If pregnancy is in your near future, there are a handful of important tests you should do in order to prepare. As a fertility doctor, I see women before they are pregnant which gives us time to make sure everything is in order for a healthy pregnancy. If you got pregnant before seeing a doctor, don't worry, you still have time!
There are some general lifestyle recommendations that will give your baby the healthiest environment possible.
- The most important things are to quit smoking and eliminate alcohol.
- Moderate caffeine intake of less than 300mg per day (one to two cups of coffee) is considered safe.
- Taking at least 0.4mg of folic acid daily in the three months leading up to pregnancy will ensure your body has adequate stores to support the growth of an early pregnancy.
- Achieving a healthy body weight before conceiving will help limit the risk of diabetes and other complications in pregnancy.
I recommend scheduling a preconception visit with your family doctor or gynecologist. She can assess your health and your family history to determine if any special tests are required. Here are some of the most important tests every woman should do:
Your thyroid is an essential organ for nearly every metabolic function in your body. It is located in your neck, just below your jawline. The thyroid is a gland that produces a hormone called thyroxine. Women who have underactive thyroid glands are termed "hypothyroid." If you are hypothyroid you may suffer from fatigue, reduced ability to exercise, weight gain, hair loss, dry skin and constipation.
Hypothyroidism has also been associated with infertility and miscarriage. A study of women who had hypothyroidism during pregnancy showed that their children had lower IQ scores when they reached school age. Your doctor can check your thyroid function with a blood test for thyroid stimulating hormone (TSH).
When the thyroid is underactive, the brain tries to stimulate it by sending out a stronger TSH signal. A high TSH indicates that the thyroid is underactive. The treatment of hypothyroidism in pregnancy can be complex and it is a very active area of scientific research. Your doctor should personalize your treatment.
Immunity to chickenpox
The first vaccine for Varicella Zoster (a.k.a. chickenpox) was licensed in Canada in 1998. That means a lot of women planning to get pregnant today did not have the chance to be vaccinated in school. Most people became immune to chickenpox simply by catching the virus as a child and enduring the symptoms.
It is very important to check if you're immune to chickenpox before you get pregnant. This can be done with a blood test of your immunity level, known as an antibody titre. You cannot get the chickenpox vaccine during pregnancy. If you're not immune to chickenpox, see your family doctor to get vaccinated (it is usually a two-step process) then wait at least a month before trying for pregnancy. If a woman catches chickenpox during pregnancy, her baby could be at risk of serious malformations such as growth restriction and severe brain and eye abnormalities.
Immunity to rubella
Most people in the world are immune to rubella because of immunization. The vaccine is usually given in combination with measles and mumps vaccines — referred to as the MMR vaccine for short. The rubella vaccine cannot be given in pregnancy. A titre of your antibody level, just like chickenpox, can be done to determine if you are immune to rubella. The babies of pregnant women who are exposed to rubella are at risk of congenital deafness, heart defects, eye problems and nervous system damage. Even if you got the MMR vaccine as a teenager, you may need a booster shot if your immunity level has dropped.
Sexually transmitted diseases
It is routine to test all women who are considering pregnancy for infectious diseases. These include swabbing the cervix for sexually transmitted infections such as chlamydia and gonorrhea, which can predispose a woman to infertility or preterm labour if they are left untreated. Blood tests for HIV, hepatitis B, hepatitis C and syphilis are also recommended. Although these diseases are uncommon, if they are detected early in pregnancy they can be effectively treated to virtually eliminate transmission to the baby.
Blood count and iron level
A normal woman has about five litres of blood in her body. That amount increases to nine litres throughout pregnancy! It is therefore very important to check that you are starting with a normal blood count and iron level. Your doctor can perform a blood test to check your hemoglobin level and the size of your blood cells (a complete blood count, or CBC). The red blood cells in your body are responsible for carrying oxygen, which is critical for the growth of a healthy baby. If your blood cells are small, then you could have a low iron level or a genetic disorder called thalassemia. If these issues are caught early in the pregnancy they can usually be treated or monitored to prevent complications for the baby.
Preparing for pregnancy can give your baby a head start in life by creating a healthy environment for him or her to grow within. A few tests and some general lifestyle changes can go a long way to helping your pregnancy start off in the best way possible. I wish you the best of luck!
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