The first thing to remember:

Pregnancy is not a disease.

In general, a healthy woman may not prepare for anything at all. But, firstly, who knows how healthy we are, and secondly, there is no limit to perfection. Therefore, 2-3 months of life can be devoted to preparation. In order to do everything that is needed during this time.

1. Collect information about pregnancy

You should always start with information. Understand why in general, how it goes, how the fetus will develop and what to expect from childbirth. This must be done in advance. Then at least it will be clear how the body will behave.

You need to ask and learn from specialists, and not from people's experts from the forums. There are schools and courses for future parents that can and should be attended not only during pregnancy, but also before it.

Gather information with a partner. It's not just a women's job.

2. Visit a therapist

First, you need to go to the doctor if you have chronic diseases. Ask what to do if you are planning a pregnancy. You may need to adjust your diet or change some medications.

Secondly, if there are no diseases, you need to make sure of this and at least donate blood to check your sugar level.

3. Go to the dentist

You will still have to go to the dentist after registration for pregnancy. But it is better to treat your teeth before that, so as not to take additional medicines (the same painkillers) and not be nervous. Moreover, during pregnancy, the frequency of caries increases.

4. And to the gynecologist (and the future dad - to the urologist)

A gynecologist and urologist should check how healthy and ready you are in general for pregnancy. You can go to specialized doctors as a last resort. At the same time, pass the mandatory tests for sexually transmitted diseases and standard smears.

This concludes the main list of doctors.

There is no need to run to genetics for everyone. Only those who have had genetic diseases in the family, to check if there are risks. Otherwise, the examination is more likely to sow unnecessary doubts than to help.

5. Get tested

In addition to tests for STIs, which will be done by a gynecologist and a urologist, several more important examinations will be required. They can be combined with a trip to a therapist or done independently.

Both a man and a woman need to find out and be tested for the presence of antibodies to hepatitis B. Even if you think that such diseases will never touch you, check it again.

It is advisable for a woman to check whether she has immunity to rubella and toxoplasmosis:

• Rubella
  Viral disease, the most dangerous for pregnant women. Infection leads to defects, due to which the fetus becomes unviable. Therefore, you need to be vaccinated against rubella. After this procedure, pregnancy is recommended to be postponed for three months. If a woman was vaccinated or had rubella in childhood, re-vaccination is not needed: immunity is already there.
• Toxoplasmosis
  It is an infectious disease transmitted by cats. It is dangerous if they become infected during pregnancy. There are no vaccines for it. Therefore, if there is no immunity to it, then it is better to stay away from cat litter and street cats throughout the pregnancy.

We are usually sent to take an analysis for TORCH infections - a screening that shows the presence of antibodies to toxoplasmosis, rubella, cytomegalovirus and herpes. But this is a rather expensive and not particularly informative analysis: almost everyone is infected with the simplex virus, as well as with cytomegalovirus. You can’t protect yourself from them, but you can get infected at any time: at least a day before pregnancy, at least during it. Therefore, it is better to be examined for these infections according to indications. Preparing for pregnancy.

6. Start taking folic acid

Folic acid is a vitamin that is needed for the future fetus to properly form the neural tube and avoid defects in the nervous system.

To prepare for pregnancy, it is recommended to take 400 micrograms of folic acid. Planning for Pregnancy everyday. Reception continues until the 12th week of pregnancy. In some diseases, for example, with epilepsy, the dose may be increased, but this should be discussed with the doctor.

But vitamin E, which they also like to prescribe to prepare for pregnancy and in the early stages, is not needed. Not really Healthy eating and vitamin supplements in pregnancy strong evidence that this vitamin somehow prevents miscarriages or helps to get pregnant.

7. Quit smoking

Smoking during pregnancy leads to a host of problems that can affect the health of the child, and fatally. For example, mothers who smoke are more likely to have miscarriages, premature births, and children are more likely to die from sudden infant death syndrome. Stop smoking in pregnancy.

Relatives also need to be taught in advance to stop smoking in the house: passive smoking also affects health. It is necessary to get used to the new regimen before pregnancy, so as not to endanger the child.

8. Stop drinking

And even drink - just in case. So far, there is no evidence that alcohol somehow mothers. But it has been proven that it harms the child. Alcohol crosses the placental barrier, and the undeveloped fetal liver cannot process it. As a result, the risk of miscarriages and premature births increases, and the child may subsequently suffer from developmental abnormalities.

Pregnancy in the early stages is difficult to notice. Therefore, if you are planning a child and working on it, give up alcohol. Probably half a glass Drinking alcohol while pregnant champagne at a party won't hurt. But why take the risk when you can just not drink?

9. Lose weight

Usually, they begin to bring themselves into shape after childbirth. But if you are overweight or obese, it is advisable to advance. We are talking about a medical problem, and not about having to fit into XXS size clothes.

Overweight starts when the body mass index is over 25, and obesity starts when the BMI is over 30. In general, this is not the most accurate parameter, because everyone has a different ratio of muscle to fat mass. But, most likely, a body mass index with a value approaching 30 will either be in athletes (who closely monitor their condition and know if they have weight problems) or obese people.

And this can be bad for pregnancy. Excess weight in pregnant women is more likely to increase blood pressure, form blood clots and develop gestational diabetes. These conditions can harm the mother and baby, putting the entire pregnancy at risk.

10. Find your favorite sport

During pregnancy is very necessary. But not every sport is good for mother and child. Therefore, it is better to decide in advance which option you prefer: swimming, yoga or walking. Start exercising even during planning so that during pregnancy you do not get an unexpectedly large load.

11. Recalculate the budget

Pregnancy is expensive. Children are also expensive. Not that sky-high, but expensive. How not to go broke on a child and everything connected with it:

• count money
  Paid or free clinic to choose? How much is it? Who goes on maternity leave, because according to the law, not only mom or dad, but even grandparents can do this?
• Make a shopping list
  What will you have to buy? Take new things or buy used ones, but much cheaper?
• Start saving money
  If before the birth of a child you could afford to live from paycheck to paycheck, then in the status of parents such a regime will not work. There must be an airbag.

