Where to start planning pregnancy
Pregnancy is a wonderful and very exciting time for any woman. In order for all 9 months to bring joy and a sense of pleasant expectation, pregnancy must be planned. Preparing for an interesting situation will not require much time and money, but will make a great contribution to the health of mother and child.
The terms “family planning” and “pregnancy planning” are familiar to many. In these concepts specialists include several main points:
-adequate contraception before planned pregnancy
-maintaining a healthy lifestyle for future mom and dad
-necessary studies and analyzes before conception
-taking certain medicines during preparation and during pregnancy
-the correct psychological attitude of future parents
Where to start preparing for pregnancy, the following algorithm of actions will tell you:
Algorithm for preparing for pregnancy
-Rejection of bad habits
-Correction of chronic pain
-Elimination of harmful household and production factors
-Tests for TORCH infections
-Ultrasound of the pelvic organs
-Determining the level of TSH
-folic acid intake
-Identification and treatment of iron deficiency
An important factor in a successful pregnancy is its desirability. Moreover, the desire to have a child must be in both parents. It has been proven that an unhealthy psychological situation in the family often prevents the long-awaited moment from coming. But excessive “fixation” on future offspring is not beneficial. When planning, you need to continue to live a fulfilling life, have a job, engage in hobbies and take your mind off thoughts about pregnancy.
Rejection of bad habits
Everyone knows that smoking and drinking alcohol during pregnancy are associated with high risks for the baby. Women with bad habits are more likely to have miscarriages, stillbirths, preterm pregnancies and low birth weight babies (not smoking during pregnancy reduces the risk of disability and death in children). In addition, maternal smoking is associated not only with an increased risk of bronchial asthma in a child, smoking causes significant harm to the baby’s immune system by changing the DNA structure. Drinking alcohol leads to fetal alcohol syndrome (a combination of special facial features, low birth weight and mental retardation). Therefore, it is better to end bad habits before the planned conception. In addition, alcohol and nicotine can lead to changes in the egg and sperm cells, which in itself is associated with infertility and miscarriage.
Correction of chronic diseases
Many chronic ailments common in our society are successfully controlled and do not prevent pregnancy. Diabetes mellitus, hypertension, epilepsy, kidney disease – all this is a reason for a thorough examination before pregnancy. Some drugs needed for such diseases need to be replaced with safer ones for the fetus. Sometimes you need to adjust the dose or frequency of taking the pills. If for some reason the disease is not compensated at the moment (glucose level goes off scale, pressure jumps, epiactivity persists, etc.), it is better to postpone the onset of pregnancy until the causes of decompensation are clarified.
Elimination of harmful household and production factors
Work in hazardous industries (paint and varnish, associated with heavy metals and pesticides) can lead to complications of pregnancy and deterioration of a woman’s health. Therefore, when planning conception, it is important to change labor to less harmful and difficult. The same applies to household items. Pregnant women often have a desire to make repairs in the nursery. Therefore, it is better to carry out all the finishing work in advance, before conception, while avoiding strong physical overstrain. Minimize the use of household chemicals, refuse the abundant use of chlorine-containing cleaners and detergents in everyday life, switch to the use of products made by yourself from baking soda, laundry soap, vinegar and other safe and forgotten products (see harm to household chemicals, as make your own detergents).
Obesity is the scourge of the entire modern society and the cause of many serious diseases (hypertension, diabetes, atherosclerosis, and even cancer). But another important consequence of being overweight is problems with the onset and bearing of pregnancy. Excess pounds change the hormonal background, increase blood pressure, burden the kidneys, weaken the woman. In such conditions, the onset of pregnancy is difficult. If the attempts are still successful, then the fetus suffers from chronic hypoxia, and the expectant mother risks getting a hypertensive crisis or completing the pregnancy with preeclampsia. That is why all obstetricians are advised to normalize weight before pregnancy. Usually this is enough to correct the diet and rational physical activity. In rare cases, special drugs prescribed by a specialist are required. By the way, pathologically low weight also does not contribute to the onset of a normal pregnancy. To determine the norm, you can use the body mass index: BMI \u003d weight (kg) / height2 (meters). The normal index ranges from 18.5 to 24.9.
