All About Preconception

You are now ready to make commitment: you want to have a baby! Ideally you will read this prior to becoming pregnant.

Whether this will be your first or forth pregnancy, there are some facts you should be aware of.

If you have been using a barrier-type of birth control such as a diaphragm, a condom, cervical cap or spermicidal (foam, jelly, cream), you are fertile as soon as you discontinue their use. If you are using the Pill, Norplant or any hormone based medication, it may or may not take a while to eliminate the entire drug from your system. You can ovulate soon after you discontinue the medication or it may take months or longer to resume ovulation.

If you have been wearing an intrauterine device (IUD) as your method of contraception, you can get pregnant as soon as your IUD is removed.

What must take place in order to conceive, is ovulation. Ovulation takes place when a mature ovum (egg) is released from the ovary and moves down one of the fallopian tubes. If the ovum meets up and is fertilized by a sperm, conception takes place. Sperm can live inside a woman’s body for 3 or more days. An egg’s life span is only 12 – 24 hours.

To improve your chances of becoming pregnant do not use K-Y Jelly or any other commercial lubricant because they contain spermicide (an agent that kills sperm).

Plan your sexual activities around the time you ovulate.

Ovulation usually occurs about 14 days before the onset of the next menstrual period.
Ovulation usually occurs about 14 days before the onset of the next menstrual period.
A menstrual cycle is typically every 28 days but it may vary – a few days less or a few days more and still be normal.
The exact time of ovulation is difficult to determine because it can be delayed by an infection or even stress.
Clinicians advise having intercourse starting 5 days before and continuing a few days after expect to ovulate.
You can help determine ovulation by taking your temperature every morning before you get out of bed; this is your basal body temperature. Your temperature reaches its lowest point just before the pituitary gland releases a hormone (luteinizing) or LH, which triggers ovulation. Two days later your temperature rises above your baseline (as much as one half to one degree) and remains elevated, until you begin menstruating.
The rise in basal body temperature occurs after you ovulate – it does not indicate when you will ovulate.

Though there are some aspects of pregnancy that you cannot control, one very important area where you can have a major impact is in following a healthy life style.

Two major health benefits prior to becoming pregnant are:

Daily intake of folic acid and
Achieving your ideal weight. Obesity is one of the very common high-risk problems. Aggressive pre-pregnancy weight loss and careful prenatal care will help keep complications during pregnancy to a minimum in overweight women.

Overweight and underweight women should strive to reach an appropriate weight before becoming pregnant because pregnancy is not the time to limit or greatly increase food intake. The early weeks of pregnancy, even before pregnancy is verified, are crucial ones for the embryo/fetus (the first eight weeks after conception the fertilized egg is called an embryo, thereafter it is called a fetus). It is during these early weeks that the organs are being formed; it is at this stage, as well as later on that substances such as alcohol, nicotine, illicit drugs and certain medications can be most damaging to the embryo/fetus.

If you are planning to become pregnant, it is a good idea to schedule a pre-conceptual visit with your healthcare provider. A detailed family and medical history will be taken including medications/drugs you are now taking or have been taking in the past. It is very important that your answer be honest and forthcoming to help determine if there are any risk factors that may require special care should you become pregnant.

Patients taking medication for pre-existing medical conditions such as diabetes, heart disease, epilepsy, etc., should not discontinue their medication. Instead, notify your clinician of your pregnancy and see if he/she wants to adjust your dosage or change your medication.

There are other drugs which are known to be teratogen (agents that can cause birth defects), that may have to be discontinued before planning or becoming pregnant. Do Not Take :

Contraceptive drugs: discontinue one to two months prior to becoming pregnant.
Accutane (isotretinoin), Retin A (prescribed for cystic acne): discontinue at least one month prior to conception. Large doses of vitamin A before conception are also known to increase risk of birth defects. Studies indicate that women who take large amount of preformed vitamin a prior to becoming pregnant or during pregnancy the first few months of pregnancy, appear more likely to bear children with birth defects. Routine supplements of vitamin a during pregnancy are not recommended according to medical publications.
Soriatane prescribed for psoriasis should be discontinued at lest three years before becoming pregnant.
Any vaccine made from live virus, i.e., measles, mumps, chicken pox, etc. should be avoided for at least three months before becoming pregnant or during pregnancy.
Prednisone or prednisone like products.
Anticoagulants, used to prevent blood clots.
Antithyroid medication which suppresses thyroid gland function.
Tetracycline (antibiotics) used to treat acne.
Cancer treating medications.

If you have a history of sexually transmitted disease (STD), it should be reported to your healthcare provide. Some STDs can affect your ability to become pregnant; it could also infect and harm your baby should you become pregnant. Are you or your partner thinking you may have a STD, you should be tested and if necessary treated, preferably before becoming pregnant?

Avoid hot baths, saunas, hot tubs or other facilities that elevate maternal body temperature particularly during the first trimester.

Radiation is used in some jobs and in the form of x-ray to diagnose and treat disease. High doses of radiation can lower fertility in men and women and can affect the fetus. The amount of radiation exposed in a chest x-ray will not affect fertility or the fetus. Radiation to treat diseases such as cancer can be harmful.

Because most women are not aware immediately that they are pregnant and neural tube defects occur during the first month of pregnancy, it is recommended that all women of childbearing age take 0.4 mg of folic acid per day to reduce risk of having a baby affected with spina bifida or other neural tube defects. Studies have shown that women, who took multivitamins containing folic acid at the time they conceived, substantially reduced their infant’s risk for oral or facial defects such as cleft palate or hair lip.

Women who have given birth to a baby with neural tube defect are at higher risk of it recurring in a subsequent pregnancy and are advised to take ten times more folic acid than in routinely recommended, 4 mg daily for one month before becoming pregnant and during the first three months of the pregnancy. These women should take a folic acid vitamin alone rather than a multivitamin containing folic acid. In order to get enough folic acid from a multivitamin, a woman should get an overdose of other vitamins.

A father-to-be also needs folic acid like a mother-to-be. Low levels of folic acid in men are associated with decreased sperm count and sperm mobility. It is also important to obtain your partner’s personal and family history to help identify any genetic history which could affect the fetus.

Researchers have found that men who do not eat fruit of vegetables rich in vitamin C are more likely to have damaged DNA – the genetic material found in chromosomes. This could increase the risks of birth defects, genetic diseases and/or cancer in their children. Persons who smoke need more vitamin C, because vitamin C in the body is dissipated by tobacco use.

Alcohol intake of men prior to mating can result in abnormalities of the fetus even if the woman does not drink any alcohol.

Exposed to lead or certain solvents, pesticides or other chemicals can reduce a man’s fertility by destroying his sperm.

Ideally, the time to evaluate you lifestyle habits and eliminate or at least decrease risk behavior, is the time before you become pregnant.