12. Get Started

Don't try to get pregnant as soon as possible. This may take several months, up to a year. Treating Infertility. And that's completely normal.

The desire to have a child sometimes pushes parents to do strange things: the constant calculation of ovulation, scheduled sex and the endless search for miraculous means and positions, while the best way to get pregnant is to relax and make love regularly. Don't get hung up on obligatory conception, read the best ones on Lifehacker. And may you have the best memories of the period when you were going to become parents.

The logical continuation of healthy relationships in the family is the birth of a child. However, the baby does not always appear where they are expected. Therefore, in order to fully enjoy the joy of motherhood, it is necessary in advance, having passed all the necessary tests and examinations. Further in the article - how to get prepared before pregnancy, and how to plan conception correctly.

Preparing for Motherhood: Why It Matters

Preparation for happy motherhood and fatherhood is not only a moral readiness to become parents, but also physical training, control of tests, etc.

Only healthy parents can give birth to a healthy baby. What needs to be done to give birth to a healthy child, everyone should know.

Pregnancy planning: when is it relevant?

Preparation for parental responsibilities is a complex of consistent work on your physical and psychological health. Chronic diseases, latent viral and infectious diseases, pathologies of the development of internal organs and bad habits - all this negatively affects the health of future offspring, and the manifestations of such a negative impact are not always obvious in the maternity hospital.

Some consequences affect during puberty, at the time of the formation of the family. Therefore, the health of a child is in the share of a responsible parent, and without complications is an important stage in the life of every person.

Only 30% of children are born absolutely healthy, most of which - after planning and passing the necessary tests by their parents.

When and what tests should be taken

Analyzes when planning conception are determined by the doctor, depending on the state of health of the parents, the presence or absence of chronic diseases. The following features are also taken into account:

• the age of the couple;
• the presence of genetic mutations, hereditary diseases in the line from one parent;
• the presence in the past of pregnancies with pathologies, miscarriages, fading in the later stages;
• the difference between parents is more than 20 years;
• transferred oncological diseases;
• benign tumors;
• a history of more than 5 abortions;
• unfavorable living conditions;
• bad habits.

Separately, analyzes are considered when planning pregnancy for men and women. It is recommended that a married couple undergo an examination before conception, regardless of the complaints of one or the second spouse.

men

Analyzes when planning a conception for men are determined by an andrologist or urologist. Depending on the complaints and the clinical picture, it may be necessary:

1. Testosterone to determine the norm. The hormone contributes to gender development according to the male type, and with its deficiency, the formation of a physique according to the female type is noted with the deposition of subcutaneous fat on the buttocks, thighs and abdomen.
2. indicates the presence in the seminal fluid the number of active, fertile spermatozoa.
3. Thyroid hormones are essential for both men and women. Lack or excess of thyroid hormones provokes insufficient supply of germ cells.
4. Cytological studies.
5. General blood and urine tests to determine the overall health of the whole body.

Women

Women are determined by a gynecologist. Depending on the complaints and the clinical picture, the following tests are prescribed:

• Hormonal analyses. A set of studies that allow you to determine or refute the presence of diseases associated with impaired hormonal levels. So, the most frequent tests are DHEA, prolactin, testosterone, progesterone, LH and FSH, estradiol, thyroid hormones, anti-Mullerian hormone.
• Cytology.
• A smear on the microflora of the vagina.
• TORCH complex (optional).
• In the presence of unstable or absent menstruation with normal FSH and LH, a study of the pituitary and hypothalamus.

Tests for hormones for men and women are carried out exclusively on an empty stomach in the morning. Otherwise, the results will be unreliable.

Partner Compatibility

Analysis for partners is carried out after unsuccessful recurrent pregnancies, characterized by fading, pathologies. In this case, the doctor aims to determine the incompatibility of sexual partners and eliminate the pathology by medication.

The compatibility of sexual partners is determined by the method of sampling arterial blood from a vein, as well as by taking a swab from the genital organs after sexual contact. In the presence of antibodies to sperm, a treatment method is determined, aimed at suppressing the production of cells by the mother's body. In the presence of incompatibility, therapeutic methods of correction are also applied.

The only option that cannot be treated is genetic incompatibility. In this case, pregnancy is not possible.

thyroid hormones

The tool helps to restore ovulation, disturbed menstrual cycle, helps to restore fertility.

Femoston

With a disturbed hormonal background without inflammatory processes, it compensates for the lack of components, thereby contributing to the natural production of a woman's germ cells.

Curantyl

Planning after surgery and treatment

The probability and necessity of planning conception after undergoing surgical invasive or minimally invasive interventions are considered separately.

Conization of the cervix

Removal of fallopian tubes

Both fallopian tubes independent pregnancy is impossible. In the presence of at least one tube, the probability of fertilization in a natural way remains. Pregnancy comes and goes like normal.

Planning after cysts and inflammation of the ovaries

Inflammation of the ovaries, cysts and adhesions is a complex physiological process, often accompanied by the addition of a secondary infection.

The probability of conception with such diagnoses is extremely small, but it exists.

Perhaps after the elimination of the underlying cause of the disease.

Laparoscopy

It refers to minimally invasive methods of diagnosis and treatment, but even after such a procedure, the risk of complications remains. Planning for conception during diagnostic laparoscopy is established by the doctor.

spikes

The adhesive process is a dangerous, almost irreversible physiological change that sooner or later leads to infertility. The earlier the disease was diagnosed, the greater the chances of conceiving and giving birth.

Myoma, uterine cyst

Benign formations, which are uterine fibroids and cysts, depending on the degree of complexity, provoke complications for the onset of pregnancy. possible after elimination or with a small number of formations on the uterus.

