Prior To Conception

Prior To Conception

Prior To Conception
Before planning to have a baby, visit your doctor to check for risk factors that may cause complications with our pregnancy. Prenatal vitamins should be taken before you start trying to get pregnant so that your body is ready to support another life. Some medical and dental procedures cannot be done while pregnant so you can discuss with your doctor what steps need to be taken to address those issues before becoming pregnant.

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    A OBGYN (Obstetrics & Gynecology), answered on behalf of
    Several tests may help gauge a patient's fertility potential, also known as ovarian reserve:
    • Day 3 levels of FSH and estradiol: Follicle stimulating hormone (FSH) is a hormone released from the brain that triggers egg development by the ovary. Estradiol is the hormone produced by the ovary as the egg develops. Patients with an elevated estradiol and/or FSH level on the third day of a menstrual cycle have poor pregnancy rates with both ovulation induction and in vitro fertilization.
    • Clomiphene citrate challenge test (CCT): The day three FSH and estradiol levels may be normal in patients with decreased ovarian reserve. The CCT is another test to more thoroughly evaluate fertility potential. Clomiphene citrate is a medication given orally on menstrual days five through nine. Estradiol and FSH are measured on day three and day 10 of the cycle. Elevated blood levels of these hormones are associated with very low pregnancy rates with fertility treatment.
    • Response to fertility medications: The response to injectable high-dose fertility medications is another method for determining ovarian reserve. Patients with decreased ovarian reserve require larger amounts of medication to produce eggs and generally have lower pregnancy rates with ovulation induction and in vitro fertilization. Egg donation is an option for those patients who do not conceive with other therapies or have abnormal ovarian reserve testing. Egg donation involves using eggs donated by another woman. Patients may provide a donor (typically a sister or close friend) or an anonymous donor may be provided.
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    Because you have diabetes, you need special care and advice from your diabetes doctor, nurse, and health care team before you get pregnant. This "preconception counseling" is individualized for the needs of each woman. Ideally, preconception counseling should be a part of every routine diabetes clinic visit for all women of child-bearing age, starting at puberty, before a woman becomes sexually active.

    Preconception counseling will help you:

    • prevent an unplanned pregnancy.
    • take care of your diabetes before and during your pregnancy to give you the best chance of having a healthy baby and preventing complications.
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    A , Emergency Medicine, answered
    If you’re considering becoming pregnant, then congrats! You’re embarking on a miraculous, wonderful road.
     
    Speak with your physician, because there are a number of vaccines that you’d want to ideally have up to date before you become pregnant. Some, like hepatitis, MMR, meningitis and chicken pox, you may have already had—but I always advise every woman considering pregnancy to have a thorough vaccination history discussion with her doctor. There are some vaccines, such as chicken pox, that you can’t receive during pregnancy, but that could represent danger to the newborn if you’re not immune and become infected. There are other vaccines that you can get while you’re pregnant, but ideally, it’s much better to make sure you’re up to date first, to avoid exposing the developing fetus to anything that you don’t have to.
     
    One vaccine you’ll definitely receive during pregnancy is Tdap (Tetanus, Diptheria, and Pertussis). Due to research that showed that Tdap immunity wears off over time, and that newborns are highly susceptible to severe illness and even death from pertussis, we now receive this in each pregnancy, between 27-36 weeks gestation, so that the baby is born with a small amount of immunity as well.
     
    If you’re pregnant during flu season, then you should also talk with your doctor about getting the flu vaccine, as pregnant women are at much higher risk of flu complications.
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    A , Gynecology, answered
    It would be very unlikely. Increasing age (over 35) decreases fertility, and it is markedly diminished at age 50. Fibroids also can hinder a woman's fertility, and there may even be a negative impact on fertility from Uterine Artery Embolization (UAE) similar to that seen with women that undergo surgery (myomectomy). There have been numerous pregnancies reported after Uterine Artery Embolization (UAE) but further studies are needed.  
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    A OBGYN (Obstetrics & Gynecology), answered on behalf of

    A woman may need to boost her sexual desire while trying to conceive. No matter how excited a woman is about the prospect of being pregnant, she can experience just as many sexual roadblocks as her male partner. Sex on demand can be tricky for her, too -- even if she’s the one doing the demanding.

