STOCKPORT FERTILITY SERVICES PRE-PREGNANCY ADVICE

Transcription

1 STOCKPORT FERTILITY SERVICES PRE-PREGNANCY ADVICE Information Leaflet Your Health. Our Priority.

2 Page 2 of 10 IT TAKES TWO TO MAKE A BABY This leaflet has been produced by the Stockport Fertility Unit to provide information that will help you and your partner prepare to conceive. It is based on the questions our clients most frequently ask. Your body Factors required for conception: Fallopian tubes open and healthy Healthy sperm Healthy egg Intercourse at the fertile time of the woman s cycle Fertilisation Implantation (Fertility UK 2003) Timing of intercourse to conceive There is no evidence that the use of temperature charts and ovulation kits to time intercourse improves outcome and their use should be discouraged (RCOG GUIDELINES). An egg is released days before a woman has a period. This time is called ovulation when fertilisation can occur during making love. However, if a woman has a longer or shorter cycle her fertile time will have to be calculated. Day 1 of a cycle is the day a woman starts her period. It is recommended that couples make love every 2-3 days around the fertile time. Advise regular intercourse 2 or 3 times a week. Return to fertility after pill use Some women can experience some delay of fertility for up to 9 months after stopping the oral contraceptive pill. Egg and sperm production A woman is born with all her eggs already in her ovaries and is not able to produce any more in her life time. Each month an egg is released during the middle of a cycle, and if not fertilised, shed during the period. These eggs will be released until the menopause. A man produces semen and the quality and quantity begin to decrease around the mid-40s. Semen is reproduced every 3 months, but can live from hours (HEAFA 2012) after ejaculation inside the woman s reproductive organs. Fertility decreases with age, from 35 onwards and there is an increased rate of miscarriage. Some genetic defects are more common in older women, for example, Down s Syndrome. Some congenital defects are more common in older men, for example, Achondroplasia. But this does not exclude you from having a healthy pregnancy and baby.

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4 Page 4 of 10 Sexual dysfunction Making love should be fun and not a chore when trying for a baby. If making love is painful or you are having problems ejaculating or any other problems please see your GP. Counselling You and your partner may feel you would like to speak further with a professional. Contact June Platt or Pam O Brien at Stockport Fertility Unit for advice and support counselling during treatment. Further therapeutic counselling may be helpful if you wish to discuss your feelings by contacting your GP or Beacon, for referral to a psychologist at Stepping Hill Hospital (telephone numbers are located at the back of this booklet). Please contact the fertility clinic. Your lifestyle Smoking Smoking has been linked to infertility, early menopause in women and reduced semen quality in men. Men and women who smoke reduce their chances of conceiving. Passive smoking can also be linked to reduced fertility, so avoid smoky places and reduce/quit smoking. Smoking is also linked to premature babies, low birth weight babies, and problems in pregnancy. Support is available. Please ask for help at the Fertility Clinic. All illegal drugs such as marijuana and cocaine should be completely avoided (NICE 2013) Alcohol Excessive alcohol has been linked to miscarriage and is detrimental to semen quality (NICE 2013). Men should not exceed 2-4 units per day. Women should not exceed 1-2 units per day or less and should avoid binge drinking which can affect a developing foetus. Both partners when trying for a baby should have several alcohol free days per week (NICE 2013). Caffeine There is no consistent evidence that caffeine consumption affects fertility (NICE 2013) Weight (overweight and underweight [BMI]) Women who have a body mass index of more than 29 will take longer to conceive (NICE 2013). Being underweight or overweight can affect hormone production, leading to problems ovulating. Being the correct weight can improve these hormones in some cases and joining an exercise and diet class is recommended. Some fertility centres will only consider women for further fertility treatment if their BMI is correct, to ensure a healthy woman for preparation for pregnancy and the associated risk factors pregnancy carries. We will not offer treatment if your BMI is greater than 35 and your weight is more than 100kg. Please use the BMI chart to plot your weight it is also beneficial for men to be the correct BMI to optimise general health, as a BMI over 29 may reduce fertility. Women with a BMI of 30 or over and who are not ovulating will increase their chances of conception by losing weight.

5 Page 5 of 10 Women with a BMI below 19 with irregular or no periods should increase their body weight for their hormonal balance to return (NICE 2013). See the weight chart at the back of this booklet Diet Your diet should include 5 a day fruit and vegetable portions, to ensure a varied well balanced diet. Preparing the body to conceive is important so reduce junk food and stock up on green leafy vegetables which are rich in folic acid, complex carbohydrates such as whole grain, brown rice, oats and wholemeal bread, meat, fish, poultry and pulses such as peas, beans and lentils. Exercise It is recommended that an adult should achieve a total of at least 30 minutes of moderate exercise 5 days a week or more. For those who are overweight minutes of exercise may be necessary for weight reduction and maintaining weight loss. Physical activity and a healthy diet maximises weight loss, preserves lean tissue and maximises fitness (DOH 2004). Commencing or continuing regular exercise during pregnancy can assist the control of weight gain, reducing the associated risk of gestational diabetes and ultimately the risk of obesity. It increases uterine blood flow and increases birth weights. Women are encouraged to continue their exercise regime but should avoid contact sports. Nonweight bearing exercises such as cycling, swimming and walking are ideal (MIDIRS 2006). Stress Some fertility experts believe that stress can cause problems when trying to conceive and relaxation techniques are beneficial to both partners. Remember to avoid ovulation kits and temperature charts as these are stressful! Just have intercourse every 2-3 days. Alternative therapies such as reflexology, yoga, Qi-gong, hypnotherapy, art and drama therapy, Chinese Herbs, homeopathy and acupuncture can be helpful for relaxation techniques. Pilates is excellent for men and women for sexual function and pelvic floor exercises. Massage There is a wide range of techniques each with their own particular benefits: Swedish/western circulation, muscle tone and connective tissue. Aromatherapy insomnia, anxiety, panic attacks and headaches. Shiatsu stimulates energy flow releasing blockage of illness, stress relaxation circulation and enhancing immunity. Ayurvedic restores balance for overall health.