How to plan a conception for men

Planning for pregnancy is not the exclusive responsibility of women. In 40% of cases of infertile marriages, the reason for the lack of pregnancy is a man. There may be several factors provoking such a complication of reproductive function.

Varicocele and conception

Varicocele is not the cause of infertility, but provokes complications and physiological changes in the spermatic cord, through which the seminal fluid passes.

Depending on the degree of the disease, expectant management or surgical intervention is used to remove thrombosed veins. The disease does not affect the likelihood of conception.

Oligozoospermia

When there is a reduced number of active sperm. For fertilization, stimulation of the formation of germ cells is used. If the disease is advanced, pregnancy occurs in only 5% of patients.

Prostatitis

Prostatitis (acute or chronic) is not the cause of infertility per se, but the inflammatory process that is present in the prostate reduces the quality of sperm. When planning pregnancy, the characteristics of the disease are taken into account, anti-inflammatory and antibacterial therapy is used.

Other diseases

In addition to these diseases, when planning a pregnancy for men, it is worth considering such features as:

• the presence of sexually transmitted diseases: gonorrhea, syphilis, which appear after several weeks of the incubation period;
• anatomical and physiological features: the absence of an organ, the spermatic cord in men (or the baby uterus in women) will also require advance planning;
• urogenital infections - chlamydia, ureaplasmosis, trichomonas, mycoplasmosis reduce the likelihood of pregnancy.

Reduce the quality of germ cells of men and women. Harmful toxic substances accumulated in the body are excreted in 2-3 years. Therefore, before planning, it is important not only to adjust the diet, enriching it with vitamins, but also to completely stop smoking and alcohol.

Pregnancy planning by alternative methods

Alternative pregnancy planning options include preliminary preparation of the body for the conception of a child of a certain gender. Such methods differ in efficiency and effectiveness, but are always popular.

Boy or girl?

To plan a child of a certain gender, it is recommended to use diet food enriched with specific elements and. For example, it is recommended for a girl to eat oranges, tangerines, yogurts, fruits and vegetables, while for a boy's pregnancy it is important to eat more meat, nuts, and dried fruits.

Planning for a second child

When planning a second child, tests are given, which are prescribed by the doctor. If there are no complaints from the patient, standard monitoring of blood and urine parameters is used, as well as an analysis for infections, vaginal smears.

Lunar calendar, non-traditional options for planning the sex of the child

Non-traditional methods include calculating the best day for conception according to the lunar calendar, the Chinese calendar for updating the parents' blood group, and calculating the month for conceiving a child of a certain gender.

Pregnancy after IVF, ICSI

The use of IVF and ICSI is the last option to become parents for most couples who have lost hope of natural insemination. There may be many reasons that led to such a sad outcome, but there is always the opportunity to try artificial insemination. In the course of preparation, hormonal correction is applied, and the implantation of the embryo into the uterine cavity.

Yoga and conception

Quite original methods of pregnancy planning include the use of gymnastics, yoga for conception.

Exercises used to improve the microcirculation of the pelvic organs contribute to recovery, relaxation, resulting in pregnancy immediately.

Non-traditional methods: massage, hirudotherapy, acupuncture

Other common pregnancy planning options include:

• massage of the lower part of the pelvis, back;
• use for blood purification - hirudotherapy;
• - as an ancient Chinese method of getting rid of infertility of unknown origin, with diseases of the reproductive organs of men and women.

Planning for conception and choosing positions

The latter methods include the choice of positions during intercourse. The choice of the desired position is advisable to apply to couples without the presence of inflammatory processes, sexually transmitted diseases, but with the anatomical features of the structure of the uterus, with its bending backwards, sideways.

Pregnancy planning is an important start for a happy motherhood and fatherhood in the future. According to psychologists, a child born on time to a couple who becomes a happy and full member of society.

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If you want to give birth to a healthy child, then pregnancy planning is a must. Planned preparation for pregnancy will help to conceive correctly, endure safely, give birth easily and raise your children well. It allows not only to reduce the number of factors that negatively affect these processes, but also to increase and strengthen the favorable ones.

Where to start planning pregnancy

More and more modern couples today come to the understanding that only pregnancy planning can significantly increase the chance of conception and the birth of a healthy baby. The quality of his whole and your future life may depend on this important step. However, far from everyone knows where to start planning pregnancy. And this step is quite simple and obvious - an appeal to a reproductive specialist or a gynecologist. After a conversation with the couple and clarification of a number of important questions, the specialist will refer potential parents to the necessary examinations.

Pregnancy planning includes a complete examination of a man and a woman, passing all the tests, treating chronic diseases, changing some habits and establishing new ones. Giving up bad habits, a balanced healthy diet, taking vitamins and psychological preparation when planning a pregnancy - all this will help protect the expectant mother and baby from unwanted potential problems.

Perhaps planning a pregnancy specifically in your case will force you to undergo more than one procedure unknown to you by this time. Let this not scare you: any activities carried out at the stage of planning and conceiving a child are necessary for a successful outcome. And you can always draw the missing information or the experience of other planning couples from the pages of our site.

Pregnancy planning calendar

Moreover, especially for women planning a pregnancy, it is proposed to use an electronic service - a pregnancy planning calendar. This online calendar will help you correctly determine the date of ovulation, plan conception for a certain period and immediately calculate the expected date of birth of the unborn child. The pregnancy planning calendar allows you to plan even the approximate birthday or zodiac sign under which your baby will be born.

The calendar is built on the individual characteristics of your menstrual cycle and shows the truthful data for you personally. But we must not forget that a huge number of factors that can lead to a change in these dates affect ovulation, and the process of conception, and gestation, and the date of birth of a baby. However, the likelihood of such a method is still quite high.

1. Is it true that with frequent sex life, spermatozoa do not have time to form, and the likelihood of conception decreases (option - they become inferior, not fast enough, etc.; the idea is that pregnancy should refrain from frequent sex in order to give time for a sufficient portion of spermatozoa to mature)?

