combined with increased relaxation and relief from side effects experienced.

Although Western medicine isn't completely convinced of the healing power of acupuncture as there is no apparent physical relationship between Qi channels and actually body parts, research supporting its effectiveness in enhancing fertility is beginning to emerge. So, if you're not too squeamish and prefer to take a more alternative approach to your health, acupuncture could be the avenue for you to explore.

Charting your BBT

BBT or 'Basal Body Temperature' is a measure of your resting body temperature and should be taken first thing in the morning before you get out of bed. Charting your BBT helps to establish the phases of your menstrual cycle and enables you to work  out exactly when ovulation occurred - it is the only charting method that enables you to do this, the others simply predict when it is likely to occur.

What you need

If you are planning on using BBT to monitor your fertility and identify your peak fertility times you will need a special BBT thermometer; digital and mercury varieties are available. Regular fever thermometers are not suitable as they are only likely to display temperature to 0.2deg rather than the necessary 0.1deg accuracy.

The thermometer should be kept on your bedside table so you can take your temperature first thing on waking before you get up or have a drink or even speak (this is so a true reading of your resting temperature can be taken). You will also require a menstrual cycle chart to plot your daily temperature on - you should record the time your temperature was taken as well as any other features monitored on this chart

How it works

BBT charting works on the basis that your post-ovulation temperature (during the luteal phase) is at least 0.4deg higher than your temperature prior to ovulation (in the follicular phase). Average pre-ovulation BBTs typically range between 97deg - 97.7deg and 97.7deg - 99.0deg post-ovulation, although this varies between individuals.

Charting your BBT not only enables you to establish when ovulation has occurred but also the typical duration of your menstrual phases. Although the average cycle length is 29 days with ovulation on day 14, this is not the case for many women, especially those with irregular periods. Variation in the menstrual cycle is likely to be due to the follicular phase, by contrast, the luteal phase is likely to remain constant each cycle. BBT enables you to establish the length of the luteal phase and therefore work out post-ovulation fertility and when to test for pregnancy.

You tend to be most fertile 5 days before, and 2 days after you ovulate, so charting for several months will help you to establish when in your cycle this period falls. 18 days of increased temperature is a good indicator of pregnancy and additionally, this method enables you to work out the date of conception and due date relatively accurately.

The temperature increase seen at ovulation is due to an increase in progesterone cause by the corpus luetum (the follicule from which the egg was released). If fertilisation of the egg occurs, BBT will remain high throughout the first trimester. However if fertilisation doesn't occur, the corpus leutem disintegrates and progesterone levels drop causing temperatures to lower and menstruation to occur.

To get the most reliable measurements you should take your BBT on waking each morning. It is best if you take your temperature at the same time each day, even on the weekends as BBT increases by approximately 0.1deg every half an hour and so could skew the results. Although it is possible to adjust the temperature by adding or subtracting 0.1deg for every half an hour earlier or later BBT is recorded compare to the usual time, this isn't advisable on a regular basis and you should make a note of the adjustment on your chart.

It is best to take your temperature after at least 3 hours of continuous sleep and to get a more reliable result at least 5 hours is preferable. It is possible to take BBT orally or vaginally and although orally measuring BBT is easiest first thing in the morning, some believe that vaginally provides a more reliable result as it avoids the influence of factors such as sleeping with your mouth open etc. It is important to use the same method (and thermometer) each day. It is also advisable to mark on your chart days when your temperature may be unreliable due to illness or alcohol consumption etc.

Monitoring your BBT

You should begin to take readings on day 1 of your menstrual cycle (this is the first day of your period) and continue for each day until the first day of your next period when you should begin a new chart.

After a complete cycle you should join the temperatures for each day (in the form of a line graph)and look for a jump in temperature. When you see the BBT shift you should draw a line 0.1deg above the 6 previous highest readings - this is known as a cover line - and your temperature should stay above this line until 1 or 2 days before the end of the cycle.

