Preparing for pregnancy - where to start and how to prepare for pregnancy after 35 years

How to test your fertility

You can start with a simple fertility test, which exists in many versions on open Internet sources. A simple algorithm for analyzing answers to questions about age, the presence of diseases and surgical interventions, cycle regularity, bad habits and other parameters assesses the level of fertility.

Of course, such a test may be more of an informational test and cannot be considered a real diagnostic tool. But it is also a reason to think about the correspondence of lifestyle and health to the task that the couple sets for themselves.

Other types of fertility tests have been developed for home use by both men and women and are already on the market. The first, for men, determines the number of sperm in semen, but does not provide any information about their viability and activity, which are key factors for male fertility. Therefore, the practical value of such a home test is questionable. However, it may turn out to be a good motivator for the future father and make him think about his male health. The second, for women, is an ovulation test, the onset of which is signaled by an increased level of luteinizing hormone (LH). However, such a test does not show what stage of this stage a woman is at. If you've been keeping a diary of your menstrual cycle for a long time, you may already be well aware of your ovulation days, and this knowledge will soon come in handy. If not, you can start recording your morning basal temperature to see if you're ovulating.

To get the most complete and reliable information about whether you can have children, you need to undergo a series of tests by consulting a doctor. We will talk about them below.

If a couple is determined to make major changes in their lives, it is better to begin thorough preparations for pregnancy. What is included in the concept of “pregnancy planning”? Let's talk about it.

When checking a woman's fertility, AMH - anti-Mullerian hormone - is a very important indicator. It is not included in the list of hormones initially tested, but is an important marker of functional ovarian reserve.

Family information.

For a doctor, information about childhood illnesses, severe and/or frequent acute or chronic diseases, and family heredity is very important. Future parents can find out all this information from their relatives. This information will help the doctor correctly draw up an examination plan, prescribe consultations with other specialists, and, if necessary, carry out treatment before pregnancy to reduce the incidence of possible complications during subsequent pregnancies and childbirth.

Another important aspect of pregnancy planning is to establish the nutritional pattern, lifestyle and bad habits of future parents.

How to prepare for pregnancy

Start preparing for pregnancy at least three months in advance, and preferably a year in advance.

In order for your future pregnancy to be easy, and for your baby to be born strong and healthy, you need to make sure that before conception you get rid of bad habits and bring your lifestyle and physical condition into line with the upcoming changes. What do you need to remember when preparing your body for pregnancy?

Nicotine, alcohol, drugs. Smoking is associated with 20 to 30% of cases of low birth weight babies, up to 14% of premature births and up to 10% of deaths of children after birth. A safe dose of alcohol for consumption while expecting a baby has not yet been clinically established. Even soft drugs increase the risk of miscarriage, premature birth, intrauterine fetal death, developmental delays, and later learning and behavioral problems. Taking all these substances and pregnancy are incompatible.
Medicines. Some medications can cause birth defects. Be sure to inform the doctor who is preparing you for pregnancy and will manage it about all medications you are taking.
Chemical substances. Some chemicals are harmful to the fetus, especially in the first trimester. The period of pregnancy from 3 to 8 weeks, when the central nervous system in the form of a neural tube begins to form, is the most sensitive. The situation of interaction with chemicals is all the more dangerous because during the most sensitive period of intrauterine development of the embryo, a woman may not yet suspect that pregnancy is occurring.
Stress. Stress has been linked to irregularities in the menstrual cycle, including delayed and absent ovulation. Free yourself from stressful conditions and situations as much as possible. Relaxation techniques, yoga, and meditation can help balance the level of internal emotional stress.
Caffeine (coffee, cocoa, tea, chocolate, cola). Studies have linked high-dose caffeine consumption to difficulty conceiving, with some citing a decline in fertility by up to a third.
Excessive physical activity. They affect the fertility of both women (they reduce progesterone production and disrupt the cycle) and men (especially in combination with sports nutrition).

If you have mentally ticked one or more of the boxes mentioned above, change your bad habits to new ones. What can you do to enter pregnancy with confidence in your good physical and psychological shape?