Not true. They succeed. The quality of sperm certainly depends on the time of abstinence, but more on its increase. When planning a pregnancy, you don’t have to abstain at all and adhere to strict rhythms, rules, calendars; you can't do it on a schedule. This is a creative process, it is, first of all, an act of love, and it should be voluntary and when you want, and not when you think you need it. Exceptions are insemination, IVF, rare sex life (business trips, etc.), but it is not in vain that assisted reproductive technologies do not give a high percentage of conception.

2. Examination before pregnancy planning.

- therapist

- dentist

- Vaccination against diphtheria after 16 years - every 10 years. All adults in the family. Protection and passive immunization of the unborn child. 1 month of protection.

- antibodies to rubella and in the absence of immunity - vaccination. 3 months of protection. Re-determination of the antibody titer to make sure that a strong immunity has formed.

– spermogram

– TSH, thyroid antibodies

– blood coagulation (hemostasiogram) + antibodies to phospholipids + lupus anticoagulant + antibodies to hCG

- complete blood count, urine

- antibodies to herpes, CMV, toxoplasmosis - IgM and IgG, with titers. With the exacerbation of these infections, you can not plan.

- measurement of rectal temperature - firstly, in order to understand what to expect most in case of a delay, and secondly, if it does not work out for some time, and you go to the doctor, you will already bring him a huge amount of necessary information. Thirdly, it's easier to calculate favorable days :)

3. Examination after a frozen pregnancy (miscarriage)

- histology of removed tissues (do not expect much, the maximum that can be found is signs of a specific viral infection, for example, herpes)

– spermogram (poor quality may be one of the reasons)

– Ultrasound of the pelvic organs – twice per cycle (before and after menstruation)

– TSH, thyroid antibodies

– blood coagulation (hemostasiogram) + antibodies to phospholipids (lupus anticoagulant)

– blood for RV, HIV, hepatitis B and C

- antibodies to herpes, CMV, toxoplasmosis - IgM and IgG, with titers. Treatment of exacerbations.

- a regular smear on the flora, if necessary - sowing with the determination of sensitivity to antibiotics and antifungal drugs.

- PCR for "hidden infections" - chlamydia, mycoplasma, ureaplasma, CMV. And on unhidden - streptococcus, trichomoniasis, gonorrhea. Treatment of acute infections together with her husband. The entire cycle of treatment is protection with a condom.

- blood hormones on day 5-7 of the cycle: LH, FSH, estradiol, prolactin, DHEA-S, testosterone.

– in case of repeated miscarriages – medical genetic counseling

Do not worry if the cause is never found, this is most often the case, many genetic abnormalities and the consequences of natural selection remain unexplained. Therefore, the examination is carried out not to find out the reasons, but simply to find out the situation in the body. search for undertreatment and elimination.

4. Preparation for a planned pregnancy after the examination.

- multivitamins (better for pregnant and lactating).

- daily dose of iodine - 200 mcg. With a lack of iodine in multivitamins, an additional intake of potassium iodide. Iodized salt is an insufficient dose. With insufficient saturation of the mother's body with iodine before pregnancy, during pregnancy, the deficiency does not have time to be replenished. The intellectual level of the child is laid from the earliest stages of development. - in addition to multivitamins, folic acid 2-4 mg per day for both spouses. Regular intake by both parents of therapeutic doses of folic acid for six months dramatically reduces the incidence of malformations of the nervous system in the fetus.

- a gradual decrease in the total time of communication with the computer, rationalization of the working day (regular breaks, refusal to work overtime)

- a healthy lifestyle, nutrition, fresh air.

- while you are protected, or in the first phase of the planning cycle, it would be good to go on a two-week full-fledged vacation - with a change in climate, an airplane and all sorts of loads. Have a rest so that there is a supply of health and strength and there are no regrets that this year the vacation was not successful and now it is not known how much :). Get some rest, because then you won't be able to go anywhere.

5. Do I need to cancel sports, in the gym, in the pool, when you are planning a pregnancy

Don't until you know you're pregnant. Then cancel the exercises on the press, power. The pool can and should be left. You can enroll in special groups for pregnant women for special gymnastics.

6. Pregnancy does not occur for a whole month-two-three-five-seven-nine. Help!

Infertility is the non-occurrence of pregnancy within 13 ovulatory cycles without contraception with regular sexual activity. Not getting pregnant earlier is not a disease, and there is nothing to treat. And there is absolutely nothing to worry about, even if previous pregnancies occurred the first time, even if you think you are many years old, even if all your friends got pregnant, even if everyone tells you that this is not normal. Fine. There is nothing to treat yet. But a woman needs to be examined even outside of pregnancy planning once every six months, so after the expiration of this planning period, you can come for an examination - ultrasound, smear. Measure rectal temperature from the very beginning Where to start planning pregnancy ... so that you have something to come to the doctor with. The only study you can do without waiting a year is a spermogram.

7. What is the normal frequency of sexual activity?

For the soul - as suits both of you. For conception - very much depends on the parameters of the spermogram. Still, optimally - in a day or two. Two or three times a week, which are considered the norm, are very relative - because if they occur only on weekends - then this is irregular sex. There is no need to “save” spermatozoa - the more often they are spent (within reasonable limits), the faster new ones are formed. Reasonable limits are in a day or two. Then the necessary two or three times a week are obtained.

Just don’t make pregnancy planning an end in itself and force the other and yourself to do “this” when you don’t want to, but you need to. This rarely leads to the desired result, and the atmosphere in the family heats up. After all, you are not germ cell donors and live together not for the sake of planning, but for the sake of each other. And you plan the child for the sake of each other, and not as an end in itself.

