Before the preganancy
When you first start to think about having a baby, the majority of people will just stop using contraception and get started on the baby making process! However it is super important to have some blood tests done at this point because some deficiencies may prevent pregnancy from occurring, some may make pregnancy really difficult for mum, and others can be detrimental for the health of your baby.
For example, every pregnant woman is told to have folate, but the most important time to have folate at its optimal level(and not just begin supplementing) is within the first 5 days when the sperm and the egg having their first meeting. If folate is not at adequate levels at this point, the risk for spinabifida greatly increases.
Another thing to think about is iron. If mum is low in iron at the start of pregnancy her pregnancy will most likely leave her extremely fatigued, and bub may be born iron deficient as well.
Low iodine levels which is a really common deficiency in Australia can lead to miscarriage, mental retardation and other health concerns for the baby.
The most common deficiency that I see in clinic believe it or not is Vitamin D. Levels less than the optimum of 100 can also unfortunately result in a miscarriage
These things are so easy to screen for and remedy prior to starting for a baby. But the reason why we don’t just take these supplements anyway, is that everyone has different blood chemistry. Some women may have high iron, low B12, low Iodine and adequacy Vitamin D, while another will be opposite. They need very different treatment with diet and supplements.
The basic testing you want to ask your GP for are:
- Blood Chemistry Screen
- Blood group
- Rubella status
- Thyroid studies (TSH, Free T3, Free T4, and Thyroid antibodies)
- Full blood count
- Iron studies
- Vitamin D
- Urinary Iodine
Further testing is required if you encounter issues. The latest thinking of GP’s is that a woman needs to have 3 miscarriages before they will investigate. However if you wish to have things looked at before this you may just need to pay for the tests. Things to look at further include prolactin, autoantibodies, pro-thrombic studies, AMH, CF gene, MTHFR gene, Sex hormone studies FSH, LH, SHGB, Testosterone, 17-hyroxy progesterone, oestradiol.
Detailed investigations that can be explored are laparoscopy, uterine natural killer cells, hysteroscopy, HSG and dye studies. ALSO without forgetting Dad’s part blood chemistry, FSH, LH, Testosterone, and semen analysis may be warranted.
Some tests are essential and some you have based on your symptom profile. Having an experienced practitioner to guide you through the maze of tests and the results are important as your GP may not see fertility patients all the time and not be up on the current research.