Preconception care

Preparing for pregnancy

lady-600A healthy lifestyle is recommended before and during pregnancy. You may be surprised to learn that your diet, lifestyle and environment all have a profound bearing on your individual reproductive health and on the health of a baby. Put simply, preconception care involves making sure there is an adequate supply of all factors essential to the quality of sperm, eggs and fertilisation, and a trouble-free pregnancy and delivery of a healthy baby.

Given the formation of mature sperm takes about two months and maturation of eggs about 100 days before ovulation, your reproductive health today is actually the product of your health, diet, lifestyle and environment two to three months earlier.

 

Maximise your chances of conception and give your baby the best start in life

A number of factors beyond your control can influence your fertility, but you can do several things to maximise your chances of conception. Some of these factors will affect both the male and female partners, but we will endeavour to cover them separately.

Female

Smoking

Smoking cessation should be an integral part of preconception care.

Apart from the long-term health risks, smoking is one of the biggest lifestyle factors that can negatively affect fertility.

Women who smoke have increased miscarriage risks, reduced live-birth rates and babies with lower birth weights.

Smoking cessation should be an integral part of preconception care. Women who need support are encouraged to contact 13 QUIT (13 7848).

 

Alcohol

For women, alcohol consumption can increase the risk of miscarriage.

The current Australian recommendation is that if you are pregnant or are planning to conceive, avoiding alcohol is the safest option.

 

Caffeine

Caffeine can have an effect on both partners’ fertility. For women it increases the risk of miscarriage, so you should limit your daily consumption to one or two cups of coffee a day.

Remember that caffeine comes in many guises, not just coffee. Caffeine is present in tea, some soft drinks, energy drinks, chocolate, and certain other foods and medicines.

 

Weight

 Calculate your BMI 

Weight (kg)/Height x Height (m)

Example: 67kg/(1.78×1.78) = 67/3.17

= 21

There is a clear relationship between weight and fertility. As the body’s weight moves away from the normal range (above or below), fertility decreases. Pregnancy may still occur, but not at the normal rate, and the miscarriage rate is higher than average.

Ideal weight is determined by a formula known as the Body Mass Index (BMI). It is calculated using the following formula: weight (kg)/height (m).

The optimal BMI range for fertility health is 20-25. A BMI of under 20 is considered underweight, while over 25 is considered overweight. A BMI over 30 is considered obese. Women with a high BMI put themselves and their babies at risk of complications during pregnancy and in the postnatal period, and damage their long-term health. The good news is, studies show that even a 5-10% reduction in weight can make a significant difference to your fertility health.

 

Diet and exercise

Following a sensible diet and exercise program can help boost your reproductive health. A healthy, balanced diet rich in lean proteins, fresh fruit and vegetables is recommended. Aim to do at least half an hour of moderate-intensity physical activity on most days.

 

Folic acid

Taking folic acid at least one month before trying to conceive, and for the first three months of pregnancy, can reduce your chance of having a baby with neural tube defects such as spina bifida and anencephaly (a congenital abnormality of the skull and/or brain).

We recommend that women planning a pregnancy increase their dietary intake of folic acid a minimum of a month before trying to conceive. Folic acid supplementation (0.5mg daily) should also continue for the first three months of pregnancy. It is available in tablet form, and can be bought from a chemist or health food store. Recent studies indicate that an adequate intake of vitamin B6 is necessary for full absorption of folic acid.

Folic acid is a water-soluble vitamin found in many fruits (particularly oranges, berries and bananas) and leafy green vegetables such as spinach, silverbeet, broccoli, Brussels sprouts, cabbage, endive and avocados. It is also found in cereals, legumes and liver.

 

Immunisation and general health screening

Before you start trying to conceive, it is recommended that you visit your GP for an antenatal screen. This may include blood tests to:

  • Check for HIV, hepatitis B and C, syphilis and your blood group.
  • Determine your immunity to rubella (German measles) and varicella (chickenpox).

