Checklists

These will be discussed in more detail below:

1. PRECONCEPTION TESTING

Make sure you visit your doctor to have basic pre-pregnancy screening.  You should have a blood pressure assessment, breast check, weight, pap smear and gynaecological examination and lifestyle advice.

Make sure you are immune to rubella and varicella.  Ask your doctor regarding testing for cystic fibrosis – 1/25 is a carrier and testing is easing and affordable.
Other tests that should be performed include – Blood group and Antibody screen, FBE, Fe studies, vitamin D and TSH, pelvic ultrasound, day 2-3 of cycle FSH, LH and estradiol level, antimullerian hormone and luteal phase (2nd half of cycle) progesterone level.

2. DIET AND VITAMIN SUPPLEMENTATION

Make sure you start folic acid (at least a supplement with 500mcg) 3 months before becoming pregnant.  Folic acid is important to help reduce neural tube defects.  It is a good idea to start a pregnancy specific vitamins as it will they will have other nutrients and minerals essential for pregnancy such as iodine, iron, vit D, B group vitamins and fish oil.

Try and attain your ideal body weight prior to conception as this will assist your natural fertility and lower any pregnancy complications that increase with high BMIs. Avoid rapid weight loss programmes but follow sensible eating such as the CSIRO Diet.

3. LIFESTYLE CHANGES

CAFFEINE

Cut down caffeine – no more that 2 cups of coffee, 2 glasses of cola or 2-3 teas a day is recommended.

SMOKING

Smoking reduces your fertility – it affects oocyte and sperm quality.  Women who smoke are only 60% as likely to conceive as non-smokers and smoking increases risks of miscarriage, complications during pregnancy and smaller babies.

Smoking ages you – it speeds up your reproductive clock by 10 years.  It is associated with early menopause.

Avoid smoking – smoking affects your unborn baby and may have long-lasting effects on your baby throughout its life – such as cancer and heart disease.

ALCOHOL AND ILLICIT DRUGS

Ideally women should stop drinking when trying to conceive but 5 standard drinks a week is the maximum if this is not possible. Men should not have more than 10 standard drinks a week.

Illicit drugs such as marijuana, cocaine, heroin, ecstasy and ice all have detrimental effects on sperm and egg quality.  They have serious effects to unborn children. The use of illicit drugs should be stopped at least 3 months prior to conception.

EXERCISE

Make sure you maintain a healthy exercise programme – this help reduce stress.  Once you are pregnant try and avoid raising your pulse above 120.

4. MEDICATION REVIEW

If you are on any medication for example, blood pressure medication make sure it is safe the medication is safe in pregnancy.  Please check with your doctor for safety of any medication you are taking and ask for an alternative if it is not safe.

5. EARLY REFERRAL TO FERTILITY SPECIALIST IF REQUIRED

See your fertility doctor earlier if you have the following :

• You are over 35
• You have a history of endometriosis, pelvic infection ovarian cysts, ruptured  appendicitis
• Your cycles are irregular
• You have a family history of early menopause (i.e. menopause before 35).
• You suffer from pain with intercourse or have issues having intercourse