6 Page 6 of 10 Always consult your GP / instructor if you are on medication before starting to exercise / alternative therapies, as some medications that your GP has prescribed may be contraindicated or the effects not known with alternative therapies. Tight underwear There is an association between elevated scrotal temperature and reduced semen quality. Try to avoid tight fitting underwear, saunas, and long periods of sitting (NICE 2013) i.e. long distance drivers. Occupation Some occupations involve exposure to hazardous substances which may affect both male and female fertility. Please seek advice from your health and safety officer. Vital checks - (Simple health checks to safeguard you and your baby) For her Blood tests These can be done at your GP Practice. Progesterone test Day 18, 21, 24 of your cycle to see if you are ovulating FSH/LH oestradiol, to check for hormone imbalance (NICE 2013) Folic acid It is recommended that women who are embarking on a pregnancy should take 400mcg of folic acid daily, to decrease the risk of Spina Bifida and other neural tube defects in the foetus; it should be taken until the 12th week of pregnancy (these folic acid tablets can be bought at any chemist). Women who have had a baby with Spina Bifida or those women who are taking antiepileptic drugs or diabetic should take 5mg per day (please see your GP for this prescription). Cervical smear Ensure your smear is up to date (see your GP / practice nurse / fertility clinic). Rubella (German Measles) German measles can cause blindness, deafness and mental abnormalities in a developing foetus. If you are not vaccinated against German Measles you may need to be vaccinated before you try to conceive. If you do have the vaccine, try and ensure you do not become pregnant for 1 month (NICE 2013). Are you immune to rubella? (See your GP) Anaemia Ask your GP to take a blood sample before you get pregnant.

7 Page 7 of 10 Diabetes - Are you diabetic? Have you seen the Specialist Diabetes Midwife to ensure you are on the correct insulin before you get pregnant? The Specialist Diabetes Midwife works at Stepping Hill Hospital and is available for diabetic pregnancy advice please give her a ring to book an appointment or ask your GP to refer you. For him Sperm test to check for abnormality. For him and her Family history If there is anyone in the family with a genetic disorder for example Down's syndrome or cystic fibrosis ask your GP about genetic counselling or further tests. Drugs (prescription or non-prescription) Before trying to get pregnant see your GP to check if the drugs that you are taking are safe in pregnancy, or might affect your fertility. Epilepsy, diabetes, high blood pressure, high cholesterol medications need checking out for both partners. All recreational drugs need discussing with the GP or the Stockport drug team (confidential service) as these may affect fertility and harm the baby (NICE 2013). Sexual health Do you and your partner need a check-up before you start trying for a baby? NICE guidelines require that couples are screened for Chlamydia, which can affect your ability to conceive, prior to commencing fertility treatment. Please contact the GP or the GUM clinic for confidential advice. Contact us BEACON counselling (Stockport) Tel: Specialist Diabetes Midwife Tel: GUM Clinic (Stockport) Tel: Human Fertilisation and Embryology Authority (HFEA) Tel: / Fax: / enquiriesteam@hfea.gov.uk Foresight

8 Page 8 of 10 Stop Smoking Midwife Practitioner at Stepping Hill Tel: / / text phone Healthy eating information booklets / leaflets (SHH recommended): British Diabetic Association British Meat Nutrition Education Service Food Standards Agency Weight Watchers Tel: Terrence Higgins Trust (HIV & AIDS) If you have any tips or advice that you would like to share please let the unit know so that additions may be made to the leaflet. Please contact the fertility clinic on References (1) DOH (2004) At least five a week: evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical Officer: Department of Health Publications pp 3, 4, 59, 60. (2) The effect of maternal exercise on foetal growth & development: Kane, F. MIDIRS Midwifery Digest. Vol 16, No. 1, March 2006 pp (3) NICE (2013) Fertility: assessment and treatment for people with fertility problems - Clinical guideline: National Institute for Clinical Excellence Supervisors of Midwives Need extra information, support or advice? Contact a Supervisor of Midwives by ringing the main switchboard at Stepping Hill Hospital: A Supervisor of Midwives is available 24 hours a day. Supervisors are concerned with ensuring the safety and well-being of mother and baby and with the provision of high quality midwifery care.

9 Page 9 of 10 BMI Height - cms (metres) Body Weight (kilograms) 147cm (1.47m) cm (1.50m) cm (1.52m) cm (1.55m) cm (1.57m) cm (1.60m) cm (1.63m) cm (1.65m) cm (1.68m) cm (1.70m) cm (1.72m) cm (1.75m) cm (1.78m) cm (1.80m) cm (1.83m) cm (1.85m) cm (1.88m) cm (1.91m) cm (1.93m) BMI Normal Weight = : Overweight = : Obesity = 30+

10 Page 10 of 10 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number MAT108 Publication date August 2013 Review date March 2016 Department Fertility Unit Location Stepping Hill Hospital