Although BBT is useful for establishing when ovulation has occurred, it is best to use it in conjunction with other fertility charting measures such as cervical mucus and cervical position. By combining different charting methods you will be able to establish when you are most fertile and predict the period in which you are most likely to conceive.

Will Stress stop me from getting pregnant?

When all your best efforts at baby-making go unfulfilled, it's easy to become frustrated. Plus, when your friends are telling you to 'just relax' and assuring you 'it will happen when the time is right', you may find yourself getting angrier by the second. Unfortunately all this does is add to the vicious cycle of stress which can be hard to overcome.

If you are also feeling the pressure of other sources of stress in your life, such as work commitments or family relationships, you may be feeling more stressed than ever. This can be hard to overcome and can all add to a build-up of unwanted anxiety.

How can stress affect chances of conception?

Some scientific studies have shown that periods of prolonged stress can interfere with your chances of conceiving, by affecting the hypothalamus. This is a gland in your brain that, among other things, regulates the hormones required to control ovulation. When you are under stress you may therefore ovulate less often or less regularly than when you are feeling more relaxed.

Science aside, stress can be one of the contributing factors to a loss of libido. If you or your partner are feeling stressed or anxious, you are simply less likely to be in the mood to make love. Therefore your chances of getting pregnant can be less when you are stressed.

What can I do to reduce stress?

If you are trying for a baby, chances are you will get frustrated with yourself or your partner if months go by and you still aren't getting a positive reading on your pregnancy test. Instead of the fun and playfulness of making love that you experienced before trying to conceive, you may find that love-making becomes strictly about baby-making, and therefore has an added pressure it didn't used to have.

The stresses and strains of work or family commitments could also be adding to your feelings of stress. So how can you lower your stress levels when trying for a baby? Trying one or all of the following is a good start to reducing your feelings of stress and anxiety, and by doing so increase your chances of pregnancy.

Relax your mind and body

• One of the most important things is to take time to rest. Set aside some time where you won't be disturbed, even if it's just half an hour, and do something you enjoy. Don't feel guilty about just 'doing nothing' - it's important that your mind and body are relaxed. Try having a hot bubble bath, watching a film, or reading a book.
  
  
• Exersicizing  is also very important when trying to fall pregnant. It will ensure your body is in tip-top condition, and will help to relax you and ease tension. Exercise routines like yoga or pilates are especially effective for lowering stress levels.
  
  
• A balanced Diet  is also key. Making sure you get a good nutritional variety of proteins, vitamins and minerals is enormously helpful both for lowering your stress and ensuring you are fit and well.
  
  
• Other therapies such as massage, meditation and reflexology will go a long way towards helping you relax. Breathing exercises may also be beneficial.

Talk about it

• Try not to bottle up your feelings if you are experiencing stress. It will do you the world of good if you share what you are going through with those around you.
  
  
• Talk to your partner, your best friend, for advice and reassurance from those that are going through the same experiences as you.
  
  
• Consider writing in a journal if you would prefer. This way you can express things you are feeling, and hopefully gain perspective - which will help to reduce stress.
  
  
• Don't be hard on yourself. If you feel frustrated and upset with yourself, you will only increase your feelings of stress. Treat yourself when you are feeling down, and try to practice feelings of calm and patience.

Be an optimist

• The more feelings of optimism you have while trying to get pregnant, the more likely you are to be successful - optimism is the perfect antidote to stress.
  
  
• Try to resist comparing your own situation with those around you. It may be very disheartening to see others seemingly falling pregnant at the drop of a hat, when you have been trying for months. But remember that everyone's situation is different, and feelings of jealousy or exasperation will only put you under more pressure than is necessary.
  
  
• Try to remain relaxed with your partner. If love-making becomes solely about baby-making, you will both feel anxious about the event instead of enjoying what comes naturally.

Keep in mind that conceiving a baby can be a great time in your lives, so approach it with a sense of fun and playfulness. If you feel your stress levels rising take a deep breath and try your best to stay calm - and let nature take its course.