Get a medical genetic examination.
Be physically active. The minimum recommended weekly physical activity is 150 minutes of aerobic exercise, or 5 times 30 minutes (maximum - 5 hours per week). Find a form of physical activity that you enjoy and stick with it. If you're not into sports at all, choose walking at an intense pace (don't forget that the load and calorie consumption when walking is lower than when doing aerobic exercise).
Bring your weight back to normal. It is known that both deficiency and excess weight can affect the successful course and outcome of pregnancy, as well as fertility itself. To determine your optimal weight, you can use the formula for calculating body mass index (BMI): BMI = weight (kg) / height (m)2. Having calculated your index, compare it with the norm and think about what you can change in your lifestyle if your numbers do not fit into the desired range of values.
Eat right, provide your body with all the necessary vitamins (first of all, you will need folic acid and zinc). If you have severe vitamin deficiencies (this can be shown by tests, as well as your own condition), start taking prenatal vitamins. Which of them is better - discuss with the doctor who is preparing you for pregnancy.
Get plenty of rest, relax, get enough sleep, and maintain a positive mental attitude.
Monitor your cycle and ovulation.

Let's take a closer look at some of the most important aspects of pregnancy planning.

Stages in detail

Stage 1: Health improvement for future parents

In order for conception and pregnancy to go smoothly and a healthy child to be born, it is worth taking care of visits to doctors and health improvement.

Tests in preparation for pregnancy that parents need to take:

smears and polymerase chain reaction blood test, which will detect STI infections;
blood for detection of the causative agent of syphilis in the body or its absence, for the human immunodeficiency virus;
blood to determine the group and Rh factor.

A woman should see the following specialists:

The gynecologist will take a smear from the vagina to check the microflora and identify hidden infections. During the conversation, he will find out the progression of the menstrual cycle and, if necessary, correct it. He will study the medical record, ask about previous pregnancies, whether there were abortions, how the birth took place, what diseases the woman had, how she used contraception. An appointment with a gynecologist involves examining the vagina to rule out cervical pathologies. After this diagnosis, the doctor will give a referral for tests and further examination.
The therapist will conduct a general examination, review tests, and measure the woman’s blood pressure, pulse and weight. If anemia is detected during the examination, adequate treatment with iron supplements will be prescribed.
At an appointment with an endocrinologist, a woman will have her current hormonal levels checked and recommended to take hormone tests. If tests show a woman has high levels of testosterone (male sex hormone), treatment will be prescribed to reduce it, as there is a risk of miscarriage.
During the period of family planning, it is necessary to go to the dentist and not for the sake of a beautiful and snow-white smile, but to check the condition of the oral cavity, because if there is caries in the mouth - a source of microbes, a huge amount of them enters the body.
It is recommended that any couples dreaming of a baby visit a geneticist:
if the family has blood relatives with hereditary diseases (Alzheimer’s disease, Down syndrome, muscular dystrophy, etc.), genetic disorders or developmental pathologies;
if parents have preferences in the field of the future baby;
if the lady is over 35 years old;
if there were previously problems with bearing a child, cases of stillbirth, miscarriages;
marriage between spouses who have a common ancestor is usually implied within the next generation;
the fair half have chronic diseases, especially of the endocrine system.

An experienced specialist will give a fairly accurate prognosis for the birth of a healthy child. It is recommended to schedule a visit to a geneticist in advance - 4-6 months before pregnancy.

Examinations:

blood - general and biochemical;
Analysis of urine;
blood for hepatitis B, C;
coagulogram;
oncocytology;
blood for sugar;
bacteriological culture;
undergo an electrocardiogram;
fluorography;
undergo an ultrasound examination of the abdominal and pelvic cavities to assess the condition of the ovaries, uterus, etc.
tests for a number of infections that are most dangerous for fetal development.

If necessary, the specialist will refer you for additional diagnostics:

if the fair half is overweight or underweight, or the menstrual cycle is disrupted, there are problems with conception, or there has been a miscarriage, the specialist will refer you for tests for sex hormones;
additionally, the endocrinologist can give a referral for diagnostics of the endocrine system organs;
consultation with an immunologist;
in case of miscarriage or a diagnosis of infertility, the gynecologist will refer for the determination of antibodies to phospholipids and hCG, lupus anticoagulant, TPO antibodies;
appointment with an allergist, nephrologist and other specialists.