8. Planning the sex of the child before conception.

Impossible. Only in the IVF and ICSI program - when spermatozoa with a certain set of chromosomes are selected. This is not good from the point of view of natural selection, and should only be used for hereditary diseases linked to sex, when the birth of, for example, a boy is undesirable, since the probability of his disease is much higher than that of girls (hemophilia).

It is possible to find out the sex of a child at a relatively early date - by taking his cells and studying their chromosome set. The cells are taken either from the cord blood (cordocentesis) or from the amniotic fluid surrounding the fetus (amniocentesis). These manipulations require the insertion of a needle and the collection of the desired fluid, and are associated with the risk of abortion.

So planning and recognizing the sex before it is visible on the ultrasound is not harmless, and should only be done for medical reasons.

9. Incompatibility by blood type and Rh factor.

If the woman is Rh-negative and the man is Rh-positive, the baby can be either Rh-negative or Rh-positive. Rhesus is a special protein on the surface of human blood cells. If such cells enter the blood of a person who does not have them, he forms antibodies on them that destroy foreign cells. With a short contact of different blood (the first pregnancy of an Rh-negative woman with an Rh-positive fetus, mixing of blood occurs during childbirth), antibodies are formed. but they do not have time to act on the cells of the fetus, because childbirth has already occurred. Antibodies continue to exist in the blood for several years, and during the second pregnancy with a Rh-positive fetus, they are already ready, and when the fetal cells enter the mother's bloodstream, they begin to destroy them. Normally, and during the second and subsequent pregnancies, mixing of blood occurs only during childbirth, and this is not so scary. But unfortunately, in modern conditions, the permeability of the placenta is often increased during pregnancy, and the baby's blood can get to the mother during pregnancy, antibodies have time to form (2 weeks) and act during pregnancy. Therefore, the Rhesus conflict can develop in the first pregnancy. Moreover, it does not matter how the pregnancy ended - childbirth or interruption, the duration and presence of antibodies are important. Blood cells begin to form at week 7, therefore, antibodies may not appear earlier than this period - from this moment it is necessary to check their presence in the blood every month.

Before a planned pregnancy, a Rh-negative woman should check the level of antibodies to the Rh factor in the blood. If they are not, pregnancy is planned, starting from 7 weeks each month, the level of antibodies is determined, if they are not until the end of pregnancy, within 72 hours after the end (any and at any time), it is necessary to inject anti-Rhesus D-immunoglobulin. It prevents the formation of antibodies after mixing the blood at the end of pregnancy. This drug must be purchased during pregnancy and kept in the refrigerator, because it is not known when the pregnancy will end, and neither maternity hospitals nor hospitals may offer to inject immunoglobulin, and you yourself must remind the doctors about this and bring your drug.

If there are antibodies, you can remove them from the blood by plasmapheresis, you can block their synthesis with hormonal drugs, you can wait. They are gradually removed from the blood, the best prevention of the Rh conflict is a long interval between pregnancies.

If a woman is Rh-positive, she cannot have any Rh-conflict, because she herself has a Rh, and antibodies cannot form against it.

Blood groups are also encoded by special proteins on the surface of blood cells. Group 1 (0) means the absence of these proteins - "negative" blood. 2 - group A, protein A. 3 - group B. 4 - group AB. If a woman does not have some protein that her husband has, the child may also have a paternal protein, and a woman negative for this protein may form antibodies and act as if she had an Rh conflict. This situation develops much less frequently than the Rh conflict, but it must also be remembered and the level of antibodies to blood groups also determined from the 7th week of pregnancy.

There can be a conflict if a woman has 1 blood group (0), and a man has 2 (antibodies to protein A), 3 (to protein B), fourth (to both antitags); if women have 2 (A), and men have 3 (B) or 4 (AB) - antibodies to antigen B; if a woman has group 3 (B), and a man has 2 (A) or 4 (AB) antibodies to antigen A.

So there is no incompatibility in terms of the Rh factor and blood types as such, and different Rh does not mean the impossibility of becoming pregnant and bearing a healthy child.

10. The ideal interval between pregnancies - after vaginal delivery and after caesarean section

2 years, after caesarean - 3 years. After termination of pregnancy - 3-6 months.

11. What to do if semen leaks from the vagina?

First, within an hour after intimacy, you need to lie on your back or on your side. The aging time depends on the time of semen liquefaction, this parameter is determined during the analysis of the spermogram, but as a rule it does not happen for more than an hour, therefore this is the maximum period.

Secondly, the whole will not flow out. It seems to you that everything follows. Not all.

Thirdly, during ovulation, when conception is possible, the opening of the cervix is ​​open, and all conditions favor the suction of sperm into the cervical canal. If you follow yourself, you will see. that all the same during ovulation does not follow or not so much.

Of course, there is always a way to fight, for example, insemination can be done by injecting sperm directly into the cervical canal, but this is unnecessary. In fact, this is only a psychological problem, and it does not affect conception at all.

12. Pregnancy does not occur. According to the charts - the absence of ovulation. What should I drink to stimulate ovulation?

First, "does not occur" means more than a year of regular unprotected intercourse. You don't have to drink anything before.

Secondly, the absence of ovulation is more often put on the charts than it really is. For example, it is absolutely not necessary that the temperature of the second phase should be above 37: In general, the graphs need to be analyzed, maybe there is ovulation after all. And the causes of infertility can be quite different. And the first thing to do is to check the spermogram.

Thirdly, if it really does not exist, then it is necessary to deal with the reasons. It is necessary to examine the hormonal status - donate blood on the 5th-7th day of the cycle for hormones: LH, FSH, estradiol, DHEA-S, testosterone, prolactin, cortisol, TSH. It is not the hormone deviation itself that is important, but the fact that this deviation causes anovulation. Those. we are fighting not for the number of the hormone, but for ovulation. And since there can be many reasons for its absence, you can’t “drink” something universal to stimulate it - it won’t help and hurt. For example, clomid (clostilbegit) should not be taken with an insufficient level of estrogen, it will only harm. In general, ovulation stimulation is an unsafe procedure, and it alone is not enough for pregnancy, you still need to support the second phase, you need to monitor the body's response - in general, you need to do all this ONLY under the supervision of your doctor. Otherwise, the risk of harm is greater than the benefit.

