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Pre-pregnancy & Fertility

Planning for Pregnancy

Pregnancy is a wonderful and fulfilling journey for both a woman and her family. Staying healthy will help prepare a woman better for the changes that come with pregnancy. Apart from ensuring adequate intake of nutritious food, keeping fit, and steering clear of unhealthy habits such as smoking and alcoholism, it is important for a couple to take this step together and understand what to expect prior to conception and pregnancy.

In this page, we look at preconception screening methods vital for planning healthy pregnancies, signs and symptoms of pregnancy confirmation, and medical conditions that may affect the fertility of a woman. Speak to your obstetrician to understand more.
Screening for Couples

Babies inherit genes from their parents that determine characteristics like hair and eye colour. In rare cases, even if if both parents do not display any symptoms, genetic diseases may be passed on to the baby.

Today, preconception screening is available where the tests detect genetic abnormality, infectious diseases such as hepatitis B or HIV, or other fertility and health complications. Knowing before conceiving can help couples make informed choices for their family's well-being.

Preconception screening could be in the form of premarital screening or even DNA screening. Talk to your obstetrician to understand more about preconception screening.
Confirmation of Pregnancy: Signs and Symptoms
Conception occurs when an egg is fertilised by a sperm and the fertilised egg implants into the uterus wall. However, most women do not experience symptoms at the moment of conception. Certain signs and symptoms of being pregnant can also be confused with other illnesses.

As a baby's vital organs and structures start developing in the first few weeks of pregnancy, it is important to be aware of the signs and symptoms of pregnancy so that the expectant mother can take the necessary steps to ensure proper care for both herself and the baby.

Common signs and symptoms of pregnancy include:
- Missed period
- Breast tenderness
- Fatigue
- Darkening of areola at breast area
- Nausea and vomiting
- Frequent urination
- Changes in smell and taste
- Constipation
If you experience any of the above signs and symptoms, there are several ways to confirm your pregnancy. Apart from home pregnancy urine tests, your doctor may also perform an internal examination or order a blood test for a more reliable result.

Once your pregnancy has been confirmed, your obstetrician will help you to work out the baby's estimated delivery date. Consult your obstetrician to understand the necessary antenatal care for a healthy pregnancy.
Infertility in Women
Infertility is when a couple is unable to get pregnant after 6 – 12 months of regular, unprotected sexual intercourse. If the woman is above the age of 35, the duration of inability to get pregnant may be reduced to 6 months. Although infertility problems can be due to both infertility in males and females, in this section we explore the common risk factors and medical conditions that affect a women's fertility.

Risk Factors

The risk factors for female infertility include
- Advancing age – a woman's fertility begins to decline in her mid-30s
- Unhealthy lifestyle habits such as smoking or alcoholism
- Being extremely underweight or overweight
Talk to your obstetrician and gynaecologist to understand more.

Medical Causes

Certain medical conditions that interfere with ovulation, damage the fallopian tubes, or cause hormonal complications may also result in female infertility. These include endometriosis, uterine fibroids, and polycystic ovarian syndrome (PCOS).
a) Endometriosis
Endometriosis is a disease involving growth of tissue resembling the endometrium (uterine lining) in places outside the uterus. In the ovaries, cysts known as endometriomas or 'chocolate cysts' may form. Implants of endometriosis may grow on the peritoneum (the lining of the abdomen and pelvis), sometimes causing scarring that may involve the ovaries and block the fallopian tubes, resulting in infertility.
b) Uterine fibroids
Uterine fibroids are non-cancerous growths that develop in the uterus. Fibroids may increase pregnancy complications and delivery risks. Common symptoms include heavy and prolonged menstrual bleeding, frequent urination, pain during intercourse, or pressure in the abdomen.

Diagnosis & Treatment

If you have been unable to conceive after 6 – 12 months of unprotected sexual intercourse, talk to your obstetrician & gynaecologist to explore having your fertility checked. Your doctor may perform a physical examination and analyse your partner's semen. If you are found to have underlying medical conditions, your doctor will discuss treatment approaches which may include lifestyle changes, medication, or assisted reproductive technology. Speak to your obstetrician & gynaecologist to find out more.
Common Misconceptions about Female Fertility

Reproduction and infertility are complex topics, and many misconceptions and misinformation about the subject may arise. Here, we debunk common myths surrounding female fertility:
Myth: Getting pregnant is easy
Fact: Multiple factors affect a couple's ability to get pregnant, including timing of intercourse, sperm quality, a couple's age and weight, as well as lifestyle habits. Certain medical conditions may also affect the fertility of a couple. It is important to go for preconception screening if you are planning for a baby.

Myth: Sexual intercourse daily will increase the chances of conceiving
Fact: The key to increase chances of conceiving is not the frequency of intercourse, but rather on the timing of intercourse. Intercourse during a woman's fertile window (during ovulation in the menstrual cycle) will increase the chances of conceiving. For most women on a 28-day menstrual cycle, this is generally during the 10^th – 17^th day of a woman's menstrual cycle.
Myth: Infertility is due to the female partner
Fact: Infertility may be due to both the male and female partner. Apart from age, weight, and lifestyle factors of a couple, in males, infertility could be due to sperm abnormalities, anatomical problems, or hormonal imbalances. In females, infertility could be due to certain medical conditions that interfere with ovulation or damage the fallopian tubes. Understand more about female infertility.
Myth: Infertility means you can never have a child
Fact: Infertility is when a couple is unable to get pregnant after 6 – 12 months of regular, unprotected sexual intercourse. However, infertility does not mean that the couple will never be able to have a baby. There are numerous treatment options to help a couple conceive. Consult your obstetrician & gynaecologist to gain a better understanding of the cause of infertility.

These are just a few of the common misconceptions surrounding female fertility. Clear your doubts by addressing your concerns with your doctor.

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