A woman planning a pregnancy, in accordance with the direction and agreement with specialists, must be vaccinated:

against rubella - provided that the expectant mother has not had this disease and there are no antibodies in her body. I get vaccinated at least three to four months before conception;
from hepatitis B;
antitetanus, influenza and diphtheria.

If the gynecologist prescribes it, then make a basal temperature chart.

After studying the diagram, the specialist will determine whether there are any violations and prescribe treatment.

If a woman has taken antibiotics or hormonal medications, talk to a gynecologist when you can plan to have a baby.

Stage 2: Preparing the male body for conception, the female body for pregnancy

Diagnostics, tests, consultations with doctors are self-evident processes, but future parents can do quite a lot themselves. What can you do on your own?

Balanced diet

During the period of visiting doctors before conception and during pregnancy itself, eat more vegetables and fruits, fiber-rich foods, lean meats, dairy products, and whole grain bread. Any diets while carrying a baby are prohibited, but you should not mindlessly consume mountains of food.

Adequate nutrition is good, but it is better if a woman takes a vitamin and mineral course during pregnancy planning and pregnancy.

The purpose of the vitamin program is to reduce the risk of a lack of these beneficial substances necessary for the unborn child to a minimum, to ensure normal development for him, and to create favorable conditions for a successful pregnancy.

2.Give up bad habits

No smoking, let alone alcoholic beverages or drugs.

Medical examination before pregnancy

Some health conditions may affect your ability to conceive. These include: structural features and condition of the pelvic organs, diabetes, high blood pressure, anemia, problems with the thyroid gland, and genital infections.

Therefore, the main task facing you is to identify all health problems and, if possible, eliminate them as much as possible before pregnancy.

It is best to start planning a pregnancy with a visit to the doctor, followed by a medical and biological examination and genetic consultation.

Consultation with a doctor before pregnancy

Based on the results of the examination, the doctor will give recommendations for correcting conditions if disturbances were found in the functioning of one or another body system. All detected infections, acute diseases, and dental problems should be treated before pregnancy. This will not only increase the chances of conception and a pregnancy uncomplicated by any side conditions, but will also lay the foundation for the health of both the child and the mother for years to come.

In some cases, a couple may need separate genetic counseling. According to available data, from 3 to 5% of children are born with congenital malformations or serious hereditary diseases.

Medical genetic testing is aimed at identifying potential risks of transmitting hereditary diseases to a child. A geneticist identifies families with an increased risk of such diseases, studies and analyzes the problem, searches for and recommends a possible solution.

Although genetic counseling can be beneficial for any couple planning to have children, only a small percentage of families will have a strong indication for this procedure. This group includes:

couples with a hereditary disease in one of their close relatives;
couples who already have a child with developmental defects or genetic disorders;
couples in which one or both partners are over 35 years old;
consanguineous married couples;
women with previous experience of miscarriage, frozen pregnancy, intrauterine fetal death or stillbirth.

The questions that are raised during a conversation with a genetic counselor include: family pedigree, family history, cases of serious physical, mental and mental illnesses in relatives, existing and treated diseases of future parents, medications currently taken, living conditions, work and rest and other medical, psychological and social factors.

Based on the results of the conversation, if necessary, additional cytogenetic, molecular genetic and other laboratory tests may be prescribed.

After analyzing all the collected information, the geneticist makes an approximate prognosis for the health of the unborn child and gives parents recommendations on further actions.

The couple underwent an examination, received and followed the doctors’ recommendations - and a new question was on the agenda: how to bring “Day X” closer - the very day when the idea of a child will come true?

Nutrition rules in preparation for pregnancy

If you haven't yet started a healthy eating routine, your upcoming pregnancy is a great time to make changes that will have long-term benefits for your health and will likely add years of happiness and fulfillment to your life.

A rational diet will ensure that the body receives all the necessary vitamins and minerals for the effective functioning of not only the reproductive system, but also the entire body as a whole. What healthy eating principles do you need to adopt when planning a pregnancy?