It is possible to stimulate ovulation, even if this decision is made, only after being convinced of the patency of the fallopian tubes. Obligatory hysterosalpingography (X-ray) or laparoscopy. Ultrasound check of the patency of the fallopian tubes - a biased study

And in general, an internal specialist is engaged in the treatment of infertility. Everything else is a waste of time and health and can cause irreparable harm.

13. How to conceive twins? Is it true that after the abolition of COCs, the likelihood of conceiving twins increases? Is it true that when ovulation is stimulated with drugs, this probability increases? With insemination? With IVF? Is it true that this ability is inherited?

This ability is indeed inherited in the sense that if there were twins (identical or fraternal) in the family (and it doesn’t matter if you or your husband) had twins, then you are more likely to conceive twins than if you don’t have twins in the family. But there is no categorical rule in this rule. And without a hereditary predisposition, they may be born, and with a hereditary predisposition, they may not be born.

With IVF - yes, several embryos are specially planted in the hope of natural selection. Sometimes a few survive.

With insemination, the probability does not increase, there is simply no reason - insemination is the introduction of processed sperm not into the vagina, but directly into the uterus. The sperm is the same, the eggs are the same, the probability does not increase.

When ovulation is stimulated, it increases slightly, it depends on the doses of the drugs used, and this is known in advance - the ultrasound shows the number of mature eggs and the formed corpus luteum.

After the abolition of COCs, the probability practically does not increase. Sometimes the abolition of COCs in itself is the stimulation of ovulation. But still, you can’t count on it, i.e. the probability does not change as noticeably to the eye as with IVF, for example.

So, you can specifically conceive twins - as well as plan a sex - only with IVF. And there is no full guarantee.

By the way, the formation of twins is not the norm for a person. This is a genetic feature of the maturation of the eggs or the development of the embryo, and therefore it is inherited. And this is some deviation. The human body is still not adapted for the full bearing of two - most often it copes, but there is more risk than with a normal pregnancy. Therefore, to specifically plan twins and tempt fate - and it’s good that it doesn’t work :)

14. What is the best position for conception (if there is a backward bend of the uterus, :) Is it true that you won’t get pregnant with a bend of the uterus

Absolute myth. The bend of the uterus (its deviation backwards) is most often an anatomical feature and in itself does not interfere with either conception or gestation. If you really want to create the appearance of violent planning activity, you can lie on your stomach after intercourse instead of the Birch pose. But no matter how you lie and no matter what you do, the spermatozoa will enter the tube in 90 seconds, regardless of where your uterus is turned.

Another thing is that if earlier the uterus was located differently, its displacement and fixation in the bend, especially during painful examination on the chair, attempts to remove, pain during intercourse in some positions - all this is an indirect sign of the adhesive process in the small pelvis. Sometimes adhesions can interfere with conception, but never the very fact of the uterus bending (retroflexion).

15. What is the best time of the year to plan a pregnancy?

It is better not to plan it for a certain time of the year, month, zodiac sign, etc. To avoid unnecessary disappointments and lessons.

16. How to plan a pregnancy if there is a seasonal allergy (for flowering, etc.)

Understand the medications you are taking, work with a general practitioner or allergist to find medications that you can take during pregnancy, and plan for your health. It will not be possible to guess for certain months so that pregnancy does not fall in the spring, do not even think about it.

17. Beer and pregnancy planning

Of course, when planning, a healthy lifestyle is shown. But this does not mean that it is necessary to deprive the husband of a bottle of beer on the day off for six months. In everything you need to know the measure. The systematic use of beer is alcoholism.

18. How much protection should be taken after taking alcohol, antibiotics, x-rays, etc. - wife / husband

A woman - one cycle, a man ideally - 3 months. After taking large doses of vitamin A (aevit) - a woman up to 6 months.

19. Stop smoking abruptly - is it harmful?

No, not harmful, but very useful. At any age, at any length of service, at any time. Even if you start again later, even if you throw like Mark Twain, every episode of throwing is still useful. It's proven. All the most important things are laid down in a child at the very beginning, when you do not know about pregnancy, it is formed against the initial background that exists in your body during planning, BEFORE pregnancy. Therefore, while you will gradually feel sorry for yourself, reducing one cigarette a day, it will be completely formed against the background of chronic hypoxia and chemical treatment with toxins and carcinogens. If you are a smoker and are thinking about planning, quitting smoking is your first priority before testing for rubella immunity. There is only a psychological addiction to smoking, so abrupt cancellation does not pose any danger to your body.

20. Does the onset of pregnancy depend on orgasm

No way

21. What vaccinations can be done when planning a pregnancy, how much to protect after them

If you are over 26 years old, or if you did not have an injection under the shoulder blade in the last grade of school, the diphtheria vaccine ADSm.

Hepatitis B vaccination is optional but highly recommended. Now it is not only people from the "risk groups" who become infected with it - at the dentist, in the hospital, in the beauty salon - anywhere. The vaccination consists of 3 vaccinations, the second - one month after the first, the third - six months later. Through a cycle after the third it is possible to plan.

From rubella, if there is no immunity by blood. You can plan after the formation of a protective IgG titer and the disappearance of IgM from the blood. as a rule, it is 2-3 cycles after vaccination.

From the flu, if you usually do it, the season matches, your work or family (school-age child) is associated with a high risk of getting sick in an epidemic. It is not necessary to protect yourself after vaccination with an inactivated vaccine, it can be done even during pregnancy.

All vaccinations must be done with imported vaccines.

