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Fit for Pregnancy: Health Behaviours and Risk Factors

We recommend going for a pap smear and completing your vaccines and undergo a mammogram if you are 40 years and above.

Healthy Behaviours

Many couples will try to adapt a healthy lifestyle pre-pregnancy. These include engaging in a healthy diet, having regular physical activity and promoting emotional well-being. Women will also ensure that their immunisations, sexual health checks and pap / cervical smear tests are up to date. Furthermore, they will consume folic acid supplements prior to conception to reduce the risk of neural tube defects.

Risk Factors

Early intervention to manage or reduce risk factors as they emerge can significantly improve maternal and child outcomes.

Preconception risk factors include:

Smoking – In the UK, smoking during pregnancy causes up to 2,200 premature births, 5,000 miscarriages and 300 perinatal deaths every year. It also increases the risk of stillbirth, complications in pregnancy and low birthweight. Smoking during pregnancy can also result in the child developing other conditions later in life.

Alcohol - Alcohol is a teratogenic, which means that it can affect foetal development and cause birth defects or complications during pregnancy. Foetal alcohol spectrum disorder is an umbrella term for conditions that can occur in a person whose mother consumed alcohol during pregnancy. The most severe form is known as foetal alcohol syndrome.

Obesity - Babies born to obese women have a higher risk of foetal death, stillbirth, congenital abnormality, shoulder dystocia, macrosomia and subsequent obesity.

Long term physical and mental health conditions.

Previous pregnancy complications.

Genetic risks – Genetic risk is an important factor to consider as genes play a significant role in the development of congenital anomalies, which are a major cause of infant mortality. Genetic disorders can be inherited in different ways, including in situations whereby both parents are carriers (eg. sickle cell and thalassemia) or when one parent carries a genetic mutation.

Advance maternal age – In 2016 (UK), 22 per cent of births were from women aged 35 and above, with 4 per cent from women over 40 years of age. The risks of birth complications, such as congenital abnormalities, stillbirth and emergency caesarean section increase with age. However, the exact age at which these risks increase is uncertain and are dependent on additional risk factors such as smoking.

A large proportion of couples with infertility can achieve positive results with simple treatments or modifications such as:

Weight management: A normal BMI optimises fertility treatment success. Overweight women who undergo weight loss (even as little as 10 per cent of their total body weight) may ovulate without the need for fertility medications. Severe obesity in men has been shown to alter fertility as the imbalances in hormone regulation affects sperm production. However, it is important to make sure that you are losing weight in a healthy manner. To lose weight, you need to burn more calories than you consume, and you can do this by eating healthier food and exercising regularly. At Raffles Fertility Centre, we recommend working with a dietitian or joining a proven weight loss programme to optimise your fertility potential. 

Lifestyle changes: Lifestyle changes have a positive effect on fertility too. If you are having trouble conceiving, consider some of the following approaches:

  • Quit smoking – Tobacco smoking has been linked to lower fertility in both women and men. Women smokers have higher incidences of miscarriages and lower egg reserves. They may also reach menopause two years earlier than expected.
  • Drink coffee, tea and alcohol in moderation – Excessive alcohol consumption can lead to difficulty in conceiving and may lead to developmental problems in the unborn child. Therefore, we strongly advise that you stop or reduce your consumption if you are planning to get pregnant. 
  • Manage stress – There is no real evidence that stress causes infertility, but when it is hard to conceive, the couple may feel like they don’t have control of their bodies to achieve their goal of having a family. Stress relief can go a long way in helping you and your partner cope with infertility issues.Yoga, meditation, and acupuncture are some practices that help people relax and reduce stress, while others engage in other forms of exercises regularly to help them cope with stress. We understand if you would prefer to speak to someone and here at Raffles Fertility Centre, we have professional counsellors who can help you and your partner cope with stress.

Managing your medical conditions: Couples who have chronic medical conditions should see their doctor for advice about their health before trying for a baby. Correction of thyroid disorders, stabilising diabetes and auto-immune disorders will improve your chances of conception and give your baby the best start in life.

When to Seek Help?

Starting a family is a big undertaking, the stress level increases when a couple is faced with fertility problems. Don’t be afraid to seek help and talk to a medical professional. Your doctor will schedule tests based on your situation and medical history. Therefore, not all tests may be required, and they may be done in a different order. Seek help early if you satisfy the following conditions:

• Female partner above 35 years old

• Irregular or absent periods

• Two or more miscarriages

• Previous pelvic or testicular surgery

• Painful menstruation

• Major illnesses

• Not pregnant despite one year of trying

Infertility Information

Many people defer starting a family due to reasons such as pursuing education, building up a career, leading a carefree lifestyle and financial stability.

Majority of couples conceive without any difficulty or undue delay. However, infertility affects one in six couples. A woman’s age has an important effect on fertility. As a woman grows older, she has fewer eggs (and they are less likely to be fertilised). Furthermore, the eggs that have been fertilised have a lower chance of developing, and there is also a higher risk of genetic problems in the foetus for women above the age of 35. Do consider starting your family as soon as you are ready so that you can maximise your chances of having a successful pregnancy and a healthy baby.

Infertility treatment usually starts when a couple is unable to conceive naturally after one year of unprotected intercourse. Infertility treatment includes lifestyle changes, medical or surgical treatments. Although there is no guarantee of a successful pregnancy, there are reasons to be optimistic about the various medical advancements, as almost three quarters of infertile couples eventually succeed in having a child.