Biologically and energetically rich and varied food.
Emphasis on fresh and high-quality (preferably organic) vegetables, fruits and whole grains. The meat is lean. Fish - from trusted sources. Dairy products must be pasteurized. Complex carbohydrates (grains, legumes, vegetables, fruits, cereals, durum wheat pasta). Healthy fats (polyunsaturated fatty acids).
Moderation. Small portions. The calories eaten should not be more than those burned per day.
Diet: 5 – 6 times a day.
Water: 1.5 - 2 liters of liquid per day, it is better if most of it is clean drinking water. Sweet carbonated drinks contain too much sugar; instead, preference should be given to compotes and fruit drinks made from berries and/or dried fruits.

Pregnancy after 35 years

What are the features of pregnancy management after 35–40 years, we will tell you in a separate article. In the meantime, I would like to briefly touch on this topic.

In many civilized countries, women become mothers at this age. In previous years, the birth of children even after 30 years of age was already considered by doctors as a difficult case; expectant and existing women in labor were called “starparous”; they were threatened with multiple risks and developmental defects.

The standard of living and medical care today allows women to become mothers at an age that was previously considered not the most successful in terms of health, physical and moral strength required to raise children on their feet. However, some points still deserve the attention of the expectant mother and the doctor who will manage such a pregnancy. Let's talk about them.

As a woman ages, her fertility begins to gradually decrease. This is expressed in the fact that the ovaries do not produce an egg in every cycle, and the very ability of the egg to divide after fertilization decreases. The process begins after 30–40 years.

Factors that complicate pregnancy after 35 years are also:

chronic health conditions accumulated by this age, including high blood pressure and diabetes;
infections and surgeries that lead to the formation of scar tissue that prevents conception;
inability to bear a pregnancy, which also increases with age;
chromosomal disorders, etc.

How to increase your fertility after 35 years?

Schedule a visit with your doctor. The specialist will assess your health, family history, analyze your lifestyle and, if necessary, give recommendations for its improvement; will prescribe all necessary diagnostic tests and procedures, prescribe treatment if required.
Stay physically active, stay mentally active, and maintain a positive emotional outlook on life to increase your chances of getting pregnant.
Lead a healthy lifestyle: alcohol, nicotine, lack of sleep, poor nutrition negatively affect fertility.
Bring your weight back to normal: extra pounds or, conversely, underweight make a negative contribution to the ability to conceive because they disrupt hormonal balance.
Keep an ovulation calendar: it allows you to determine the best day to conceive.
Use home fertility tests.
After 6 months of regularly trying to get pregnant (provided you visit a specialist before they start and follow all his recommendations), return for a second consultation with your doctor to adjust your actions. You may need to see a fertility specialist and also have a laboratory fertility test done. Before 12 months of active attempts to conceive a child, doctors have no reason to make serious diagnoses.
Remember that the natural conception of a child is influenced by a whole range of factors. And time. Be patient and have a positive attitude: after 35 years, trying to get pregnant can take longer, and you need to be prepared for this. At this age, it may take 1 to 2 years to get pregnant naturally.
After consulting with your doctor, take inositol and other vitamins necessary for the normal functioning of the reproductive system.

Health of the future father

Taking care of an upcoming pregnancy is not a purely female topic; men also need to try to get themselves in the best shape. Several external influences resulting from the lifestyle of the expectant father affect the man's ability to produce viable sperm. About a third of all cases of infertility occur among representatives of the stronger half of humanity.

Consult your doctor. Not only the expectant mother, but also the future father should also start preparing for conceiving a child with a visit to the therapist.
Be careful about what substances you take, be it medications or sports nutrition. Medicines have a direct effect on the body and, as a result, on reproductive function. Therefore, if you are taking them, be sure to tell your doctor. After analyzing the state of your health, the doctor may decide to discontinue a particular drug or replace it with another, safer one during the period of preparation for conception.
If possible, eliminate harmful effects on your body, such as radiation and chemicals (pesticides, fertilizers, lead, mercury, nickel, chromium, benzene, petroleum products and other agents) that you may encounter at work or at home.
Don't forget about healthy eating. Take care of your physical fitness if you have gained extra pounds. Create a diet and exercise program to bring your weight back to normal. Some studies show that men with low sperm production have a zinc deficiency in their bodies. Include meat, whole grains, seafood, eggs, and mushrooms in your diet. A nutritious diet that includes foods from all food groups will ensure your body gets all the vitamins and minerals it needs. If they are severely deficient, the doctor will recommend additional intake of chemically synthesized vitamin complexes.
Provide yourself with proper rest. Lack of sleep affects both the quantity and quality of sperm.
Avoid alcohol, nicotine, caffeine in high doses, and drugs. Alcohol removes many vitamins from the body, including zinc. Drugs affect the quality of sperm.
Do not expose your reproductive organs to heat. Baths, saunas, long showers (more than 30 minutes), a laptop on your hips, tight underwear - all this kills sperm. Intense cycling also increases the temperature of the testicles, so avoid it for a while.