22. What is better for checking tubal patency - x-ray hysterography (HSG, MSH) or ultrasound (EchoSG)? Is it true that adhesions in the tubes develop from the first, it is painful and uninformative, and the second is painless? On what day of the cycle are they made?

Better x-ray HSG (hysterosalpingography). It is done on the 18-22nd day of a 28-day cycle, soreness depends on your psychological mood and the usual soreness of your menstruation - the sensations correspond to those on the first day of menstruation. They can be reduced with the help of preparation: a week before the no-shpu procedure, 3 tablets per day, valerian and bromcamphor, on the day of the procedure - an injection of baralgin. Basically, this is not done for pain relief itself, because the sensations are tolerable, but to relieve spasm from the fallopian tubes, so as not to get a false negative result when, due to spasm, the tubes seem to be impassable. The best prevention of spasm is the absence of fear in you.

Adhesions from HSG do not develop, it does not give inflammatory complications if done correctly! Before the procedure, a smear is taken for the flora. And in the presence of an inflammatory process, it is not done because of the danger of entering an ascending infection - from the vagina to the uterus.

EchoSG - the introduction of fluid into the uterus and ultrasound, fixing the presence of this (?) Fluid in the abdominal cavity - i.e. released through the pipes. At the same time, the very process of the passage of fluid through the pipes on ultrasound is not visible, just as the shape of the tube and uterus, the lumen, the difficulties of passing, obstructed patency, from which tube the fluid went, how it was distributed in the small pelvis, are there any adhesions - everything that is visible on the HSG, after filling all open cavities with contrast.

What do future parents need to do in order to create the most favorable conditions for conception, pregnancy and the birth of a healthy baby? So, let's start planning pregnancy

Tip 1. You need to prepare for pregnancy together - both a woman and a man

You can often hear from men the opinion that the birth of children is a purely feminine affair and only a woman needs to prepare for this process. But such an attitude cannot be accepted as true. After all, at conception, the male and female sex cells merge. All genetic information goes to a person from his parents. Of course, the health of the baby is also affected by the course of the prenatal period, and the process of childbirth (therefore, the state of health of the mother is most important), and the influence of the external environment and lifestyle of a person subsequently, however, it is mainly provided by the health of both mother and father, so it is necessary to be examined before conception.

It should be borne in mind that the maturation of spermatozoa occurs within 3 months, so the impact of various adverse factors during this period (infections, stress, bad habits - alcohol, smoking) can have a negative effect on the germ cell involved in conception and, therefore, on the health of the child. . For women, the course of the menstrual cycle is important, during which fertilization will occur - it is during this period that negative factors can affect the maturing egg. However, due to the fact that in the next 9 months the health of the baby will largely depend on the state of the mother's body, a number of measures must be taken at least 3 months before conception, and negative factors should be avoided throughout pregnancy.

Tip 2. When planning a pregnancy, we give up bad habits

Everyone knows about the dangers of smoking, alcohol, and even more so drugs. Expectant mom and dad are advised to completely abandon these bad habits already at the stage of pregnancy planning.

Nicotine, methylamine, methylmercaptan, pyridine bases, etc., contained in tobacco smoke, can reduce the ability to conceive in both men and women. Tobacco components cause menstrual irregularities in women, impair erections in men. Smoking, including passive smoking, causes circulatory disorders in the placenta during pregnancy, which is a serious risk factor for insufficient oxygen supply to the fetus and retardation of its intrauterine development. Therefore, the mutual refusal of smoking is one of the important stages in preparing for pregnancy.

It has been proven that narcotic substances and ethyl alcohol cause mutations, leading to fetal malformations, intrauterine death, severe physical and mental disorders in born babies. Therefore, future parents should refrain from drinking alcohol already at the stage of pregnancy planning.

Currently, there are special schools for those who want to quit smoking at polyclinics and health centers.

When planning pregnancy, it should be borne in mind that both overweight and underweight can interfere with its onset. To understand whether everything is in order with your weight, the body mass index (BMI) is currently most often used. Calculating it is simple: body weight (in kilograms) must be divided by height (in meters) squared. A BMI in the range of 18.5 kg/m2 to 24.9 kg/m2 is considered normal. Smaller and larger values ​​are regarded as indicators of underweight or overweight, respectively. If a deviation from the norm is detected, it is advisable to consult an endocrinologist to check whether this is due to hormonal disorders. If everything is in order with hormones, then it is recommended to consult a dietitian who will help you choose the right individual diet: a diet that is sufficient in calories and balanced in protein, fat, carbohydrates, minerals and vitamins. By adhering to the recommendations received, the expectant mother will be able to normalize her weight, since any deviation from the norm (both in the "plus" and "minus") can adversely affect the course of pregnancy. But it is important to take into account the fact that it is not worth planning a pregnancy against the background of any diet, since in most of them the principle of a balanced rational diet is violated.

It was revealed that easily digestible refined carbohydrates (sugar and sweets containing it, sugary drinks), saturated fats (margarines and baked goods with margarine, french fries), a large amount of animal proteins contained in meat products have an adverse effect on conception. Slowly digestible carbohydrates (cereals, wholemeal bread, etc.) and vegetable proteins help increase the ability to conceive. Men are recommended zinc-rich seafood, tomatoes containing the antioxidant lycopene, fruits, vegetables and berries rich in vitamin C and the trace element copper (wild berries, citrus fruits) - all these products increase the quality of sperm and the ability of sperm to fertilize.

Tip 4. In preparation for conception, we “stock up” with vitamins and minerals

Early intake of certain vitamins (for example, folic acid), minerals and trace elements (iodine) several times reduces the likelihood of malformations and a number of diseases in a child. The results of large clinical studies have confirmed that the use of folic acid at least 0.4 mg per day by both spouses for 3-6 months before pregnancy prevents the occurrence of many fetal malformations, including severe neural tube pathology.