For the onset of pregnancy, its bearing and prolonged lactation, it is very important to eat fully and balanced. The diet of a woman planning to become a mother should include cereals, vegetables and fruits, meat (red is a must), eggs, fish, and a sufficient amount of liquid. But it is even more important to avoid foods that are potentially harmful to the unborn child. Indeed, in the planning process, it is impossible to say exactly when the pregnancy will occur. Therefore, you need to behave as if an interesting situation has already arrived. A pregnant woman (and therefore one who plans to become pregnant) should exclude the following foods from her diet:
-Poorly fried meat and fish
-Dishes with raw eggs
-Soft cheeses made from unpasteurized milk (brie, feta)
-Hot dogs and convenience foods
-Sugary carbonated drinks
-Large amounts of coffee (more than 6 cups a day)
These simple rules will help protect against infections and improve the body before the planned conception.
Analyzes on TORCH
Be sure to take tests before pregnancy for a group of infections that are especially dangerous for pregnant women, combined under the abbreviation TORCH: Toxoplasmosis during pregnancy Rubella, pregnancy Cytomegalovirus and pregnancy Herpes during pregnancy Some other infections (viral hepatitis B and C, syphilis, HIV infection) Analyzes for rubella and CMV. All pregnant women are tested for antibodies. But it will be much easier to interpret the results, evaluate the risks, and determine the need for treatment if the levels of these antibodies are known just before pregnancy.
To determine the activity of immunity against TORCH infections, it is necessary to donate blood for immunoglobulins M and G. The former increase during the initial infection, persist during the acute period of the disease, and then gradually disappear altogether. The second ones mean the formation of an immune response to the invasion of infection, appear some time after infection, then decrease to a certain level and persist for a long time, sometimes for a lifetime.
On the form of the results of the analyzes, you can see the following designations:
IgM – negative (less than reference values),
IgG – negative In such a situation, the woman has never encountered this infection, she has no immunity. In the case of rubella, it may be recommended to get vaccinated against the disease six months before pregnancy. Negative immunity to Toxoplasma is a reason for careful heat treatment of food and reducing contact with cats. Similar results for CMV and herpes require examination of the partner and careful attention to the prevention of sexual infections, as well as limiting communication with children attending preschool institutions.
IgM – negative,
IgG – positive Test data indicates immunity to infection. Perhaps the woman had been ill in the past, or immunoglobulins were developed as a result of vaccination (for rubella, for example). In any case, the fetus will be protected by the mother’s antibodies from a dangerous infection. Do not forget that there is an extremely low probability of infecting a baby during an exacerbation of a chronic asymptomatic infection (CMV, for example). But the risks of doing so are negligible.
IgM – positive (at any IgG values) Typically, these results indicate a currently tolerated acute infection. During pregnancy, this conclusion is made after an additional examination and special tests. In preparation for the conception of a child, the presence of IgM – to postpone pregnancy until the disease subsides and the formation of stable immunity (confirm this by re-analysis).
Ultrasound of the pelvic organs
Ultrasound examination is an informative, safe and inexpensive way to diagnose serious and not very diseases. It can be used to detect large fibroids, polyps of the endometrium and cervix, oncological diseases of the genital organs, large ovarian cysts. All these conditions before pregnancy must either be treated, or removed, or ensured that they are safe for the baby. In addition, ultrasound is often able to detect ovulation. This is especially helpful for women with unstable or long menstrual cycles. By finding out the approximate day of ovulation, the preparation of a woman for conceiving a child will be better.
Determining the level of TSH
Thyroid-stimulating hormone is a substance that regulates the functioning of the thyroid gland. With violations in its work, TSH rises or falls. It is known that hypothyroidism (low functioning of the thyroid gland) adversely affects the development of the baby, leading to mental development disorders. Therefore, it is important to identify this condition even before pregnancy. An elevated TSH level (greater than 2.5mU/L in a non-pregnant woman) is often an indication for taking Thyroxine. The dose of the drug is prescribed by the attending physician, adjusting it when pregnancy occurs. In some cases, it is necessary to take additional tests. TSH is the only hormone needed to check when planning a pregnancy for every woman.
Folic acid intake
Numerous studies have shown that taking folic acid (vitamin B9) in preparation for pregnancy and in its first months reduces the likelihood of fetal malformations (neural tube defects). Until recently, these defects were widespread, leading to the death of the fetus and newborn, as well as to severe disability of the survivors. Some of these defects are visible even before birth (anencephaly – the absence of most brain structures), and some are closed and give themselves out after many years with back pain, shortening of the limbs, scoliosis and headaches. The main means of preventing defects in the closure of the neural tube is the intake of folic acid a few months before conception and during the first 12 weeks of pregnancy.
all healthy women: 400 mcg daily
women with epilepsy: 1 mg daily
women with children with similar defects: 4 mg daily
Some drugs interfere with the metabolism of folic acid in the body, so sometimes the dose of this vitamin needs to be adjusted (many anticonvulsants, calcium channel blockers, triamterene, bactrim, phenobarbitals). When choosing a folic acid preparation, it is important to consider not only the dosage. Recently, this vitamin is often produced in the form of dietary supplements. It is better not to make such purchases. Dietary supplements are not tested for safety, so taking them before and during pregnancy comes with a lot of health risks. It is better to purchase a conventional drug – folic acid.
