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| How to plan a pregnancy |
Why plan a pregnancy?
- It is advisable to prepare for the arrival of a baby in advance. If the future father and mother
are healthy, there is a better chance that pregnancy and childbirth will go well.
What doctors to consult?
- First of all, both expectant parents are recommended to see a general practitioner, who will be
able to assess the state of their health and, if necessary, refer to other specialists for examinations.
This is especially true for women, because during pregnancy, her body is subjected to a special
load, and the diagnosis and treatment of diseases can be difficult due to the unfavorable effects
on the fetus. It is necessary to make sure that everything is in order, or eliminate already
existing problems. Different examinations are possible in each case. Final recommendations
will be able to give a doctor who talks to the patient, examines the medical record.
A man should also check the general state of health. Especially important is the absence of
acute and chronic infectious diseases that will pose a danger to the future mother and child.
Also in the process of examination may be revealed genetic pathology.
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Do I need to do some vaccinations if one of the partners has missed them?
- As such, there are no mandatory vaccinations in preparation for pregnancy. However, it is
worth knowing that there are diseases that are dangerous for a pregnant woman.
For example, rubella. This infectious disease is teratogenic (causes fetal malformations). At the
stage when a pregnancy is planned, the future mom would be well advised to test for the
presence of antibodies to rubella. If there are no antibodies, it means that there is no immunity
to the infection and it makes sense to vaccinate.
To protect herself, it may be necessary to take other vaccinations, but it is better to discuss this
issue with doctors on an individual basis.
What age couples, as a rule, turn to doctors at the stage of conscious planning of pregnancy?
-It is challenging to precisely define the parameters of an age group. Awareness of pregnancy
planning has recently increased significantly, so the age range has expanded. People come to us
both at the age of 18 and much later. The possibility to use reproductive technologies according
to the legislation of the Republic of Belarus is limited to the age of 50.
What role does the age of a man and a woman play in successful conception?
- With age the frequency of chronic diseases increases, unfavorable environmental impact and
bad habits accumulate. All this can not bypass the reproductive system.
Age-related changes in sex cells increase the risk of giving birth to a fetus with genetic
pathology.
As for the activity of spermatogenesis, age is not so significant, and if there are no
"aggressive factors", spermatogenesis, and thus the possibility of conception can be maintained
for a long time.
For the female organism, age-related changes in sex cells begin to appear closer to forty years
of age. Here we are talking about a decrease in the ovarian reserve - a decrease in the number
of oocytes, a change in their "quality". After 45 years of age, the probability of a positive result
(birth of a child) even with IVF is less than 5%.
It is believed that by the age of 42, 60-80% of all pregnancy terminations are due to embryo
abnormalities.
Do I need to check my ovarian reserve?
- Ovarian reserve is the supply of eggs in a woman's ovaries. Simply put, the ovaries are
the "storage chamber" of unripe eggs. Every menstrual cycle, the leading follicle grows and
the egg matures in it. Usually one egg matures, but it happens that there are several dominant
follicles, and then there is a chance of multiple pregnancy - the birth of so-called "identical"
twins. The stock of eggs, unfortunately, is not infinite and decreases over time. It can indeed
be checked, but the question is - is it always necessary?
I do not consider this examination mandatory when planning a natural pregnancy.
But it makes sense to check the ovarian reserve if:
- There are problems with conception;
- You are preparing for IVF;
- There was or is planned a surgical intervention on the ovaries, and it is necessary to check
their functioning;
- Menstrual cycle is disturbed.
Laboratory tests (determination of follicle-stimulating (FSH), luteinizing (LH) and
anti-müllerian (AMH) hormones), as well as assessment of the ovarian structure by ultrasound
(counting antral follicles and determining the ovarian volume) are performed to determine the
ovarian reserve.
What tests should a woman take in advance?
- Tests to detect sexually transmitted infections are of great relevance. It is important to
remember that if the presence of infection is confirmed in one of the partners, treatment is
mandatory for both men and women, since the infection can occur in a hidden form, have no
clinical symptoms and not even be detected by laboratory examination.
It is necessary to check the condition of the cervix. To do this, colposcopy is performed and a
cytologic smear is taken. It is also important to assess the function of the thyroid gland by
hormonal profile indicators and, of course, to conduct general examinations (clinical blood and
urine analysis, biochemical blood analysis, chest fluorography, ECG).
Is it true that even if a woman does not menstruate, she can get pregnant?
- It depends on the cause. If it is a genetic disease, then, unfortunately, the woman is infertile.
If the problem is related to some functional disorders, then by identifying the cause and carrying
out the necessary treatment, it is possible to restore the reproductive function and get the desired
pregnancy.
What tests are recommended for a man?
- For a man as well as for a woman it is important to exclude sexually transmitted infections
and chronic diseases.
If there are already difficulties with conception (the planned pregnancy does not occur for more
than 6-9 months), it is necessary to assess male fertility. The peculiarity is that changes in
spermatogenesis have no effect on the general condition. A man may not have a single living
sperm, but he will not know about it. Clarifies the situation spermogram - semen analysis,
which helps to establish fertility and identify possible diseases of the sexual system.
Why is it recommended to stop smoking at the stage of planning pregnancy?
- By causing chronic intoxication, smoking destroys the reproductive system. The development
and maturation of spermatozoa occurs for a fairly long period of time - about three months.