After all the prohibitions, let's look at the list of what you can and should do.

The most important thing to remember is that by following all the above prohibitions, you are doing yourself an invaluable service by healing your body and developing good eating and sports habits. Rest assured, you will avoid many complications in adulthood by following these instructions not only while preparing for parenthood, but throughout your entire life.
Fortify yourself with food, vitamin complexes, dietary supplements. Of course, food is the best natural source of nutrients necessary for the health of the reproductive and all other body systems. But if, due to a number of circumstances, a person experiences a severe nutrient deficiency, the issue of additional nutrition with chemically synthesized vitamins does not raise controversy among doctors and nutritionists.
Try a home fertility test. He will give you food for thought, a positive attitude, or refer you to the doctor again for a laboratory test or spermogram.
Enjoy intimacy with the woman you love, who is ready to become a mother to your children. Don't make trying to conceive a chore. Remain loving, romantic and caring towards the expectant mother. The birth of a child will bring many wonderful moments into your life, enrich it, make you a real man, but love for your woman is unlikely to be as carefree as it is now. Enjoy the moment!

It is just as important for men to take care of their health before conceiving as it is for women. More and more research is showing a connection between the lifestyle, body condition of the future dad and his fertility, as well as the physical well-being of the child. By forming good habits and giving up bad ones, a man invests in his own men's health and the health of his future children.

Bad habits.

It's no secret that smoking, alcohol and drugs are contraindicated during pregnancy. Unfortunately, in practice, quite often one has to deal with the unpleasant smell of tobacco emanating from a pregnant woman. But this habit is harmful to both the mother and her unborn baby. Cigarette smoke contains nicotine (constricts blood vessels and, thereby, reduces the delivery of nutrients to the baby), carbon monoxide (competes with oxygen, thereby reducing its delivery to the baby), benzene (a potential carcinogen, i.e. increases risk of developing tumors), hydrogen cyanide (used by humans as rat poison) and formaldehyde (is a poison and leads to mutations in cells). Why not a modern detective?!

A whole criminal gang! And they act, these poisons, every day, imperceptibly, but methodically, according to the selfish desire of the expectant mother to “take a couple of puffs.” In addition to her own smoking, a woman can receive all the same substances while in a smoky room. Many women are mistaken in thinking that smoking should be stopped gradually, because... the body is accustomed to nicotine. The sooner you quit smoking, the better for you and your child. There are many ways to self-heal from this addiction. You just need to understand and want it.

Alcohol easily crosses the placenta and is found in the same concentration in the fetal blood as in the mother's blood. Excessive alcohol consumption leads to birth defects, especially in the arms, legs and heart. Brain cells are severely damaged. To prepare for pregnancy, you need to know that alcohol can reduce ovarian function. Therefore, when planning a pregnancy, the amount of alcohol should be limited to 2-3 units for a woman, and 3-4 units for a man. One unit is equal to 125 ml of dry wine (8-9%) or 25 ml of fortified drinks (40% strength). There is an opinion that you should not drink alcohol for three months before conception. If you and your spouse follow this opinion, then honor and praise to you! At the moment of conception, the egg and sperm are least susceptible to the effects of alcohol, since they are in “free flight”, moving along the fallopian tube to the uterus. But already 5-7 days after conception, the small embryo becomes susceptible to alcohol, because... attaches to the wall of the uterus and is washed by maternal blood.

