It is easy to forget some of the tiniest details when your mind is focused on the bigger picture. Rescu. expert, Dr Claudia Lee, shares five important fertility and pregnancy facts you need to know.
1. As a general rule , if you want a private obstetrician for your pregnancy, you need to update your private health insurance three months before falling pregnant.
The reason I reiterate this is that women have been known to get caught out, and private health cover rules do not accept ‘oops’ as an excuse. However, do not fear, because the Australian health care system completely covers all things related to pregnancy, childbirth and breast-feeding through the public system and is wonderful.
What private health does cover does give you is the option to choose a particular obstetrician, hospital and private room and paediatrician. Having said that, women who do have private cover, often opt for the public birth centres, midwife or GP shared pregnancy programs as it may be more convenient, less expensive and more in line with their ideas about birth. This is an extremely personal choice, so if you want all the options then be sure to call your private health cover to check and update your pregnancy.
2. A little pre-pregnancy planning and testing can have you on track and speed up the whole process.
One of my favourite parts of being a GP is pre pregnancy planning, because couples are often at their most motivated, and are best placed to assess and improve their own health and well being and that of their offspring.
For both partners, this means checking for thyroid and hormone function, nutrients such as iron, zinc, Vitamin D, essential fatty acids (omega 3), iodine and folate; checking for risk factors that may affect fertility such previous STI’s or lifestyle factors like smoking, alcohol and drug use, checking immunisation,menstrual cycle and Pap smear status for women, checking family history for inherited disorders and referring to clinical genetic services, and of course checking for mood, well being and social structure that may be able to support them with newborn(s).
3. One vitally important component for speeding up falling pregnant is learning about ‘ovulation timing’, or knowing when ‘an egg is ready or fertilisation’.
The other reason this is important these days is that often couples are both rather busy and may just be missing the ‘main fertility event, especially if both are working or already have other children and fell pregnant easily the first time(s).
As it easier explained and monitored with an website or application, some of the best fertility Apps for cycle tracking are Fertility Friend, Glow, Kindara, Clue, and Conceivable,to give your the best chance of pregnancy.
4. If falling pregnant is taking longer than you expected, (>12 months if younger than 35 years or > 6 months if older than 35 years), then you will be referred by your GP to a fertility specialist.
A fertility specialist will investigate to help uncover any reasons that may be reducing your chances of becoming pregnant, and will also help you move quickly to the next levels to achieve your goal.
This will generally involve blood tests, a pelvic ultrasound, and could involve minor surgical procedures for woman with issues involving endometriosis, uterine polyps or ovarian cysts or tumours.
The male partner is generally asked to provide a sperm sample to be examined under the microscope at a fertility laboratory and there is a strict protocol of 3 days abstinence prior to the test.
Couples may also be directed to Assisted Reproduction known as Inter Uterine Insemination (IUI) where sperm is injected into the uterus at ovulation, or invitro fertilisation (IVF) where an egg is collected and placed/ injected with sperm and put back into the uterus. After ages 45 years, discussions usually include egg donors or surrogates, although we have all heard of the circumstances where someone fell pregnant after this age.
5. Non Invasive Prenatal Testing (NIPT) is now available as a blood test as early as 10 weeks in pregnancy, which tests the likelihood (98-99% accurate) that your unborn baby may have one of the common genetic disorders (including Down syndrome). So what do you need to know?
NIPT is an optional test, is not covered by Medicare or private health insurance and requires a referral from your GP or obstetrician.
It costs around $400, and the results are available within 3-5 business days..
If your baby has a high likelihood of having an abnormality, your doctor may suggest other diagnostic tests such as a CVS or Amniocentesis (where a needle is inserted into the uterus to collect foetal cells for testing).
As NIPT only tests for certain chromosomal abnormalities, it cannot detect developmental malformations such as spina bifida, so you should still have an ultrasound at 12 weeks.
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