Conception may seem as simple as adding two people together to make another, but the process can be filled with unseen obstacles that make life a lot more difficult for prospective parents. The good news, however, is that these obstacles can be taken care of, or even fully removed, by planning and getting the best medical advice before these issues become too difficult to navigate. Below, we list topics to consider in the pre-conception process.

Preconception doctor visit

In your journey to parenthood, the first stop should be to your local family doctor’s room, as prospective parents should be in the best health they can be, to give their future children the best chance at a wonderful life.

After explaining that a couple wishes to proceed in conceiving, a doctor can then order a multitude of tests and check-ups that will highlight areas of health that may need addressing before this can occur. These may include, but are not limited to:

• Medication currently taken
• Genetic conditions and family history of disease
• Sexual health
• Immunization status
• Weight & lifestyle choices
• Mental and physical health
• Other underlying conditions.

Even though this list may seem concerning, it is much better to know about any prospective issues and sort them out before conception, rather than finding out during a pregnancy and potentially affecting the health of a baby in the long-term [1].

Preconception nutrition

Preconception health.

Nurture Central has published reviews on important nutrients during the entire pregnancy process. In general, however, there are many essential preconception nutrients for couples to consider, which have many important roles in the normal functions of the reproductive systems in men and women. including:

• Vitamins such as B6, B9 (folate), B12: For healthy metabolic function.
• Vitamins C & E: Used by the body as support antioxidants in preventing free radical damage.
• Minerals: Selenium, magnesium, iron, iodine, and zinc, which support healthy metabolism.
• Omega-3 Fatty Acids: For early brain development in utero, though building up stores before conception is quite important in this process, too.

Through the preconception check-up process, a practitioner will be able to determine what issues exist regarding a couple’s nutrient intake, and so will be able to recommend steps to take to improve nutrition and hence the chances of an optimal pregnancy outcome.

Healthy weight before pregnancy

Peak physical health in both partners is extremely important to a couple’s goal of a healthy conception and pregnancy, for a variety of reasons [2-4]. A sedentary lifestyle combined with an abnormal BMI tends to make conception, pregnancy, and post-partum outcomes more difficult for couples than if both partners are within the acceptable ranges for each parameter. Furthermore, as noted in other Nurture Central articles, healthy diet and nutrient intake (particularly folate/folic acid) are also vital to each stage of conception and pregnancy. Hence, obtaining medical advice on how to best meet such nutritional and lifestyle requirements during this time should be a priority for couples, as it is recommended that such issues be addressed well before conception to decrease the risks of poor outcomes for all involved.

Lifestyle factors to avoid

As the reproductive system quietly maintains itself in the background of a couple’s life, specific lifestyle choices can severely impact it in both men and women. These habits can cause progressively worsening effects upon these systems, heightening the risk of poor pregnancy outcomes occurring for a couple and their baby. Common factors to avoid include:

• Alcohol: While adults can tolerate the molecule, it is essentially a chemical toxin that can damage delicate eggs and sperm, as well as blood vessels in the testis, ovary, and endometrium.
• Smoking: It is well-known that smoking cigarettes comes with a multitude of potentially fatal consequences – however, because cigarette smoke introduces microtoxins all over the body, it will inevitably affect the reproductive system, too.
• Caffeine: Inappropriate amounts of caffeine can affect the endocrine and cardiovascular systems that aid in the reproductive process; as such, it is not critical to remove it completely, but consumption should be moderated.
• Chemicals and pollutants: Chemicals such as garden products or insecticides that are handled on a regular basis can be absorbed by the body and negatively affect the reproductive organs, so couples should be mindful of what is being used in their environment.

Stopping contraception

Adults often spend a lot of time, effort, and money in ensuring that pregnancies are timed as intended, as well as in optimizing the chances of such a pregnancy. However, the transition from avoiding pregnancy to ensuring pregnancy is not as simple as it may seem.

Simpler contraceptive measures, such as condoms, are obviously easy to cease use of; however, while avoiding their use will significantly improve the chances of conception, an often-overlooked aspect of this contraceptive measure is that a condom is also an excellent method of keeping couples healthy (particularly in the case of people who have not had a recent sexual health check). So, couples who would like to stop using condoms are also encouraged to speak to a doctor about getting a full sexual health check. While this conversation may seem awkward, it is much better to know about any underlying conditions before proceeding, rather than afterwards, particularly because sexually transmitted infections carried by a parent can also affect a developing fetus in utero [5].

On the other hand, more complex contraceptive measures are not as simple to separate from than the simpler alternatives. For example, chemical measures such as the contraceptive pill need to be ended months before trying to conceive, as the hormone levels in the body are not “normalized” immediately after ending use of the pill – such issues can also be observed after the use and removal of intrauterine devices (IUD) [6]. A local GP will be able to plan a timeline for couples during a consultation, again making a visit to the local clinic an excellent idea.

Preconception stress and mental health

Among the most important aspects of both pregnancy and life in general is mental health. While the day-to-day reasons for maintaining mental health tend to be well-known, it may be less well known to people that stress or depression in the pre-conception phase of pregnancy can have direct negative effects upon a baby throughout the process and following the birth [7].

While it is nearly impossible to avoid all stress in life, it is important to manage it as well as possible during these key phases of pregnancy, to decrease the risks of negative effects upon a baby becoming a reality. While every couple’s situation is different, general stress-decreasing options taken by couples include:

• Making personal time a daily activity
• Maintaining good sleep patterns and exercise regimes
• Avoiding stimuli that can increase anxiety (e.g.: excessive caffeine intake throughout the day [8])

For couples who require extra assistance in maintaining their mental health, a medical professional will be able to recommend more ways to decrease stress and improve mental health, whilst also having the ability to prescribe appropriate mental health medication, where necessary.

References

1. Atrash et al. Matern Child Health J. 2006;10(5 Suppl):S3-S11.
2. Sha et al. Int J Environ Res Public Health. 2019 Mar 28;16(7):1110.
3. Ornagh et al. Pregnancy Hypertens. 2018 Apr;12:90-95.
4. Ng et al. Nature. 2010 Oct 21;467(7318):963-6.
5. Tang et al. Sex Transm Infect. 2020 Aug;96(5):322-329.
6. Spira et al. Contracept Fertil Sex (Paris). 1985 Jan;13(1 Suppl):353-8.
7. Moss et al. Arch Womens Ment Health. 2020 Feb;23(1):53-62.
8. Richards et al. J Psychopharmacol. 2015;29(12):1236-1247.

from an Expert Author

George Thouas

BSc, MRepSc, PhD – Biomedical Scientist

George has worked as a medical researcher for 17 years in the university sector, at both Monash University health institutes, and The University of Melbourne. He spent 12 of those years in reproductive health and fertility research, in roles such as Clinical Research Associate, Clinical Embryologist, Post-graduate Demonstrator, Lecturer, and later as a Senior Research Fellow and Lab Manager. His doctoral thesis investigated the effects of mitochondrial damage in the oocyte. He also worked on improving the nutrient and growth requirements for in vitro fertilization and embryo development.

George has authored and coauthored more than 50 publications, including 1 book, 5 book chapters, 30 peer-reviewed journal reports and reviews, 6 patents, international scientific conference proceedings and health practitioner journal articles.

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