Immunisation can help protect an expecting mother from infectious diseases that can cause a birth defect in her unborn child, and prevent transmission once the baby is born. With some immunisations, it is recommended to wait 28 days before trying to conceive.

Your GP may also recommend you undergo a Pap smear test and a breast screening.

 

Recreational drugs

Studies have shown that recreational drugs can increase the risk of birth defects and cause medical problems in the mother.

 

Lubricants

Lubricants can affect sperm quality, so should be avoided if you are trying to conceive.

 

 Stress

Difficulty conceiving a child has been described as one of the most stressful events in a couple’s life. Studies have shown that women under stress produce prolactin, which can interfere with regular ovulation.

It is important to ensure you have adequate rest and relaxation. Let go of all daily non-essential activities and concentrate on your own wellbeing first. Maintaining a positive state of mind improves your health and your chances of a successful pregnancy. A degree of stress in your life is inevitable, but how you deal with it is important.

 

Toxins

We are faced with a myriad of environmental toxins on a daily basis. If you work with or around toxins, you need to use protective face masks, etc. Talk to your doctor or specialist if you have any concerns.

Male

Smoking

Men who smoke have a reduced sperm count and poor sperm morphology (quality). Smoking cessation should be an integral part of preconception care for both partners.

 

Alcohol

Studies have shown that as little as one beer a day can affect the sperm, increasing the risk of miscarriage and reducing the chance of a live birth. Therefore, restrict alcohol intake if trying to conceive.

 

Caffeine

Caffeine can affect sperm motility and morphology; therefore, you should limit your daily consumption to one or two cups of coffee a day.

 

Weight

As with the female, there is a clear relationship between weight and fertility. Men who are significantly overweight may have decreased sperm count and quality.

 

Diet and exercise

Your exercise can be spread over the day in smaller bursts. Try three 10-minute walks daily.

Diet and exercise play important roles in the production of sperm. A healthy, balanced diet rich in lean proteins, fresh fruit and vegetables is recommended.

Men need to keep in mind that sperm is produced at slightly below body temperature, so it is important to exercise at a sensible pace and not overheat yourself.

 

Keep cool

Overheating can affect sperm quality. The testes are outside the body to keep them cooler for a reason. Avoid hot spas, saunas, tight jeans or even sitting with your computer on your lap.

 

Vitamin supplements

Zinc deficiency can reduce testosterone levels and semen production. Taking a supplement can improve DNA quality.

We recommend taking a supplement with antioxidants and zinc. Several formulations are available, so ask your doctor for advice. You will need to start taking these three months before attempts at conception.

 

Recreational drugs

Marijuana and anabolic steroids can affect sperm count and quality. It is not advisable to use any form of recreational drugs when trying to conceive or after conception.

 

Ejaculation frequency

A common misconception is that if you “save it up” and don’t ejaculate until ovulation you will have more sperm and achieve fertilisation. This is definitely not the case. If you “save it up”, the sperm becomes sluggish and tends to have more chance of DNA damage. You need to ejaculate regularly to keep the sperm healthy and motile.

For best results, try to ejaculate every two days, especially when your partner is ovulating. Often we are asked: “Can you ejaculate too much?” If you are ejaculating daily, this will not cause a problem with most males. The quantity will not be as large but the quality should be good.

 

Stress

Studies have shown that semen quality declines during periods of stress. Engage in stress-lowering activities such as walking or golf.

 

Toxins

We are faced with myriad environmental toxins on a daily basis. If you work with paint, diesel fumes or pesticides, for example, use protective equipment.

Pollution can also cause DNA damage to sperm. Avoid all these harmful factors while trying to conceive, or take all safety measures possible if exposed to them. Talk with your doctor or specialist if you have any concerns.

To learn more, please read our fact sheet:  Sperm health

As a couple

Making positive lifestyle changes together is one way that a couple can feel like they are taking control of their fertility health. Trying to conceive can be an emotionally challenging time for both of you, individually and as a couple, and as such any step to improve your chances of conceiving should be considered.

 

To learn more, please read our fact sheet:  Tips to boost your fertility

 

 

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