Identification and treatment of iron deficiency
A decrease in the amount of iron in the body, and as a result, hemoglobin, adversely affects the health of any person. There is weakness, brittleness of nails and hair, increased bleeding of blood vessels, subfebrile condition, changes in appetite and many other unpleasant consequences. But for a woman in an interesting position, anemia is especially dangerous. It can lead to more severe pregnancy, placental insufficiency and a decrease in the health of the fetus. Without exception, all women planning a pregnancy are recommended to take 50-80 mg of iron until the end of breastfeeding (see iron preparations for anemia). If symptoms of anemia appear, or hemoglobin drops below 110, then the dose of the drug can be doubled. To assess the depot of iron in the body, the level of ferritin is used (ideally, it should be above 40). It is convenient to use for those who want to get pregnant, the drug Ferretab, as it also contains folic acid. But according to the appointment of a specialist, you can take many other preparations of 2-valent iron. It is important to remember that low ferritin without symptoms of anemia is not a contraindication to pregnancy. At any level, iron intake for prevention will be recommended. In addition to this, it is worth including a sufficient amount of red meat, eggs and fish in the diet (see pregnancy with low hemoglobin). Useless activities before pregnancy.
There are a number of actions that are often recommended by doctors, but completely meaningless when planning a pregnancy:
Taking complex vitamins to prepare for pregnancy
Multivitamin supplements that are trendy at the present time are usually completely unnecessary (myths about synthetic vitamins, good or bad). After all, pregnant women from all vitamins need to take folic acid, as well as two trace elements (iron and, in some cases, iodine). The remaining vitamins and elements are prescribed only with a confirmed laboratory deficiency, and in the form of individual drugs, not complexes. Moreover, actively consuming multivitamins and vitamin-containing dietary supplements before and during pregnancy can greatly harm the health of future offspring. For example, when the concentration of vitamin A is more than 10,000 IU / l, deformities and damage to the fetus occur, and there is some cumulative effect. Therefore, vitamin A intake should be stopped in advance.
Care must be taken when taking vitamin D, as well as iodine-containing drugs.
Complete “preventive” sanitation of the vagina
An ordinary visit to the gynecologist and a banal smear on the flora is a frequent reason to prescribe unnecessary treatment. Some doctors, seeing on the form positive results for gardnerella, thrush, E. coli and other conditionally pathogenic organisms, immediately rush to prescribe antibiotics or antifungal agents (see fluconazole in the 1st trimester is very dangerous). Undoubtedly, all these pathogens at high concentrations and obvious symptoms in a woman can complicate the course of pregnancy. But if the same gardnerella does not exceed 105 CFU, while beneficial lactobacilli are not less than 105 CFU, and there are no symptoms at all, no treatment is required! Thoughtless sanitation destroys the normal flora, contributing to the reproduction of dangerous microbes (see bacterial vaginosis, colpitis during pregnancy).
Examination for “hormones”
Another common way to make a woman worry is to conduct an analysis for all hormones in preparation for pregnancy. The dubious list usually includes progesterone, androgens, estrogens, prolactin. All of them rise or fall during the life of a woman, and even within the same menstrual cycle, within individual boundaries. Therefore, even with the diagnosis of “infertility”, when there were signs of ovulation on ultrasound, examination for these hormones is not necessary.
Measurement of basal temperature
A method widely used in the past has been used to determine the day of ovulation. It is built on an increase in the rectal temperature of a woman, depending on the ovulatory process. This method is extremely inaccurate and uninformative for several reasons: measurement technique errors, individual characteristics of the female body, the presence of ovulation not in every cycle. Usually, a low basal temperature is just a source of excitement for a woman. Therefore, to determine the fact and time of ovulation, it is better to use ultrasound or special tests (ovulation test).
Complete examination for unsuccessful pregnancy attempts within 11 months or less
A fruitless marriage is considered after a year of planning without effect. Therefore, 3-4 months without the onset of pregnancy is not a reason to panic. In women after 30 years of age, ovulation occurs less and less, so conception occurs more often after 6-12 months of trying (see pregnancy test results).
