How to Get Pregnant: Part 2

Step 2: Preconception Counseling

fertility counseling
Informing your obstetrician of your intention to get pregnant is advised. He or she can tell you what the risks of pregnancy are for you, given your past medical history. Prior to pregnancy, your Pap smear and breast examination should be up to date.

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Vaccines:

Chicken pox can be devastating to a baby and fatal to a pregnant woman. If you have no history of chicken pox and never received the vaccine, your doctor should test you to see if you are immune. Prior to pregnancy, the chicken pox vaccine can be administered and very effectively reduce the chances of infection during pregnancy.

Rubella (which causes German measles) can also harm a pregnancy. Just because you had a vaccine once (or twice) does not mean you are immune. Rubella testing can tell you if you are at increased risk for German measles. If you are not immune, you may receive a two-dose booster to induce immunity.

Neither the chicken pox or Rubella vaccine should be given during pregnancy; therefore, testing and vaccination prior to conception are advised.

Genetic testing:

Your doctor should determine if your ethnicity or family history places you at increased risk for having a baby with a genetic disorder. If a known genetic disorder runs in your family, you may be at increased risk for having a baby with that disorder. Frequently, testing can be done to screen for that disorder in an individual patient.

Groups at high risk for genetic disorders include:

Women who are 35 years old when they deliver: While the risk of having a baby with Down Syndrome or other chromosomal abnormality is never zero, the risk does increase with age. At age 35, the risk of having a baby with a chromosomal abnormality is greater than the risk of losing a baby from amniocentesis (test for the abnormality), so counseling is advised.

African Americans:

approximately 1 in 12 carry the trait for sickle cell disease.

Caucasians:

approximately 1 in 25 carry the trait for Cystic Fibrosis.

Ashkenazi Jews:

are at increased risk for multiple diseases including Tay-Sachs, Canavan, Neimann-Pick, Blood Syndrome, Fanconi’s Anemia, Familial Dystautononemia, BRCA mutations and many other diseases and syndromes.

Families with a history of Autism or mental retardation should consider testing for Fragile X Premutation.