Conception

Preconception visit, 10 questions to ask your doctor

The preconception visit is the perfect opportunity to ask your doctor a series of questions that can help you experience the search for pregnancy in a more serene, healthy and aware way.

Before starting the search for a child, it would always be recommended to undergo a  pre-conception visit . During this appointment, the gynecologist will ask you a few questions about your state of health, examine you and perform an ultrasound to evaluate the condition of your uterus and ovaries. In addition, he will give you some advice to reduce the risk of complications during pregnancy, first of all to start taking a vitamin preparation based on folic acid .

This visit represents the right opportunity to ask the specialist a few questions that can help you resolve doubts and uncertainties and face the search for a child with greater serenity and awareness .

So let’s see together a list of ten useful questions to ask the gynecologist during the pre-conception visit.

1. How long will it take to get pregnant?

No one can give a certain answer: statistics are the only references we have available. We know that, in the absence of fertility problems, a couple has a 25% chance of conceiving per menstrual cycle, i.e. a one in four chance.

There are luckier couples, who succeed on their first attempt, and others who take 6 to 12 months . Unfortunately, there are also some couples who will have to resort to further tests, because the pregnancy is late in coming.

In any case, there are some indications that can be useful for the doctor to make predictions (even if approximate), such as age, family history and any previous pregnancies.

2. Can I get pregnant immediately after the pill?

When you stop taking the birth control pill, it is not always possible to conceive quickly. Hormonal pills, in fact, can alter the cycle for several months after their interruption and the same can happen with birth control rings. Likewise, if you have opted for the IUD, you should consult your doctor about the timing for the removal of the intrauterine device.

3. Will my health condition affect my fertility?

Some medical issues can affect your ability to get pregnant. These include, for example, polycystic ovary syndrome (PCOS) and endometriosis .

As for men, a decrease in the number, motility or quality of sperm can complicate conception. In all these cases, the specialist is the best person to assess the situation and offer the most suitable solutions for the couple.

4. How will the medications I take affect my fertility?

Some medicines, including drugs for high blood pressure and epilepsy , can reduce the chances of conceiving, while others (such as some antidepressants and antipsychotics ) can harm the unborn baby if taken during pregnancy.

For these reasons, before starting the search for a child , it is necessary to review the drug therapies in progress with your doctor , to understand if they are compatible with a possible pregnancy or if they need to be replaced. Also beware of some herbal or phytotherapeutic remedies: natural does not mean free from risks to the health of the future mother or child.

5. Should I change my diet or lifestyle?

A diet that is not varied and balanced can lead to nutritional deficiencies that can negatively influence fertility, both in men and women. In addition, obesity , overweight and excessive thinness are related to lower chances of conception, as well as a greater risk of complications during pregnancy, with potentially dangerous consequences on the health of the expectant mother and the child.

Smoking , alcohol abuse , stress , and excessive exercise also have a negative impact on male and female fertility, the well-being of the future child, and successful pregnancy outcome.

Consequently, during the preconception visit, it will be important to speak openly with your doctor about your habits , to understand how to improve them and face the search for pregnancy in the best possible way.

6. Should I take vitamins or supplements?

Women trying to conceive should start taking a folic acid supplement  at least one month before trying to conceive . This vitamin, in fact, reduces the risk of some congenital malformations in the child, such as spina bifida . In addition, your doctor may recommend certain prenatal vitamins, especially if you have specific nutritional deficiencies .

7. Do I need to get any vaccinations?

Some infections, if contracted during pregnancy, can seriously endanger the health of the future mother or baby. this is the case, for example, of rubella, for which there is an effective vaccine which, however, must be performed before pregnancy and not during. For this, the doctor will request a blood test to check immunity to the disease and, in case of a negative result, will recommend that you undergo vaccination.

8. Do I need to undergo genetic testing?

If there are cases of hereditary diseases in the family, it is possible to request genetic tests to verify if the future parents are carriers of any hereditary anomalies. In case of a positive result, the next step is to visit a geneticist .

One option for preventing the transmission of hereditary diseases to children is to resort to in vitro fertilization with preimplantation genetic diagnosis (PGT) , which allows for the identification of any genetic pathologies before the embryo is transferred into the uterus.

Judgment 229/2015 of the constitutional court established that the PGT  can be applied in all those conditions in which it is expected that prenatal genetic diagnosis can be carried out  (villocentesis and amniocentesis), furthermore in 2017 the right to access the PGT was sanctioned also by those  couples carrying genetic conditions with reduced penetrance and variable expression  (such as neurofibromatosis).

9. Why can’t I conceive?

If a couple has tried to have targeted intercourse (i.e. in the fertile period) for a year without success (or for six months if the woman is over 35-36 years old ), the gynecologist will probably recommend proceeding with medical investigations , to investigate possible causes of failure to conceive.

10. What should I do after the pregnancy test is positive?

Many couples have no idea what to do after the thrill of a positive test . Do blood tests? Book a gynecological visit right away? During the pre-conception visit, the doctor will provide all the necessary information to start the pregnancy in the best possible way.

Dr Kathryn Barlow

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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