Preparing for Pregnancy

Trying to fall pregnant can be both exciting and stressful. There are many factors that influence fertility and if you are planning a pregnancy, getting your body prepared gives you the best chance of a healthy pregnancy and baby. Below are some of the things you should take into consideration.

Your Health

General Health Check

If you have decided to try for a baby, see your GP for a chat and a check up. A general check up might include:

• making sure your pap smear is up to date
• a breast check
• blood pressure
• weight screening
• blood tests
• lifestyle advice
• determining your immunity to rubella and chickenpox

Your male partner should also have a Semen Analysis which your GP can arrange or it can be done at Repromed.

Folic Acid and Iodine

The Fertility Society of Australia recommends women take 500 micrograms of Folic Acid (also known as Folate) and 150 micrograms of Iodine per day for a minimum of 1 month before falling pregnant and for the first 3 months of pregnancy. Research shows folic acid helps reduce the risk of neural tube defects (NTD) in babies.^[1]  

If you have a family history of NTDs, Diabetes, a body mass index (BMI) over 30, or are on some select medications talk to your GP or Fertility Doctor about the best dose for you.

Healthy Diet

Keeping healthy helps boost your chances of falling pregnant, and research shows women with a healthy diet before conception are less likely to have a baby with birth defects.^[2]

Try to include:

• a range of fruit and vegetables
• good quality protein like lean meat, fish, eggs, beans and lentils
• complex carbohydrates from peas, beans, whole grains and vegetables
• plenty of calcium (choose low-fat dairy products)

Try to avoid:

• eating fish with high mercury content (e.g. mackerel, shark, swordfish and some tuna)
• additives, artificial colours, flavours and preservatives
• a high fat diet
• foods and treats high in simple sugars (e.g. cakes, lollies)

Your Weight

Being severely overweight or underweight can affect your chances of falling pregnant or put you and your baby at risk during pregnancy:

• women who are overweight women (obese) can have reduced fertility through hormonal changes
• women who are underweight can also have reduced fertility through hormonal imbalances (you are more than twice as likely to take over a year to fall pregnant)
• in men, obesity can cause hormonal problems or sexual dysfunction which can lead to infertility

Understanding Your Weight

Calculating your body mass index (BMI) is a good way to measure if you are overweight or underweight.^[3]

If your BMI is higher than it should be, do not panic. You can boost your fertility by losing weight with healthy eating and regular exercise. You do not need to become super-fit overnight, even moderate exercise and modest weight loss improves your chances of conceiving. This goes for the males too.

If you are concerned, talk to your GP or Fertility Doctor.

Your Lifestyle

Smoking

If you smoke, please stop. It is bad for your health and your fertility. Some quick facts to think about:

• smokers are more likely than non-smokers to be infertile^[4]
• cigarette smoke contains thousands of chemicals harmful to your reproductive organs
• smoking can cause erectile dysfunction
• it can increase DNA damage to eggs and sperm
• there is a link between heavy smoking in males and childhood cancer^[4]

The good news is the effects of smoking on fertility can be reversed. Quitting smoking increases your chances of getting pregnant and having a healthy baby.

Alcohol

There is no agreed safe level of alcohol intake while trying to conceive or during pregnancy – so women should ideally stop drinking alcohol.

Alcohol can cause impotence and damage sperm quality. Men should stick to ‘safe drinking guidelines’ – an average two drinks per day maximum, with several alcohol-free days each week and no more than four standard drinks in one session.

Caffeine

Caffeine is not just in coffee. It is also found in tea, energy drinks, some soft drinks and even chocolate. There is no clear evidence that caffeine affects fertility, but some studies show large amounts of caffeine makes it harder to conceive and leads to a higher risk of miscarriage.^[4]

Men and women should aim for less than 200mg of caffeine a day – about 1-2 cups of coffee or 2-3 cups of tea. If you need to cut down, do so slowly to reduce the impact of withdrawal symptoms.

Exercise

Being at a healthy weight improves your chances of having a baby – and exercise is important for managing your weight. Remember, even modest weight loss can improve general health and fertility, and there is no better motivator than a baby.

Quick tips to get moving:

• any exercise is better than none
• try to be active most days (preferably all)
• go for a quick walk to break up times when you have to sit down for long periods
• try to avoid excessive ‘high impact’ exercise (more than 45 minutes, 5 or more times a week)

Emotional Health

Maintaining a positive state of mind also improves your health and well-being, and your chances of a successful pregnancy. A degree of stress in life is inevitable, but how you deal with it is important. At Repromed we provide counselling support for individuals and couples. Our counsellors have extensive therapeutic experience and have specialised skills and knowledge in the field of infertility.

Zika Virus & Pregnancy

Data involving Zika, its transmission and infectivity, and its adverse effects on fetuses and adults is changing daily. Guidance based on current knowledge is iterative as our understanding of this virus rapidly changes. Any guidance published today may not be accurate for counseling and treatment of individuals tomorrow. Refer to the CDC Zika website for the most updated information: https://www.cdc.gov/zika/ or visit https://www.smartraveller.gov.au

SUMMARY TABLE. CDC recommendations for preconception counseling and prevention of sexual transmission of Zika virus among persons with possible Zika virus exposure – United States, August 2018

Exposure Scenario	Recommendations (update status)
Only the male partner travels to an area with risk for Zika virus transmission and couple planning to conceive	The couple should use condoms or abstain from sex for at least 3 months after the male partner’s symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic). (Updated recommendation)
Only the female partner travels to an area with risk for Zika virus transmission and couple planning to conceive	The couple should use condoms or abstain from sex for at least 2 months (8 weeks) after the female partner’s symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic). (No change in recommendation)
Both partners travel to an area with risk for Zika virus transmission and couple planning to conceive	The couple should use condoms or abstain from sex for at least 3 months from the male partner’s symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic). (Updated recommendation)
One or both partners have ongoing exposure (i.e., live in or frequently travel to an area with risk for Zika virus transmission) and couple planning to conceive	The couple should talk with their health care provider about their plans for pregnancy, their risk for Zika virus infection, the possible health effects of Zika virus infection on a baby, and ways to protect themselves from Zika. If either partner develops symptoms of Zika virus infection or test positive for Zika virus infection, the couple should follow the suggested timeframes listed above before trying to conceive. (No change in recommendation)
Men with possible Zika virus exposure whose partner is pregnant	The couple should use condoms or abstain from sex for the duration of pregnancy. (No change in recommendation)

Source: Polen, KD, Gilboa SM, Hills S, Oduyebo T, Kohl KS, Brooks JT, et al. Update: Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Men with Possible Zika Virus Exposure – United States, August 2018. MMWR Morb Mortal Wkly Rep 67:868-71