Preconceptual Counseling

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There are many important steps that a couple must consider when getting ready to conceive. Both partners need to prepare themselves both physically and emotionally for this life-enhancing event.

The first step is to inform your regular Obstetrician/Gynecologist that you are ready to begin building a family. Meeting with your Ob/Gyn will help to prepare you for meeting with a reproductive endocrinologist at RMA of New York, as you discuss your medical history and determine if you are ready to begin care under a fertility specialist.

Visiting with a Reproductive Endocrinologist at RMA of New York

The visit to your doctor should occur at least three months before you begin trying to get pregnant. This visit may include a full physical examination including a Pap smear and cervical cultures, as well as blood tests. These blood tests will test you for anemia and your immunity to rubella and chicken pox. If you are not immune to one or both of these viral infections, you may need to be vaccinated. In this case, you will need to wait one month after receiving the last vaccine before trying to conceive.

Genetic disorders Preconception genetic testing, also referred to as carrier screening, can be performed to find out whether a couple is at risk for having a child with certain conditions. Some examples include Tay Sach’s disease, most commonly seen in those of Ashkenazi Jewish decent; sickle cell anemia; and cystic fibrosis. If both husband and wife are carriers of a certain disease, there are procedures available in in vitro fertilization (IVF) known as preimplantation genetic diagnosis (PGD) which drastically reduces the chances of passing these diseases to the child. If you and your partner are both carriers of a genetic disease, it is best to discuss your pregnancy options with a genetic counselor.

Sexually transmitted diseases Sexually transmitted diseases (STD’s) can also have an effect on a woman’s fertility. Your doctor should discuss your medical history with you and may decide to perform cervical cultures or blood tests to prove that there are no infections that would hinder your ability to conceive. STD’s, like chlamydia, gonorrhea and genital herpes, can affect your ability to conceive by causing scarring of the fallopian tubes.

Lifestyle

In addition to visiting your doctor, another important step a woman should take before trying to conceive is to begin taking prenatal vitamins that provide between 400 and 800 micrograms of folic acid (most prenatal vitamins have at least this much). Studies have shown that taking prenatal vitamins, especially those with at least 400 micrograms of folic acid, can reduce the chance of having a baby with brain and spinal cord malformations called neural tube defects. RMA of New York’s recommendation is to consume a minimum of 800mcg of folic acid per day.

The prenatal vitamins should, of course, be supplemented with a well-balanced diet. Not having enough nutrients in your body can cause many problems as your baby develops. A woman who is anemic, for instance, may not have enough iron stores for normal red blood cell production in the fetus. Most importantly, deficient caloric intake can lead to growth retardation and a smaller fetus.

Good Fitness

Being physically fit is also a plus during the pre-pregnant and pregnant stages. Studies have shown that good fitness during conception and pregnancy result in a much easier labor and delivery. Maintaining a body weight of no more than 15% above or below ideal body weight will provide an optimal environment for the fetal growth period. If a woman is underweight, she may not ovulate normally, and this may make it more difficult to conceive. Additionally, in the first trimester many women have such extreme nausea and vomiting that they lose a significant amount of weight. For these reasons, it is important to optimize health prior to conceiving.

It is recommended that women exercise lightly to moderately throughout initial stages of pregnancy, however, some modifications may be necessary. Consult your physician in determining the level of exercise that will be safe for you. These guidelines should be applied to the time just prior to conception as well, as the fetus is nearly 2-3 weeks old before most women even know that they are pregnant.

Adequate nutrition and hydration must be maintained and overheating avoided. The core body temperature, and thus the uterine temperature, can exceed 102° during “spinning” or other vigorous exercise in a hot, crowded gym. Attempts to lose weight should occur before, not during pregnancy.

Controlling Habits and Environment During Pregnancy

It is also important for a couple to evaluate their daily surroundings and habits as they are trying to get pregnant. Asbestos, lead, and radiation exposures should be avoided. If you have a cat, speak with your doctor about taking blood tests to see if you have antibodies to toxoplasma (parasite that can cause birth defects). If you do not have antibodies, you should use gloves and a mask to change litter boxes during pregnancy.

Consuming alcohol, smoking cigarettes or using recreational drugs should be stopped, once you begin trying to conceive. They all can have detrimental, lasting effects on your baby as its organs are developing, even before you know for sure if you are pregnant. For your own health as well as your baby, quitting these habits will impact your overall health and wellness. Your doctor can give you information about support groups, treatment centers and other sources of help.

Get started by clicking below or calling 212-756-5777.

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