What is preconception care?
Preconception health care occurs at least three to four months prior to conception and aims to support both female and male fertility. Ensuring great quality chromosomes in the egg and sperm leads to increased chances of ovulation, conception, and healthy pregnancy. At present one couple in six is infertile and one woman in four will suffer a miscarriage. The combined evidence of many eminent researchers shows that conditions such as infertility, miscarriage, low birth weight, premature birth, malformation, breastfeeding difficulties, learning problems, allergies and many more are often preventable with preconception health care.
"When a flower doesn't bloom you fix the environment in which grows not the flower"
Why is the preconception period so important?
Four months prior to ovulation a follicle, which houses the body's largest cell, your ova (egg), is stimulated to go through its most demanding transformation.
At the same time, sperm, the body's smallest cell but equally complex goes through its own transformation called spermatogenesis.
Spermatogenesis and follicular development are the most intensive during the three to four months prior to ovulation and conception. At this time they are extremely susceptible to DNA damage. The food you eat, the environment you surround yourself with, stress levels and how deeply you sleep can all have an impact on your hormonal regulation and fertility. Some factors are out of our control, others we have the ability to reverse or alter, setting the foundation for our fertility to flourish.
"Egg and sperm are extremely susceptible to DNA damage in the three months prior to conception"
What does preconception health care involve?
Preconception health care involves, preparing the body for a conception by ensuring that there is, as much as possible an adequate supply of all those factors which are essential for male and female fertility, the health of ova and sperm and the development of the embryo and foetus.
It is also essential to ensure the absence or removal, where possible, of those factors which have been shown to be harmful to any of these processes.
This looks like choosing foods that have the highest quality materials and eliminating household toxins where you can. Preconception health care not only ensures the foetus has everything it needs but is a continuing part of the health care plan for the mother throughout pregnancy and breastfeeding.
An example of this is ensuring the Mother has an adequate intake of iron, B12, and folate. These nutrients are needed for gene expression, methylation and DNA synthesis. As we know well low folate levels entering pregnancy can result in neural tube defects in the fetus and low iron can persist throughout pregnancy causing problems for Mum and baby well into postpartum.
Preconception care can include:
Detoxification – screening for heavy metals, gentle cleansing and reducing environmental factors that contribute to the toxic load
Adequate nutritional status – correcting nutritional deficiencies and enhancing nutrients that are most important for conception
Ensuring regular cycles and balanced hormones
Getting fertility fit, weight management
Lifestyle advice – stress reduction and positive mind-set
Fertility charting - learning to identify your fertile days and the optimum time to conceive
These considerations then need to be continued as part of a health care plan for the mother throughout pregnancy and breastfeeding
Recent research is starting to confirm that the beginning of a child’s life and what the parents do three months pre-conceptually is of profound importance in determining the future health of the child.
Who is preconception care for?
No matter if you are trying to conceive naturally or by assisted reproductive technology the most important factor in this equation is the quality of the egg and sperm. This is one of the most important factors that we can have an effect on leading to conception.
Preconception health care aims to improve and maximise the health of parents and children.
Our modern lifestyles have been shown to greatly affect our health and fertility. Using preconception methods gets your body into the optimum state to conceive, resulting in an increased chance for a healthy pregnancy and baby with a high success rate of overcoming fertility issues.
If you have been trying to conceive for a few years, have irregular menstrual cycles or reproductive conditions such as endometriosis, PCOS or fibroids. Preconception planning will have a positive influence on hormonal health. Maybe you have just started thinking about having a baby and you want to be in the best possible health.
Preconception planning is tailored to each individual, and while there is standard health information a lot is individualised to each person. Taking into account your health history, dietary specifications, and reproductive conditions you are experiencing.
"Taking at least three months to prepare your body is the greatest gift you can give your child"
How effective is preconception health care?
The Foresight Association (British Association for the promotion of preconception care) were modern pioneers in preconception health care in the 1970s. They developed a thoroughly researched and successful programme to restore fertility by optimizing health to obtain a natural conception.
1. The Foresight Study 1995 followed the progress of 367 couples.
Study involved:
367 couple
Women aged 22-45
Men aged 25-59
41% had no previous reproductive history
59% has suffered infertility, previous miscarriage, therapeutic abortion, stillbirth, ‘small for dates’ or low weight babies and malformation.
By the end of the Study . . .
89% of all couples had given birth including 81% of those who were infertile
Average gestational age was 38.5 weeks and no baby was born before 36 weeks.
Average weight of males was 7Ib.4 ½ oz.
Average weight of females 7Ib. 2 oz.
No baby was lighter than 5Ib.3 oz.
There were no miscarriages, no perinatal deaths and no malformations
2. A second Foresight study in 2003 with 1061 couples. Within two years of the preconception programme, conception rates were 78.6% and IVF rates doubled.
3. The University of New England (UNE) is conducting an independent study of 67 patients partaking in the Natural Fertility Management conception programme at The Jocelyn Centre. A high proportion of the couples in this study had serious fertility problems, all of them diagnosed infertile, and 25% of them were over 40yrs old. Preliminary results have already shown that 56% of previously infertile couples conceived within the first two months and 50% of these women were over 40 years of age. This was following the preconception protocol.
Neil Ward & Keith Eaton(1995)Preconceptional Care and Pregnancy Outcome,Journal of Nutritional & Environmental Medicine,5:2,205-208,DOI: 10.3109/13590849509000218
The Jocelyn Centre for Natural Fertility Management & Holistic Medicine, The Natural Fertility Management Conception Program, Sydney: Natural Fertility Management Pty Ltd, 2009.
Arentz, S. (2009). Fertility and Conception. The Journal of Complementary Medicine: CM, 8(1). https://search.informit.org/doi/10.3316/informit.569063296219717