According to various sources, 30–40% of women in Russia have an iodine deficiency. If you do not make up for the lack of this substance in the body, then during pregnancy the risk of miscarriage and various congenital disorders in the baby increases. Therefore, even at the planning stage, it is necessary to start taking iodine preparations at a dose of 100 mcg per day 3-6 months before pregnancy, and in the event of pregnancy, increase the dose to 150 mcg/day. In the presence of thyroid diseases, treatment, including the required amount of potassium iodide (doses may differ from prophylactic doses), is determined by an endocrinologist.

Tip 5. Minimize stress during pregnancy planning

The advice not to be nervous is one of the most frequent among those that an expectant mother receives during pregnancy. However, the ability to calmly respond to the troubles that life throws at us is an important skill not only for expectant mothers, but for everyone else (in particular, for future dads). Of course, pregnancy and stress are not the best combination, therefore, even before pregnancy, it is recommended to acquire habits that allow you to resist bursts of emotions as much as possible. increase compliance with the daily regimen, sufficient restful sleep, moderate physical activity, which should not cause discomfort. Try to develop a constructive view of things, do not be offended: people are upset not by the events themselves, but by how they react to it. You can and should prepare for the expected stressful event in life. First of all, accept the fact that stress (exams, tests, rush at work) is an integral part of our lives. Set yourself up for positive problem solving. Do not make decisions hastily, think over your actions, plan your affairs in advance if possible: lack of time in itself is stressful. Use modern time management methods, solve cases in order of their importance.

Tip 6. When planning a pregnancy, we provide ourselves with moderate physical activity

If regular physical activity has not yet become a permanent part of your life, then the pregnancy planning period is the time to acquire this useful habit. According to scientific research, moderate physical activity contributes to the normalization of hormonal levels, improves metabolism, and increases the ability to conceive (fertility). In men, regular exercise helps increase testosterone levels and improve sperm quality. At the same time, very intense physical activity has a pronounced negative effect on the ability to conceive. This is due to adverse changes in the hormonal background during serious sports activities, which can contribute to menstrual irregularities and the ovulation process. With a decrease in the intensity of physical activity, fertility is restored after a while.

Tip 7. In preparation for pregnancy, we consult a geneticist

According to experts, today all spouses planning a pregnancy, regardless of their age, are recommended to consult a geneticist. In a number of situations, such a consultation is necessary to assess the prognosis of the health of the unborn baby and draw up an action plan that contributes to the birth of a healthy child. These situations include:

• spouses are over 35 years of age;
• the presence of hereditary or severe chronic diseases in the spouses themselves or their close relatives;
• the presence in the family of children with hereditary diseases or congenital malformations;
• spouse infertility;
• two or more miscarriages or frozen in the first trimester of pregnancy (since approximately
• in 2–3% of cases, these conditions are based on genetic disorders in one of the spouses);
• in consanguineous marriage;
• if at least one of the parents was exposed to hazardous factors (radiation, toxic chemicals, toxic substances, etc.).

When counseling a couple, a geneticist determines the risk of having a child with genetic abnormalities. The risk is low, medium and high, but even in the latter case, the birth of a healthy baby is quite possible.

Of course, it is very desirable to take into account all the above tips when preparing for pregnancy. However, if suddenly pregnancy occurs before you have time to complete the preparation for conception, do not worry. Yes, pregnancy planning is very important, as it minimizes many risks, but the most important thing is that your desired baby will be born, and you will become happy parents!

Preparing for pregnancy: the necessary minimum

You should start the examination with a gynecologist (for a woman) and a urologist (for a man). Specialists will prescribe the necessary examination: as a rule, this is a general examination, a gynecological smear for women and a spermogram for men, which allows you to identify various deviations from the norm, determine the possible causes of problems with conception, and prescribe the appropriate treatment. In some cases, doctors prescribe additional examination methods (ultrasound of the pelvic organs, analysis for the content of various hormones, tests for the detection of sexually transmitted diseases, tests for infections, infection with which during pregnancy is very dangerous for the fetus - rubella, toxoplasmosis, herpes and cytomegalovirus ).

The general practitioner, after studying the vaccination card, can prescribe vaccination (against rubella, hepatitis B, tetanus, diphtheria).

It is also recommended that expectant mothers and fathers visit a therapist, dentist, otolaryngologist (ENT doctor) and, possibly, other specialists. Think it's redundant? Not at all. The oral cavity, teeth, palatine tonsils, nasopharynx, and intestines are the most common habitats for pathogenic bacteria. It should be borne in mind that the presence of sources of chronic infection in the body is a "time bomb". During pregnancy, against the background of a natural decrease in immunity, an exacerbation of infectious and inflammatory processes is possible, which can adversely affect the course of pregnancy, provoke a miscarriage or premature birth. , chronic tonsillitis, sinusitis, dysbacteriosis is easier to carry out before pregnancy than during it, when many drugs are contraindicated.

In case of any chronic diseases, future parents, especially mothers, should consult their doctor, informing him about the pregnancy planning. Of course, conception should be planned for a period outside the exacerbation of the disease. Treatment may need to be changed as a number of drugs used to treat chronic conditions (such as hypertension) are contraindicated in pregnant women. It may take time and mandatory medical supervision to select a new effective treatment that is safe for pregnant women.

When to start preparing for pregnancy?

Considering that the implementation of many items of the pregnancy preparation program requires at least 3 months (the time required to conduct an examination, give up bad and acquire good habits, the period after vaccination, etc.), then conception should be planned earlier than this period , it is advisable to allocate six months for this important event.

After a miscarriage or abortion, it is better to plan conception and pregnancy 1–1.5 years after the curettage operation. As a last resort, not earlier than in 6 months. Supervision during pregnancy in these cases should be especially careful. Currently, experts (obstetrician-gynecologists, psychologists) consider the optimal period between childbirth and the next pregnancy to be a period of 2-3 years. If the previous pregnancy ended, then the break should be at least 3 years.