If you are trying to conceive, the advice is to:
1. Ensure that any underlying diseases that you have are well-controlled. These would include hypertension, diabetes, thyroid diseases, autoimmune diseases, renal diseases, etc.
7. If you have been trying to conceive for 1-2 years without success, you may wish to see a doctor for further investigation. The gynaecologist could assist by prescribing medications (e.g. clomiphene or letrozole) to increase ovulation e.g. in patients who do not ovulate regularly, or prescribe other more advanced fertility treatments such as SOIUI (superovulation in utero insemination) and IVF (in vitro fertilization).
1. Ensure that any underlying diseases that you have are well-controlled. These would include hypertension, diabetes, thyroid diseases, autoimmune diseases, renal diseases, etc.
2. Take folate 0.4 mg to 5 mg once a day as early as 1-3 months before you start trying for a baby. This reduces the risk of spina bifida and anencephaly in the fetus.
3. If both your spouse and you do not have any past medical problems such as pelvic infection, and you are having regular menstrual cycles without unusual menstrual pain, have sexual intercourse 3-4 times a week. In general, sperms last for 72 hours while the egg lasts for 24 hours. Hence having sexual intercourse 3-4 times a week optimises the chance of pregnancy.
4. Aim for a normal BMI of between 20-25 before trying for a baby. This may be achieved via regular physical exercise and a low calorie diet. A normal BMI before trying for a baby is associated with the lowest risks of miscarriage, preterm labour, intrauterine growth restriction and stillbirth.
5. Blood tests that are normally done to screen include:
- Full blood count
- Syphilis, HIV, Hepatitis B, Rubella IgG
- Less routine tests include thyroid function tests and IgG antibodies towards toxoplasma, cytomegalovirus (CMV) and chickenpox (VZV)
- Rubella vaccination (if there is no detectable Rubella IgG level in the blood) - this involves 1 jab
- Chickenpox vaccination (if there is no past history of chickenpox and the VZV IgG is negative) - this involves 2 jabs 4-6 weeks apart
It is advisable to wait for at least 1 month after completing the vaccinations before trying for a baby.
8. Younger mothers and fathers tend to have less medical risks during the pregnancy. Where getting pregnant earlier is an option, this is usually medically advised rather than delaying the pregnancy till you are older.
Risks with advanced maternal age
Older mothers have reduced fertility, increased miscarriage risks and increased risk of chromosomal abnormalities like Down syndrome. More recently, older mothers have also been shown to increase the risk of autism spectrum disorders among the offsprings.
Risks with advanced paternal age
More recently, risks have now been attributed to older fathers (especially those older than 40-45). These include increased risks of miscarriage, rare birth defects, autism, schizophrenia, and even childhood acute lymphoblastic leukemia.
