Are you thinking of trying for a baby? Or have you already begun trying to conceive?
One of the most important things you can do for your future child, even before you become pregnant, is to make sure your body is in good health and ready to safely carry a pregnancy to term. Which is why I warmly advise having a preconception medical checkup with your doctor if you are thinking of extending your family in the near future.
Here’s a complete list of tests that are generally recommended to all women who are trying to become pregnant:
• CBC (Complete Blood Count) should be done yearly to check your overall health, whether you are trying to conceive or not. This test checks your blood for certain components, including Red Blood Cells, White Blood Cells, Hemoglobin and Platelets. It can provide a lot of information on your general health, including possible ongoing conditions like infections, anemia, blood clotting disorders and many others.
• Blood group & Rh factor. The Rh factor in particular can be very important in pregnancy. If you are Rh negative and your partner is Rh positive, this can cause your body to reject a pregnancy if the baby you are carrying is Rh positive, like your partner. Fortunately there are efficient ways to prevent this rejection response and carry successfully to term. As a side note, if you are Rh positive, then there is no need to worry whatsoever.
• The TORCH profile - this includes IgG and IGM antibodies for Toxoplasma, Rubella, Cytomegalovirus, Herpes Simplex Virus 1 and Herpes Simplex Virus 2. Each of these conditions can seriously affect your pregnancy if you contract them while you’re expecting. Ideally, you already have antibodies to all of them, which means you have developed immunity. But if you haven't, extra attention will be needed in order to avoid becoming infected during pregnancy.
• Hepatitis B, Hepatitis C, HIV - you definitely want to make sure you don’t have any of these, since they may also be passed on to the baby, either during pregnancy or during childbirth. If you are aware of having either of them, your doctor can take special precautions so as to lower the risk of transmission to the baby.
• Blood glucose - an abnormal value can affect both your fertility and pregnancy, so it’s important to check its level and if needed, take the necessary steps to keep it under control and within a normal range
• TSH (Thyroid Stimulating Hormone) is the hormone that tells your thyroid gland how much thyroid hormones to produce. Thyroid function can have an important impact on your fertility (and your overall health as well). For optimal fertility, you want to keep your TSH somewhere between 0.5 and 2 mU/L. Anything over the value of 2.5 mU/L can diminish your ability to become pregnant.
• Pap test - it screens for cervical cancer (and the cervical cellular changes which may later lead to cancer). As long as yours has a normal result (meaning negative for intraepithelial lesions or malignancy), you can keep taking one Pap every 3 years.
• Vaginal wet mount - this will check for any bacterial and fungal infections as well as local immune response, which may affect a future pregnancy if left untreated. A vaginal infection can be more difficult to treat while you’re expecting, so it’s best that you take care of any issues before conception.
• Urine test - a urine infection might also spell trouble for an early pregnancy, so testing on time will lower the risk of having to deal with it while you're expecting.
Although this isn’t always recommended by all doctors, I encourage my clients to have a transvaginal ultrasound before becoming pregnant (especially if they never had one or had one more than 3 years ago), to make sure their uterus and ovaries are healthy and working as they should. A transvaginal ultrasound can tell us a lot about a woman’s reproductive health and spot several potential problems. In most cases, correcting a dysfunction before it becomes diagnosed as infertility one year later or before it leads to one or several miscarriages is probably a kinder, smarter and overall better approach.
Last but not least, please make sure you give up smoking, consuming high amounts of alcohol and lower your caffeine intake (to less than 200 mg/day) even before becoming pregnant. All these habits can diminish fertility and furthermore can seriously harm your baby if you continue them once you are pregnant.