    It’s easy for women to get in the goal-oriented, baby-making mindset, where sex is simply a means to an end. That can mean that she may not even be in the mood when she initiates sex, but is guided instead by ovulation. Yet a lack of desire can lead to additional problems, like decreased lubrication and difficulty cli­maxing. Here’s how to boost desire when you’re trying to conceive.

     

    •   See a doctor. Antidepressants, anti-hypertension drugs, and other medications can contribute to low libido in women, as can anxiety and depression and diseases like arthritis and diabetes. 

     

    •     Get emotional. Research suggests that women tend to feel sexual desire towards those men for whom they feel an emotional connection. The most important thing a guy can do to get a woman in the mood for sex is to make a strong emotional connection outside the bedroom. One way to do this: Try hugging for 20 seconds. Studies have shown that’s about the amount of time it takes for women to produce significant lev­els of oxytocin, also known as the cuddle hormone. Oxytocin is stimulated via touch, and is directly cor­related with a sense of connection and well-being.

     

    •     A woman’s biggest sex organ is her brain. To turn her on, a man needs to help her turn her brain off. Research involving brain scans has found that the parts of the brain responsible for processing fear, anxiety, and emotion slow down significantly in women -- but not men -- as they become aroused. Help out around the house and otherwise take some of the pressure off her so she can focus on sex, not laundry, dirty dishes, or work.


    •     Relax. Not only can stress sap your sexual desire, it can also make it more difficult to conceive. Practice a form of stress management regularly, and consult a therapist if necessary to help eliminate sources of stress.

     

     

  • 2 Answers
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    A OBGYN (Obstetrics & Gynecology), answered on behalf of
    What Advice Would You Give to Someone Who Is Trying to Get Pregnant?
    Trying to conceive? Johnston-Willis Hospital OB/GYN Mark Hyde, MD offers the advice he gives to patients who are trying to get pregnant—and what he has to say might surprise you.
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    A Reproductive Endocrinology, answered on behalf of
    It is critical that the male partner in all infertile couples undergo a formal semen analysis to assess whether there is adequate sperm number and quality. The doctor may advise the man who is scheduled for semen analysis to abstain from sex for one to two days beforehand.
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    If you are diabetic, it is important to discuss any plans for pregnancy with your physician before conceiving, if possible. Most physicians like to monitor your hemoglobin A1c, a three-month measure of your average blood sugar. Ideally this should be below 7% before you conceive. Your doctor may suggest other lab tests as well, depending on your health status.
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    The largest study to date of pregnant women with multiple sclerosis (MS) or epilepsy shows that women with the disorders face only a slightly elevated risk of abnormal fetal growth rate and cesarean section delivery, and are not more likely to have blood pressure problems or deliver prematurely. The study appeared in a medical journal of the American Academy of Neurology.

    After factoring for maternal age, race and ethnicity, the researchers found that MS and epilepsy were associated with mildly increased rates of c-section delivery (42.4 percent for women with MS and 44.5 percent for those with epilepsy, compared with 32.8 percent for healthy women) and abnormal fetal growth rate (2.7 percent for those with MS and 3.8 percent for those with epilepsy, compared with 1.9 percent for healthy women).
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    A , Women's Health, answered
    The most common class of migraine medications, triptans, have not been shown to cause birth defects. The metabolism of this class of medications, or the way you clear the drug from your body, may be affected by the increased estrogen of pregnancy. Though no harm has been shown, this theoretical risk of toxic levels of triptans in a woman's system is enough that managing migraines in other ways is recommended once you know you are pregnant. Discuss with your health care provider if you should stop using triptans while you are trying to conceive. 
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