If you accidentally find yourself pregnant, well, this article is a bit late for you! For everybody else trying to conceive, a visit to your doctor before you do can help you prepare you to be in better physical shape. Also, it gives you time to think about scary things like genetic testing and decide how you want to proceed.
Every doctor will start you on prenatal vitamins months before you try to conceive. This is especially important if you have been taking oral contraceptives for a long time. Oral contraceptives deplete your body of zinc, which is important for reproduction. Also, it’s important to build up your body stores of folic acid, which most of us are aware prevents neural tube defects like spina bifida. However, prenatal vitamins are woefully deficient in calcium, so you will have to add a calcium supplement or increase dairy intake.
Your doctor will also want to do a Pap test and a breast check-up, at the very least. They will test for sexually-transmitted diseases like herpes, gonorrhea, syphilis, HPV, and Chlamydia. You should also have a blood test for HIV. Obviously, women with STDs get pregnant all the time, but knowing in advance can help protect your baby from contracting the disease from you during pregnancy or delivery.
If you are not sure of immunizations you have had, they will probably test you for immunity to things like rubella, measles and mumps. If you need to get re-immunized, usually you will be told to wait at least a month before trying to conceive as the immunizations are contraindicated in pregnancy.
You should also discuss any medications you currently take, including vitamins and herbs and topical medications like those for acne. Some are okay, some are not, but you should find out. My doctor said salicylic acid was okay, but benzoyl peroxide was not, for example.
Doctors don’t talk so much anymore about DES exposure from your mother because the drug was only used up to about 1972. In women whose mothers took DES, structural abnormalities of the uterus, like a bicornuate uterus (two-chambered uterus), might be present that can affect the ability to carry a pregnancy or even to get pregnant. That is usually discovered after a woman has been trying for a while without success to get pregnant.
Some chronic conditions, like diabetes or lupus, must be managed very carefully in pregnancy. Also, high blood pressure can be quite serious. Your doctor will want to make sure you’re in stable condition before you try to conceive, and while pregnant, you will be seen more frequently.
Now we have arrived at genetic testing. If you have a family history of mental retardation or other birth defects, you will be offered genetic testing pre-pregnancy. Some genetic risks, such as Fragile X (which is a cause of mental retardation) can be ruled out by testing you and your partner. If you have a family history of cystic fibrosis, testing can also rule this out. These tests are not required at any time. If the results would not matter to you, then maybe you should pass on testing. At least you can begin to think about it.
Now, if you have done all these things, and you have been trying to conceive for a year (if you’re under age 35) or 6 months (if you’re over 35), there are a whole slew of other tests that will be recommended. These include sperm analysis, hysterogram (HSG) to check your fallopian tubes, hysteroscopy to check inside your uterus for things like polyps, and hormonal testing.
Before you begin to worry after 3 months of trying, remember that the odds of conceiving are only about 25% every month in women under 35 years old. It can take a few months, and that doesn’t mean that anything is wrong with you. There is still so much we don’t know about conception. The most important thing is not to focus so much on this one aspect that you don’t enjoy the other parts of your life. I know you’re thinking that that is so easy to say and so hard to do, and you’re right. But at least enjoy the baby-making!

