Fertility Tips for Brides-to-be and New Couples

Dr. Chito Nwana MD, FACOG (Consultant, Obstetrics & Gynecology)

As couples plan to get married, they make several preparations for various activities and factors that will pervade their life as husband and wife. They plan for the wedding event itself, honeymoon, accommodation for the new family, transportation (cars), service and care-givers etc.

As a gynecologist, I know that a fetus arise from the fertilization of an egg with a sperm. In building a new family, therefore, I believe that newly married couples need to know some basic, yet fundamental health tips that can prepare them for getting pregnant. Below, I have itemized them for easier understanding and application.

1)     Lifestyle:

i)                  Weight: Weight of an individual can often be a sensitive social issue, fact is, being overweight or significantly underweight can inhibit ovulation by affecting hormone production. Also women at these extremes of weight are at risk for poor pregnancy outcomes should they become pregnant. Maintaining a healthy weight (Body Mass Index) is desirable.

ii)                Good Nutrition and Exercise: Even though research has not really shown any specific diet that will improve fertility, a healthy diet is still important. Your diet should include folic acid and prenatal vitamins. Caffeine intake should be limited and alcohol should be completely avoided when trying to get pregnant. Whilst, physical activity is an essential component to a healthy lifestyle, when you are trying to conceive, avoid intense aerobic activity and limit your aerobic exercise to no more than 7 hours a week.

iii)             Annual Exams: Annual medical examinations are an integral part of healthy living. Scheduling regular health visits to your doctor will help detect any medical condition that will affect your fertility or pregnancy, including possible sexually transmitted infections; as these are a leading cause of infertility in women and men.

iv)              Get Emotionally Healthy: Some research studies have shown that stress may have a negative impact on female fertility and may also be a psychological cause of male erectile dysfunction. So finding how to cope with stress is important and essential, when planning to conceive.

2)     Preconception Care and Counseling: This is a critical component of health care for all women of reproductive age, before their first pregnancy and in between pregnancies, because optimizing the health of the mother before conception is important for improving pregnancy outcomes. It provides the opportunity to educate women about fertility or pregnancy issues, identify some of the risks in pregnancy, inform them about these risks, and then institute appropriate management of these conditions before conception. Preconception counseling can be obtained from your obstetrician/ gynecologist as well as your family physician. The following issues should be discussed:

i)                  Medical History: This will enable identification of certain medical conditions like hypertension or diabetes for early intervention to be initiated. Your doctor will also review all the medications, including multivitamin and supplements, ensuring that these drugs are safe during pregnancy. For instance women can normally be treated for severe acne (pimples) with the drug isoretinoin. This drug can however cause damage to a fetus. Also, some drugs in the category of anti convulsants may be harmful to the fetus. Your doctor may thus advice you to stop them.

ii)                Reproductive History: Diagnosis and early treatment of conditions such as uterine malformations, uterine fibroids and maternal autoimmune disease may lessen the risk of recurrent pregnancy losses. Here, I will like to squash the myth that women with uterine fibroids cannot get pregnant. Uterine fibroids are very common, with some studies reporting fibroids in about 75% of women by age 50 years. Most fibroids do not affect fertility and can be left alone. The effect of fibroids on fertility depends on the location and size of the fibroid, which can be easily evaluated and managed by the gynecologist.

iii)             Family History: preconception assessment of family history for genetic risks offers a significant advantage. It allows women and their husbands to be informed of certain medical facts such as autosomal recessive risks (eg sickle cell carriers) and their implications outside the emotional context of pregnancy.

iv)              Physical Examination: A physical examination and laboratory screening to identify potential risks to the fetus and to the woman is equally vital for proper diagnosis and treatment.

3)     Keep a Menstrual Calendar: It is important for women of reproductive age, planning to conceive, to keep a menstrual calendar. This allows both them and their gynecologist to have a better understanding of their menstrual patterns. With this information the ovulation window can be calculated, avoiding poor timing. There have been cases of several couples that were unable to conceive just because their timing was off. In this case, women are advised to record their menstrual cycle for at least 3 months before returning for further evaluation.

4)     Living Together: In today’s world, characterized by professionalism and labor mobility, it is possible that couples find themselves living apart. So when couples are planning to conceive, it is advisable for them to spend more time together.

There is so much to write about fertility but I do not want to overload you with too much information. I hope these few tips will answer some questions you may have as you embark on this beautiful journey. If you have been trying to conceive for more than a year without success, please continue to be hopeful and know that there are several options.

For General Comments, post here at the blog. And for any questions you may have for Dr Chito Nwana, you can contact her directly via E-mail at cnwana@tabithamedicalcenter.com