How can a man prepare for conception?
The appearance of offspring is always the decision of two people: mom and dad. The woman bears the responsible stage of bearing a child and his birth. But this does not mean that the future dad should not prepare for this.
When planning a child, a man should:
-Refrain from drinking alcohol (including beer).
-Stop going to the bathhouse and sauna (preferably 3 months before the planned conception). Thermal exposure can affect the quality of spermatozoa and their DNA, which leads to difficulties in conception.
-Avoid prolonged sexual abstinence. The sperm depot must be constantly renewed in order to reduce the risk of mutations to a minimum.
-Get tested for viral hepatitis, HIV, syphilis and sexually transmitted infections.
-Support a woman in maintaining a healthy lifestyle and proper nutrition.
-Provide a favorable psychological atmosphere in the family. It is important to remember that the contribution of paternal chromosomes to the development of the child is very large: the size and quality of the placenta depends on them. Therefore, the preparation of a man for conception should be no less thorough than that of a woman.
Preparing couples with infertility and failures in past pregnancies
If pregnancy does not occur within 1 year, then the couple can be examined.
The first stage of preparation is for men (see how to take a spermogram, results), then – the determination of female ovulation by ultrasound and the patency of the fallopian tubes (see obstruction of the fallopian tubes). Depending on the results, the list of tests and prescribed treatment may expand. This question is decided only by the attending physician. If you plan to enter into pregnancy according to IVF protocols, then the list of hormones that require research is often expanded, and the man’s spermogram is also carefully studied.
When preparing a woman for pregnancy after a miscarriage and freezing of the embryo, it is important to understand that every 2-3 conception ends unsuccessfully. More often this happens at an extremely early date, when a woman may not know about her situation. The reason for this is genetic damage. It is believed that a comprehensive examination of couples is necessary only after 2 or more missed pregnancies in a row. With fewer failures, no additional measures need to be taken.
Immediate preparation for conception
Perfect day to conceive
For pregnancy to occur, the fusion of the male and female cells is necessary: the sperm and the egg. This process is not always possible, but only on certain days of the menstrual cycle. Approximately 12-14 days before the start of the next menstruation, a mature egg is released from the ovary. This process is called ovulation. That is, with a classical cycle of 28 days, this event falls in its middle. More precisely, the day of ovulation can be determined using ultrasound. The egg, after entering the fallopian tube, is capable of fertilization for about 12 hours. That is, half a day remains for sexual intercourse to occur and the spermatozoa to reach the goal. Spermatozoa after entering the vagina remain viable for about 72 hours.
Thus, the most suitable day for conception is the day of ovulation and two more days before it.
Abstinence before conception: benefit or harm?
It is believed that 2-3 days before the intended conception, it is better to refuse sexual contact in order to increase the chances of pregnancy. There is some truth in this: with daily sexual intercourse, the number of sperm in the ejaculate decreases, since the body does not have time to produce them. But not every woman knows the exact day of ovulation, so it is not necessary to specifically maintain three-day pauses between contacts. It is much more important that both partners are tuned in to intimacy, because the benefits of mutual orgasm in the success of conception have been proven by scientists.
How many days does a man need to prepare for conception?
The life cycle of spermatozoa is about 72 days. That is, their composition is updated every three months. Therefore, it is advisable for a man to refrain from bad habits and exposure to high temperatures three months before planning a pregnancy.
Effect of posture on successful conception
The position of both partners during intercourse does not play a role in pregnancy. There is a version that after the end of intimacy, a woman should become a “birch tree”, that is, raising her straight legs up. This is far from necessary, since the spermatozoa move towards the egg not under the force of gravity, but due to fluctuations in the fluid, villi of the fallopian tubes and uterine contractions.
How to plan the gender of the child?
On the Internet and women’s forums, there are many ways that allegedly help to program the gender of the unborn baby. This is conception according to the lunar calendar, and the use of special food on the day of intimacy, and various special positions, and many other incredible ideas. All these methods are absolutely unscientific and useless. There is evidence that spermatozoa carrying the X chromosome (that is, responsible for the birth of a girl) are slower and more enduring. And spermatozoa with a Y-chromosome are faster and live less. Therefore, sexual intercourse a day or two before ovulation will allow the X-sperm to reach the egg and increase the chance of giving birth to a girl. Accordingly, if sexual intercourse is performed on the day of ovulation, there is a high chance of conceiving a boy, because. sperm with a Y chromosome will reach the egg faster. There is a share of scientific character in this method, it has the right to exist. But there is no statistical evidence for this method.