Preconception - 4S
Providing the best for your baby starts even before he/she is conceived. This is the foundational purpose of preconception health, which should be achieved in both mothers- and fathers-to-be.
For mothers-to-be, preconception health care focuses on aspects of your health before pregnancy that will enable you to provide the optimal environment for your baby to grow within your womb.
For fathers-to-be, preconception healthcare includes staying as healthy as possible and supporting your partner physically and mentally, so that she can provide the optimal environment for the baby.
Family planning plays a role in ensuring preconception health. If you have pre-existing health conditions, sufficient time will be required to ensure good control over those conditions. If you have had a previous pregnancy, an optimal gap of about 18 to 24 months is required between pregnancies. If you are overweight or obese, it may be prudent to reduce your pre-pregnancy weight by at least 5% and optimize your metabolic health.
To help optimise your preconception health, we have created a plan which focuses on 4 key areas - Screening, Size, Supplements and Sex (4S).
The aim of screening is two-fold. First, we want to pick up any pre-existing health conditions that you may have, and make sure the conditions are well-controlled. Second, we want to keep you protected from potential health issues that may affect your impending pregnancy. Below is a checklist of items that we will screen for when you embark on this HELMS journey with us.
In women near to their late 30s, probability of achieving a pregnancy will markedly reduce; while probability of infertility will markedly increase.
Issues regarding fertility commonly fall within the following categories: ovulation issues; damage to structures of the sexual organs; male factors such as sperm count/quality.
Further investigations may be required to uncover potential diseases that can affect you or your partner’s fertility, so that steps can be taken to address these issues.
For chronic conditions, be sure to discuss with your doctor about the medications you take. He/she will be able to transit you to medications that are safe for pregnancy.
It is crucial for mothers-to-be to maintain good control over chronic health conditions as these can affect the development of the baby within the womb.
The state of mind can be affected especially when the couple faces a perceived pressure to get pregnant and feel that they are unable to do so.
The level of stress, depression and anxiety may affect your fertility and sexual function negatively.
These vaccinations protect both you and your future baby. By keeping yourself vaccinated, your body will help produce antibodies that can be transferred to the baby during the pregnancy. As the baby's immune system will not be fully functioning until sometime after birth, your transferred antibodies will help protect the baby while he/she develops his/her immune system.
Most women are vaccinated against MMR, but these antibodies may wane over time. If the Rubella antibody level is too low to be detected in the blood, we will recommend the MMR vaccine. If you have taken the MMR vaccine, you will need to wait for 1 month before trying for a baby.
More about vaccination.
It is important to make sure that you are cleared of sexually transmitted infections (STI)as these may affect your future baby as he/she develops in your womb.
There is an increased risk of having your water bag burst prematurely if you have an untreated vaginal infection.
This may result in your baby being born prematurely, increasing the likelihood of future hospitalizations for your child.
Optimising pre-pregnancy nutritional status in order to be in the best metabolic health state possible before pregnancy.
Your BMI status can affect fertility, cause health problems during pregnancy and affect the future health of a child. A little change can make a big difference.
Optimise your weight through healthy eating as guided by the 6P tool.
Being physically active can help to improve fertility. Physical activity refers to any activity that will raise the heart rate, increase the pace of breathing and warm up the body.
To optimise micronutrient reserves for preparing a successful and healthy pregnancy.
While sexual intercourse is key in ensuring pregnancy, some tips in terms of understanding the menstrual cycle and fertility could help to make things more efficient and sustainable.
Female sexual dysfunction affects up to 40% of reproductive age women. These difficulties may occur at different stages of sexual intimacy (e.g., desire, arousal, orgasm) or due to pain experienced. This may translate into actions such as not wanting to engage in sex, not being able to maintain an erection or have one, problems with ejaculation (either too early or too late), or tight vaginal muscles resulting in difficulty to have intercourse. These issues are more common in couples with fertility problems. If you have any difficulties or pain during sexual intercourse, do consult your doctor for further evaluation.
Intercourse practices: There are currently no evidence to suggest that sexual position, orgasms, or prolonged rest after intercourse can boost likelihood of pregnancy. Ejaculated sperm will reach the fallopian tubes within minutes regardless of these practices.
Lubricants can be used when some help is needed to reduce friction. Most commonly found are water-based lubricants but these lubricants may affect the movement or survival of the sperm. Thus, try to avoid these lubricants if possible. Instead, you can try hydroxyethylcellulose-based lubricants - existing research shows that this is a fertility-friendly lubricant.
References
Rosen, R. C., & Khera, M. (n.d.). Accessed 18 July 2021. {https://www.uptodate.com/contents/overview-of-male-sexual-dysfunction#H189241025}
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