Drugs, in addition to their direct terratogenic effect, carry the risk of giving birth to a child with drug addiction, with worse birth outcomes, and infection with infections such as HIV, hepatitis, and syphilis. To remove drugs from the body, future parents are required to undergo a special detoxification course.

Analyze your daily routine: how many hours do you devote to active recreation in the fresh air, a quiet walk, how much time does it take you to travel to work? How do you get to work? Are you stuck in traffic jams? Are there any hazards at your place of work that could interfere with the favorable course of pregnancy?

Nowadays, many people work with a computer. In this regard, studies have been conducted on the effects of radiation from computer monitors on humans and pregnancy. This radiation is not ionizing, like X-rays, and therefore does not have a harmful effect on the developing organism. For your information, the greatest radiation comes not from the screen, but from the back of the monitor, so as a precaution, try not to sit with your back to a colleague's monitor.

During the pre-pregnancy examination, you may sometimes need to undergo X-ray diagnostics. Ask the medical staff to provide you with a protective apron for the abdominal area to reduce radiation exposure to the genitals, in particular the ovaries, where eggs mature.

How to psychologically prepare for pregnancy

It’s good if the decision to have a child is mutual in your couple. If not yet, be sure to talk about it with your partner. Discussion of all the details of the topic of building a family is one of the most important stages of emotional preparation for pregnancy. This is a sign that you are mentally mature for a new role - a parent.

Be prepared for lifestyle changes.
Prepare yourself for the child to become a priority.
Remember that your partnership will change.
Prepare for childbirth. Take courses to prepare for pregnancy and childbirth. Read books on raising children. Find a support group.
Compare your dream of having a child with your current financial situation. Knowing that you are stable on your feet is a very powerful psychological tool for confidently entering pregnancy.
Find a support group, ask for advice from those relatives and friends who already have experience in giving birth and raising children.
Start discussing how you will raise and educate your child, and discuss the pedagogical models that you are going to adhere to.
Decide what you will devote yourself to after giving birth - a child or building a career.
Prepare for responsibility.
Always have a "Plan B". Not all couples manage to conceive a child when they are ready. Not all couples are destined to become parents naturally. Not all couples are given the chance to have their own child. Remember about alternative ways to have a child.
Tune in to daily changes and discoveries. Life does not stand still. Be internally ready to change and cope with any challenges. Family is worth it!

We hope that with the knowledge of the facts outlined in this article, you will approach conceiving your child healthy and confident that everything will work out for you. Don't forget that it may take you some time (sometimes quite a long time) before the two coveted stripes appear on the test.

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Gynecological examination and ultrasound before pregnancy

The content of the article

The very first action of a woman who wants to give birth to a child is a consultation with a gynecologist. After a routine questioning (whether there were any cases of birth of children with pathologies in the family, whether there were gynecological operations), the specialist conducts an examination in a gynecological chair. It includes two procedures: visual inspection and sample collection.

The examination begins with an examination with vaginal speculum. This is the conventional name for a bicuspid instrument, the main task of which is to expand the walls of the vagina in order to examine the vaginal walls and cervix, as well as to take a smear. A woman herself can buy a disposable Juno kit, which includes a plastic mirror, a cytobrush, gloves and other devices.

Using a speculum can be quite painful for nulliparous women because their vaginal walls are quite tightly closed.

However, an experienced specialist will make the examination as painless and comfortable as possible. In addition, when examining nulliparous women, a mirror with a diameter of 23 mm and a leaf length of up to 75 mm is used. Thanks to the mirror, the doctor identifies the following problems:

inflammation of the vagina or cervix;
false and true erosion of the cervix;
polyps;
isthmic-cervical insufficiency (inability of the cervix to completely close);
changes in the epithelium of the vagina or cervix.

If, during the examination, the doctor notices changes in the structure of the epithelium of the cervix, then he performs a colcoscopy - examination of the mucous surface using a binocular that magnifies the image up to 40 times. Atypical areas are examined using a green filter, which visualizes the vascular bed.

Colcoscopy excludes neoplastic processes in the cervical epithelium that precede cancer. According to statistics, cervical cancer occurs in 6% of pregnant women; dysplasia is much more common. If a serious pathology is detected, the woman will have to abandon pregnancy until complete recovery, because tumor growth increases significantly after childbirth.