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Preconception Health Care

FACT:  Aging and Fertility

A women's reproductive potential declines with age.  This is reflected in the decreased ability to become pregnant.  Although the ability to achieve a pregnancy decreases in all women  as they age, the precise age when a woman can no longer conceive varies between individuals.  Approximately one-third of couples in which the female partner is age 35 or older will have problems with fertility.  It is estimated that two-thirds of women over 40 will not be able to get pregnant spontaneously.  Although chronological age is an important factor of fertility, it alone does not predict a couple's chances for pregnancy.  Some women continue childbearing into their forties, and clinicians have been surprised by the fertility of select women in their late thirties.  For additional information regarding aging and infertility, you can visit the American Society for Reproductive Medicine (ASRM) website http:/www.protectyourfertility.org.

FACT:  Folic Acid

Folic Acid 400 micrograms (0.4 mg) of folic acid daily are recommended by the US Public Health Service for all women trying to conceive.  This dose has been shown to decrease the incidence of neural tube defects in newborns.  Studies show that if all women consumed the recommended amount of Folic Acid before conception and during early pregnancy up to 70% neural tube defects could be prevented.  Folic Acid FAQ's can be found at http:/www.cdc.gov/ncbddd/folicacid/faqs.htm#folic.

FACT:  Smoking

Smoking during pregnancy places the mother at an increased risk for premature labor, intrauterine growth retardation and other complications.  Recent studies have demonstrated that men and women who smoke have decreased fertility.  Women who smoke have a decreased chance of achieving pregnancy when undergoing Assisted Reproductive Technology procedures.  For additional information regarding smoking and infertility visit the American Society for Reproductive Medicine (ASRM) website http:/www.protectyourfertility.org  For help and additional information on quitting smoking go to http:/www.smokefree.gov.

FACT:  Alcohol

Alcohol consumption can impair male and female fertiltiy.  Drinking during pregnancy should be avoided.  Chronic alcohol use can lead to Fetal Alcohol Syndrome and other complications in the unborn.  For more information on the effects of alcohol go to http:/www.cdc.gov/ncbddd/fas/.

FACT:  Recreational Drugs

Recreational drug use such as marijuana may decrease sperm concentration and testosterone production.  This can impair the sperm's ability to fertilize an egg during treatment for infertility.  Recreational drug use is also detrimental to the developing fetus during pregnancy.  Women who use illegal drugs, especially cocaine, increase their risk of miscarriage.  You may read more about recreational drugs by referring to http:/www.protectyourfertility.org.

FACT:  Body Weight

A recent statement released by the American Society for Reproductive Medicine talks about the fact that 12% of infertility is caused by weight related issues, 6% in women who are overweight and 6% in women who are severely under weight.  Weight loss of 5-10% may dramatically improve ovulation and pregnancy rates.  You may read more about weight issues by referring to http:/www.protectyourfertility.org.  For more information on nutrition and healthy weight loss visit http:/www.consumer.cov/weightloss/setgoals.

FACT:  Medications

Medications you are taking should be reviewed with your physician, including prescription, over-the-counter and any herbal or alternative therapy products.  Women currently under treatment for medical conditions including, but not limited to asthma, diabetes, cardiac disease, hypertension and seizure disorders should have these conditions under control before attempting to conceive.  Your physician can work with you to ensure your medications are safe for use in pregnancy.  This will help prevent complications in the mother, and reduce the risk of birth defects.  For more information, go to http:/www.4woman.gov/faq/pregmed.htm.

FACT:  Rubella

Rubella remains one of the leading causes of birth defects if aquired during the first few weeks of pregnancy.  All women should be screened for immunity to rubella, and in the presence of non-immunity, vaccination should be administered before attempting to conceive.  Immunizations should be up to date.  Rubella FAQ's can be found on http:/www.cdc.gov/ncbddd/bd/faq2.htm#MMR.

FACT:  Sexually Transmitted Diseases

Sexually transmitted diseases have been associated with ectopic pregnancy and infertility.  Screening for sexually transmitted diseases is part of routine preconception care.  You may read more about this by referring to http:/www.protectyourfertility.org.

FACT:  Coping with Stress

According to the American Society for Reproductive Medicine (ASRM), many couples, when diagnosed with infertility, may no longer feel in control of their bodies or their life plan.  Infertility can be a major crisis because the important life goal of parenthood is threatened.  Most couples are accustomed to planning their lives.  Experience has shown them that if they work hard at something, they can achieve it.  With infertility, this may not be the case.  Infertility testing and treatments can be physically, emotionally and financially stressful.  For more information regarding Stress and Infertility, please refer to the following ASRM Patient Fact Sheets-Stress and Infertility at http:/www.asrm.org/Patients/FactSheets/Stress-Fact.pdf  and Infertility Counseling and Support: When and Where To Find It at http:/www.asrm.org/Patients/FactSheets/Counseling-Fact.pdf. 

FACT:  Enviromental Factors

Enviromental factors may lead to greater risk of miscarriage.  Exposure to toxic chemicals can be in the home, workplace and your neighborhood.  Examples of such toxins are pesticides, dyes, solvents, lead, toxic smoke and radiation.  Many times, proper ventilation and proper handling of toxins is all that is indicated.  Exposure to high levels of radiation or toxic substances may also be a factor in repeated miscarriage or birth defects.  To learn more about the exposure of toxic chemicals and substances please review the following booklets published by the National Institute of Health and Safety (NIOSH) "The Effects of Workplace Hazards on Female Reproductive Health" at http:/www.cdc.gov/niosh/99-104.html and "The Effects of Workplace Hazards on Male Reporductive Health" at http:/www.cdc.gov/niosh/malrepro.html.

Additional Resources

American Society for Reproductive Medicine, http:/www.asrm.org

Centers for Disease Control, http:/www.cdc.gov

March of Dimes, http:/www.modimes.org

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