Preparing for pregnancy

Planning for a pregnancy is an exciting time for many couples. Once the decision has been made to try for a baby, there are a number of things couples can do to increase their chances of conception. Fertility specialists from Mount Elizabeth Hospital in Singapore share their advice for couples as they prepare for pregnancy.

1. Start sooner rather than later

Trying for a baby when the woman is young, before the age of 34 years, is one of the best ways to improve the chances of conception, explains Dr Suresh Nair, senior consultant obstetrician and gynaecologist at Mount Elizabeth Hospital, Singapore. “In women between 20 and 35 years of age, where both partners are healthy, 90 percent of couples will conceive within 12 to 18 months of trying,” he says.

According to Dr Kelly Loi, a fertility specialist and obstetrician at Mount Elizabeth Hospital, the likelihood of conceiving falls from 20 percent per month for a woman in her twenties to 8 percent per month in her late thirties. “With increasing age, there is a fall in ovarian reserve, that is, the number of functioning follicles left in the ovaries. Our general health also tends to decline and there is also a decline in quality of eggs with an increased risk of genetic abnormalities,” Dr Loi says.

2. Improve your health, improve your odds

Normal body weight, regular physical activity and cessation of smoking are important lifestyle factors that can affect a couple’s odds of pregnancy success. Female obesity significantly reduces the chances of conception due to impaired fertility and the possibility of irregular ovulation and menstrual cycles, explains Dr Nair. “Research shows that obese men are three times more likely to exhibit a reduction in semen quality,” he says.

Being underweight can be just as damaging to female fertility as low body weight. A Body Mass Index (BMI) below 20 negatively influences oestrogen production, interfering with ovulation and making it difficult for an embryo to implant in the uterus.

Smokers are also advised to kick the habit, as smoking is harmful to a woman’s ovaries, accelerating egg loss and possibly advancing the age of menopause, Dr Loi says. “Studies indicate that smoking can predispose the eggs to genetic abnormalities and increase the risk of miscarriage,” she says.

Male smokers aren’t spared either – they can develop abnormalities in sperm production, quality and quantity and the possibility of impotence due to blood vessel damage, Dr Loi adds.

3. Be physically prepared

Pre-conception health screening is recommended for women to assess if there are any medical issues that might affect fertility and pregnancy. An ultrasound examination details the condition of the reproductive organs and can detect the presence of any cysts or fibroids that can impact fertilization and implantation, while a pap smear detects any abnormalities in the cervical cells so they can be treated prior to pregnancy.

Routine blood tests can screen for maternal blood count, blood group and Rhesus D antigen status, as well as hepatitis B, HIV, syphilis and rubella immunity, helping identify those conditions that could influence the health status of the woman and her future fertility.

“Health screening ensures that the health of the couple is in optimal condition before pregnancy and that any health issues can be addressed early. It also provides a good opportunity to discuss diet and lifestyle issues, as well as ways to increase fertility,” Dr. Loi says.

4. Keep on trying

Couples who are trying to get pregnant naturally are advised to have sex during their fertile window – the five days leading up to, and the day of ovulation when the women’s body releases an egg, Dr Loi says. “Your egg will survive for about a day once released from the ovary, but sperm can survive for up to a week, hence there is a six-day window for sperm to meet an egg.”

Women should look for signs of ovulation: including changes in vaginal discharge, where the cervical mucus becomes thin and resembles the texture of egg whites; a rise in basal body temperature; and a mild abdominal cramp in the middle of the menstrual cycle.

For couples striving for that positive pregnancy test, Dr Loi recommends having regular sex every two to three days throughout the month. “This improves the quality of sperm compared to prolonged periods of abstinence,” she says.

Dr Kelly Loi graduated from the University of Oxford, UK and is a member of the Royal College of Obstetricians & Gynaecologists, and fellow of the Academy of Medicine Singapore. Dr Loi is a Fertility Specialist who has been caring for Obstetrics and Gynaecology patients for over 15 years. Apart from infertility treatment, Dr Loi's interests include pregnancy care and minimally invasive laparoscopic surgery. She has been actively involved in teaching and research in these areas, and has presented papers on these topics at international medical conferences. She continues to be actively involved in public education and is a regular speaker at seminars.

Dr Suresh Nair is a Senior Consultant Obstetrician and Gynaecologist at the Seed of Life, Fertility & Women's Care Medical Centre at Mount Elizabeth Novena Specialist Centre, Singapore. He is also a Visiting Consultant at the National University Hospital, Singapore. Dr Nair received his training in endoscopic surgery in France, Germany, the UK and the USA between 1991 and 1993, after being awarded the Singapore Government Training Programme. His research interests include: minimally invasive laparoscopic and hysteroscopic surgery, robot-assisted laparoscopic surgery and assisted reproductive technologies, including ovarian tissue and oocyte cryopreservation in female cancer patients.

Mount Elizabeth Hospital
3 Mount Elizabeth, Singapore 228510
Tel: +65 6250 0000

Mount Elizabeth Novena Hospital
38 Irrawaddy Road, Singapore 329563
Tel: +65 6898 6898
www.mountelizabeth.com.sg