Pre-conceptional counselling

Pre-conceptional counselling is having a consultation with your doctor when to conceive. The goal is to have a planned, healthy and safe pregnancy. Majority of the pregnancies are unplanned and hence, many couples fail to avail the benefits of pre-conceptional counselling.

When to start pre-conceptional counselling?

Pre-conceptional counselling should start at least three months before you start planning to get conceived. This is required so that appropriate pre-medications and nutritional supplements can be started. This timeframe is needed to get yourself physically and medically fit in case you are suffering from conditions like obesity, diabetes, hypertension, thyroid disorders, etc. Assessing both partners is essential during a pre-conceptional counselling to improve the overall reproductive and obstetric outcome.

What to expect during a pre-conceptional counselling?

A detailed history, physical examination, risk screening and vaccinations are assessed. Followed by counselling regarding best time to conceive and how to maintain a healthy pregnancy is advised.

  • History: A detailed history of previous pregnancies, menstrual history, chronic medical conditions, family history of any genetic conditions, history of alcohol consumption, smoking, substance abuse, etc. is enquired. Assessment of diet, lifestyle and verification of all prescribed and non-prescribed medications is done.
  • Physical examination: Your doctor may check your body mass index, blood pressure, thyroid and breast examination. Followed by examination of respiratory system, cardiovascular system, abdomen and pelvic check is carried out.
  • Investigations: Tests may include baseline blood work up, screening for sexually transmitted diseases, hormone assays, pelvic ultrasonography and husband’s semen analysis. If any positive history of genetic disease is found in the family, then genetic testing of both husband and wife is advised.
What follows next?
  • Diet and lifestyle modifications: Advising regarding nutritious diet and healthy exercise plan. You will be counselled to attain a body mass index in the normal range as abnormal values increases the risk of infertility and pregnancy & neonatal complications.
  • Advised to quit smoking, alcohol consumption or substance abuse.
  • Appropriate intervention for pre-existing medical conditions.
  • Vaccinations: Assessment of immunization status annually for tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap), measles–mumps–rubella, hepatitis B, varicella and influenza vaccination.
  • Supplements: Folic acid and other vitamin supplementation will be started
  • Ovulation chart: Finally, you will be given an ovulation chart and advised regarding best time to conceive for the next couple of months.