Want to Conceive? Want a Healthy Baby? Here’s A Checklist and Suggestions
Nationally-recognized fertility specialist Dr. Ingrid Rodi says that women who are under 35 who have tried to get pregnant for a year with no results or women who are 35 or over and tried six months with no results, should seek a specialist.
Additionally, a woman who is over 35 and wants more than one child should consider freezing embryos.
Then Rodi, at an interview in her Wilshire office, drops a bomb: it’s not only those who having trouble conceiving who should see a doctor, but “Every baby should be planned. Once a woman’s pregnant, if there are underlying problems, it’s harder to treat.”
By planning, she urges people who are thinking about getting pregnant not to “throw caution to the wind,” but to consult an obstetrician/gynecologist. This also comes as the latest recommendation from the American College of Obstetricians and Gynecologists.
A screening might include checking for hepatitis C (HCV), which is curable, but for which there is no vaccination.
About half of people with HCV don’t know they’re infected, mainly because they have no symptoms: the disease can take decades to appear. The virus can cause liver cancer or cirrhosis and can be passed to a baby in utero. HCV can be spread sexually, through blood, through drugs or through piercings or tattoos at shops where needles are not clean.
A woman’s general health should be assessed. For example, a woman, under 35, came to see Rodi because she had been trying for two years to become pregnant with no results.
The woman’s blood pressure was 185/130, and upon further testing, Rodi discovered the woman had renal disease. A pre-pregnancy planning checkup would have discovered this problem sooner.
Rodi, a graduate of Brown Medical School, said women who are thinking about becoming pregnant should be tested for anemia. Vegans or women who don’t eat iron-rich food are likely to be anemic, which is a situation that should be taken care of before conceiving.
In addition, women who are obese need to lose weight before becoming pregnant. Rodi was asked if that was being “mean” to heavy women. Matter-of-factly, the doctor explained that it is easier to get pregnant and the miscarriage rate is lower if one is not overweight.
Women carrying extra pounds are more likely to have high blood pressure, a higher chance of diabetes and a greater chance of having a C-section during delivery.
A woman who wants to get pregnant should have the flu shot because “It can be life-threatening to get flu when you’re pregnant,” said Rodi, who completed her internship, residency in OBGYN, and fellowship in Reproductive Endocrinology and Infertility at Harbor-UCLA Medical Center.
If a woman is on medication, it should be reviewed. “Some medications are fine, some are not,” Rodi said. If a woman is going through chemotherapy, it is not a good time to be pregnant.
That would seem to make sense, but Rodi warns it has happened because planning was not in place.
An OBGYN should also review psychiatric illnesses.
If a person has been evaluated for depression, anxiety and bi-polar symptoms, the woman needs to know that “all these conditions become worse during postpartum,” Rodi said, noting that the doctor doing the screening should also have an ongoing relationship with the woman to make sure that there is no substance abuse.
A doctor who has keyed in on her patient would also be able to pick up a domestic abuse situation. said Rodi, who has volunteered at the Rape Treatment Center at the Venice Family Clinic.
Some women like flight attendants experience high amounts of radiation, which are not good for a developing embryo, and a doctor should make recommendations about occupational exposure before a woman conceives.
Finally, Rodi recommends carrier screening. She was asked, “For everyone?”
“Yes,” she said. “Most people find out they’re carriers because the first child is born with a disease, such as cystic fibrosis or fragile X syndrome or spinal muscular atrophy.” She said that with screening people can find out beforehand if they have a risk for passing on a genetic disorder.
Those people can then make a decision: 1) proceed without any changes; 2) undergo in vitro fertilization and reimplantation genetic testing; 3) conception through egg, sperm or embryo donation; 4) undergo prenatal testing while pregnant (such as Chorionic Villus sampling); or 5) adoption.
Finally, what if you’re 35, don’t have a partner and think you might want children?
“You should consider freezing eggs,” said Rodi, who joined the Pacific Fertility Center-LA last year.
She explains that women are very fertile when they’re 25 years old, and over 47 not so much.
Rodi hears stories about women who expect to have children into their 40s because their mother got pregnant late in life or did not enter menopause until she was in her 50s.
The problem, “Those women are forgetting they have half of their genetic makeup from their dad’s side of the family. What is that history?” asks Rodi.
Capturing eggs is a minor surgical procedure that is performed in a doctor’s office or an outpatient center and costs about $20,000 a cycle.
Generally, the younger the woman, the more eggs and the better quality. For example, during a cycle, a 25-year-old woman might have 12 eggs captured, which could result in eight embryos. A 40-year-old woman might have 10 eggs harvested, with one or no embryos produced.
“Between 35 and 43 years old, there is a lot of [reproductive] variation in women,” Rodi said, noting that the positive side of freezing embryos is there is close to a 90 percent success rate of having a baby later.
Rodi is past president of the Pacific Coast Reproductive Society and a member of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology. Visit:pfcla.com or call (310) 209-7700.