Preparing for Pregnancy
The goal of FSMG is to assist in the conception of healthy children. It is important that both the female and male are living a healthy lifestyle in order to increase the ability to conceive and to have a healthy child. It is impossible to be aware of all possible factors that may cause pregnancy or fetal complications. Nevertheless, common sense avoidance of known toxins and a healthy lifestyle represent a reasonable approach while attempting pregnancy and being pregnant. The following are our pre-conception recommendations:
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Genetic Diseases Prenatal Screening
It is recommended that couples consider pre-conception testing of the following ethnically appropriate genetic disease screening after consultation with their physician. Some couples may decline testing while others may choose to proceed. Referral to a genetic counselor for more in-depth information is recommended as well, if so desired. More information is available at the American Congress of Obstetricians and Gynecologists (acog.org).
- Cystic Fibrosis (Caucasian)—the carrier rate in people with no family history is 1 in 26
- α Thalassemia (Southeast Asian) and β Thalassemia (Mediterranean)
- Tay Sachs, Canavans, Gaucher (Jewish), and Tay Sachs (French Canadian/Cajun)
- Sickle Cell Anemia (African American)
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Rubella/Varicella Titre and Vaccine
Rubella (German measles or 3-day measles) is a communicable virus, which typically causes low-grade fever, upper respiratory symptoms, and a diffuse red rash. In childhood, this infection is usually mild. However, if contracted during pregnancy, this disease can have severe effects on the developing fetus, including blindness, heart defects, hearing defects, musculoskeletal defects, and mental retardation. Varicella (Chickenpox) is also a communicable disease, but now there is a vaccine available.
If you have not been tested for rubella/varicella immunity, we advise that you do this. If you are not immune, we recommend that you be vaccinated for rubella. You will then need to wait one month before trying to conceive, as the shot is a live vaccine. (Contraception should be used during this month).
If you know that you never had chickenpox or the immunization or if you are not sure, then you should be tested for Varicella immunity. If you are not immune, we recommend that you be vaccinated for Varicella. Again, you will need to wait one month before trying to conceive, as it is a live vaccine. (Contraception should be used during this month).
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Healthy Diet
For the female: A healthy, balanced diet composed of fresh foods that are not processed or overcooked is one of the best things you can do for yourself and your future offspring. Children who start life well nourished have a distinct advantage in their intellectual capacity and ability to fight disease. A recent study (published in the New England Journal of Medicine, 2000; 343:1839-45) has found that ingesting caffeine may increase the risk of an early spontaneous miscarriage among non-smoking women carrying fetuses with normal karyotypes (chromosomes). Reducing caffeine intake during early pregnancy may be prudent. The study suggests that pregnant women curtail their consumption of coffee to two cups of American coffee per day.
The US Food and Drug Administration and US Environmental Protection Agency disclosed an alert in August 2004 regarding the consumption of mercury in fish and shellfish. They recommended that women who are pregnant or may become pregnant should not eat shark, swordfish, King Mackerel, or tilefish due to their high levels of mercury. You should also check local advisories about the fish caught in local lakes or rivers. It is still recommended that you eat two servings of other fish or shellfish due to their high quality protein, omega-3 fatty acids, and low saturated fats.
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Vitamin Supplementation
A multivitamin containing folic acid (0.4–0.8 mg/day) is a good adjunct to dietary nutrition. Vitamin use should be started prior to attempting pregnancy. For a list of foods containing folic acid, refer to the March of Dimes website (marchofdimes.com). Visit the Professionals and Researchers section, and then select folic acid from the list in the left hand column.
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Exercise and Weight Management
For the female: For optimal fertility, you should try to maintain your ideal weight. If you are significantly overweight or underweight, you can develop ovulation problems. Exercise regularly. Staying fit will help control your weight and will keep your body strong enough to carry a pregnancy more easily. Excessive exercise (exercise that burns more than 2000–4000 calories per week), however, may impair ovulation in some women.
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Emotional Aspects of Infertility Treatment
Couples undergoing infertility treatment are subjected to a substantial degree of stress and an emotional upheaval. With each step in the diagnostic work-up and treatment, your physical, emotional, and financial investments become greater. Because of this, the monthly disappointments can become magnified. You feel the strain in many areas of your life. Different people also react to stress differently, which can lead to communication problems with partners and family.
Sharing information with another couple who has had problems with fertility can be very helpful. RESOLVE (resolve.org) is a non-profit national organization that offers this type of group support. Individual counseling by recommended psychologists are available to you and can be helpful on a short- and long-term basis for dealing with relationship problems that you may encounter during your infertility treatments.
Becoming knowledgeable about infertility can also help you deal with the medical and emotional aspects of your situation. Libraries and local bookstores can provide informative information about infertility. RESOLVE also has a great deal of excellent printed information and will send it to you on request.
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Emotional Aspects of Infertility
Set goals as a couple regarding how far you are willing to go with your treatment plan. Discuss these with your partner and come to an agreement based on your financial and emotional limits. Also explore with each other how you feel about adoption and child-free living. These communicated feelings will have a bearing on the limits of treatment that you set.
Take short breaks from your infertility treatment. Try not to make it the sole focus of your life. Pursue the other aspects of your relationship with your partner. Remember the interests that brought you together in the first place. Enjoy intercourse during the non-fertile times of the month. It is different than “making a baby” intercourse during the fertile period.