In order for fertilization to take place "quality" and "healthy" sperm, it is desirable to get rid of
this bad habit in advance.
For a woman, smoking can not only have an undesirable effect on the maturing egg, but also
cause significant harm to the fetus (if you continue to smoke during pregnancy).
Nicotine causes vasospasm, so the nutrition of the fetus may be impaired and the oxygen supply
will be insufficient. This can lead to stunted development, reduced compensatory capacity
during pregnancy and in labor, up to intrauterine and intrapartum death.
To end the addiction immediately after the news of pregnancy is very difficult, even with an
iron will. If a woman quits smoking in the early stages, the effect of nicotine on the fetus can
already manifest itself. It is better to quit smoking in advance, at the planning stage.
How should I revise my diet and is it worth it?
- Nutrition during pregnancy should be balanced to meet the needs of mother and fetus in all
nutrients, vitamins and trace elements. It is necessary to revise the diet in advance for those who
have a disordered diet, that is, if you eat irregularly, abuse fatty foods, eat few fruits and
vegetables and so on. Obesity can also be an obstacle - it is a factor that reduces fertility,
especially in women.
"Obesity in women can lead to pregnancy failure, increased risk of late term toxicosis and
gestational diabetes mellitus."
Do you recommend taking vitamin complexes?
- You can't just take a course of vitamins. Remember that hypervitaminosis (acute disorder as a
result of intoxication with a high dose of one or more vitamins contained in food or
vitamin-containing preparations) is no less dangerous than avitaminosis (acute lack of vitamins
in the body). Thus, an excess of vitamin D can provoke teratogenicity, which we have already
mentioned. In general, vitamins should not be trifled with.
" Vitamin supplement labels typically show the proportion of the daily recommended intake.
If the percentage is less than 100, the drug is preventive (but this does not cancel the need to
follow the instructions). If the percentage is more than 100, it means that the drug is therapeutic
and requires a doctor's consultation."
Does physical activity help or, on the contrary, hinder?
- Of course it helps. I will again emphasize women. On the background of reasonable physical
activity accelerates metabolism and improves the structure of muscles. Especially good if trained
abdominal muscles - it will help in childbirth.
But loads in excess should be removed. It can be dangerous for a woman's body due to
psycho-emotional and physical exhaustion and menstrual dysfunction.
In what cases would you recommend postponing the planning of pregnancy?
- If we talk about reasons that do not concern health - career growth, graduation, some trips - for
me these are not arguments. I believe that the only reason to postpone pregnancy is physiological
complications or the need for corrective procedures.
For all our efforts to write down, plan and calculate every point of life (which has become
fashionable today), pregnancy is not a business plan. Not everything is beyond the control of
even the most professional doctors, and it is unrealistic to predict how the circumstances will
unfold in a few years. Planning should be done when you feel the need - this is the main rule,
in my opinion.
Back to health, the most common problems that make doctors recommend postponing
pregnancy are:
- Sexually transmitted infections;
- Thyroid disorders;
- Glucose disorders, diabetes mellitus;
- Hypertension;
- Oncology.
Does it happen that both partners are absolutely healthy, but pregnancy does not occur?
- Yes, it happens. In such situations, it is necessary to pay additional attention to the examination
of the couple and planning for conception.
It is necessary to realize that the possibility of conception is only 3-4 days in the cycle. It is
important to be able to calculate the days with maximum probability of pregnancy. For this
purpose, today a lot of technical means (programs in gadgets, ovulation tests) have been
developed. If there are difficulties with this, it is necessary to contact a specialist and he will
certainly help.
" Each phase of the cycle is characterized by a different probability of conception. If a woman
has regular menstruation, you can calculate the most suitable day for conception. The best time
is in the middle of the cycle, when ovulation (the release of the egg from the ovary) occurs, as
well as a couple of days before and after that."
However, there is still a so-called form of idiopathic infertility, when no irregularities are
detected in the partners, but conception does not occur. Such cases are extremely rare, but they
do exist, and experts around the world still can not find an answer to the question of what is the
cause.
In what cases is IVF performed?
- Indications for IVF are forms of infertility that cannot be treated by other methods. Or if the
probability of overcoming infertility with the help of assisted reproductive technologies is higher
than with other methods of treatment.
This procedure is also suggested for idiopathic infertility when all other methods fail.
What is cryopreservation, who needs it?
- Cryopreservation is a safe method of freezing and preserving sex cells (eggs and sperm) or
embryos in liquid nitrogen at a very low temperature. The use of such temperature allows to
stop all biochemical processes in cells. The possible duration of storage is practically unlimited.
Upon defrosting, all cell functions are fully restored.
Who needs it? It is worth thinking about this method of fertility preservation if there is a
treatment that can damage the structure or function of reproductive organs. Most often these are
surgical interventions on the genitals or "aggressive" treatment (chemotherapy and radiation
therapy) for cancer.
The expediency of cryopreservation of germ cells should be discussed with a reproductologist.
After treatment is completed and the body recovers, the preserved cells can be used in assisted
reproductive technology programs. This will allow the family to have children. If for some
reason a woman is unable to bear a child on her own, surrogacy is an option. Even in difficult
situations it is often possible to find a way out, the main thing is not to despair and not to lose
positive attitude.