PRECONCEPTION CARE FOR WOMEN EMBARKING INTO IN VITRO FERTILISATION; A SMART STARTEGY.

In vitro fertilization (IVF) is one treatment option for a couple with infertility. In IVF, the quality of the egg and sperm are paramount to conception; so is the health of the host who is usually the prospective mother. It is understandable that IVF can be a process that is stressful yet full of hopes and expectations for success since the success rate is guarded by many factors. Studies have demonstrated that preconception care (PCC) in connection with IVF is a pivotal preliminary strategy for optimizing the health of both the mother and baby; ultimately increasing the success rate of the procedure. PCC provides a suitable environment for inception of pregnancy before the existence of even a dot of foetus in the womb.

Some components of PCC preconception care for consideration of couples intending to embark on IVF are as below.

1. Comprehensive health check-up. Couples should get a thorough medical assessment to identify any chronic medical conditions like diabetes, genetic disorders and fertility issues. Optimising any medical condition is crucial before IVF could be performed. In addition, current medications need to be reviewed and deem safe for pregnancy. Some medications may need to be modified or changed by the attending doctors.
2. Lifestyle modification and avoidance of harmful substance. A balanced diet and exercising to the recommended 150 minutes of physical activities in a week can assist to optimise a woman’s weight. Achieving a good weight (not underweight, nor over weight) can improve fertility and IVF outcome. Meanwhile, alcohol which may also influence weight gain has deleterious effect on reproduction. Similarly, consuming recreational drugs, active and passive smoking can adversely influence fertility as well as health of the future baby. Hence it is best to avoid these harmful substances and employ good lifestyle behaviours to enhance fertility and ensure a healthier pregnancy.
3. Supplements and vaccination. A woman preparing for pregnancy should supplement themselves with folic acid at least 3 months prior to conception in order to reduce the risk of having babies with congenital anomalies namely neural tube defects. In addition, vitamin D deficiency has also be implicated with miscarriage. Recent studies have highlighted that Vit D supplement has crucial role in the preparation of pregnancy. Nonetheless, vaccination like rubella and varicella, though not a supplement yet important to the mothers since their institution can reduce these infections from affecting future pregnancy.
4. Mental health support. Infertility is a stressful condition. While IVF offers a solution to this predicament, it is an expensive process that may have guarded outcome in many situations. It is comprehendible that couples can experience psychological disturbances when preparing for IVF and unfortunately, stress can affect fertility. Counselling, support group and relaxation therapy are among strategies to support these anxious couple to relieve their stress.
5. Counselling and education. The couples with issues of infertility and deem to be good candidates for IVF should receive counselling about the process, its risks and benefits. They would be counselled on the realistic journey of IVF and its success rate. Meanwhile, PCC will provide the couples on favourable environment and best timing to embark on IVF.

In short, preconception care plays an imperative role to the process of conception, regardless if one is trying to conceive naturally, more so if the couple plans for an IVF cycle. Therefore, couples should consult a doctor; either an infertility specialist, an obstetrician or a family medicine specialist for preconception care prior to contemplating an IVF.  

Dr. Irmi Zarina Ismail

Family Medicine Specialist

Department of Family Medicine

Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

Date of Input: 05/08/2024 | Updated: 04/09/2024 | nadia_rahman