People trying to conceive should be informed that:
- Vaginal sexual intercourse every 2 to 3 days optimises the chance of pregnancy
- Alcohol consumption impacts on fertility and fetal health and:
- Women should avoid drinking alcohol while trying to conceive to reduce the risk of harming a developing foetus.
- Men should not drink more than 14 units per week of alcohol as it can affect their semen quality.
- Smoking is likely to reduce a woman’s fertility and there is an association between smoking and reduced semen quality.
Rubella serology is no longer recommended as part of pre-conception care, but MMR vaccination remains important.
Zika Virus Alert:
The ECDC advises that to minimise the risk of Zika virus transmission, travellers returning from Zika affected areas should follow the guidance below:
- Female traveller, symptomatic or asymptomatic, should not try to conceive naturally, donate gametes or proceed with fertility treatment for 2 months.
- Male traveller, symptomatic or asymptomatic, should not try to conceive naturally, donate gametes or proceed with fertility treatment for 3 months.
For more information on Zika Virus please read the UK government’s advice and the ECDC’s advice.
Folic Acid Advice
Women should also be offered standard pre-conceptual advice including that dietary supplementation with folic acid before conception and up to 12 weeks’ gestation reduces the risk of having a baby with neural tube defects. The standard recommended dose of folic acid is 400micrograms per day.
A 5mg dose of folic acid is recommended for women who have:
- Had a previous baby affected by a neural tube defect
- A personal/family history of neural tube defect
- A current partner with a personal or family history neural tube defect
- Epilepsy or are taking anti-epilepsy medication
- Diabetes
- A BMI of 30 or over
All adults, including pregnant and breastfeeding women, need 10 micrograms of vitamin D a day, and should consider taking a supplement containing this amount. Lothian policy is not to do testing in this situation and the ideal is for the woman to speak to her pharmacist about this if she is not eligible for the Healthy Start Scheme. Please see https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/ for more detail about vitamins and nutrition in pregnancy.
For advice about the use of medications in pregnancy, please see https://www.medicinesinpregnancy.org/
Preconception Haematology Guidance.
RefHelp has extensive preconception haematological guidance, including on DOACs, warfarin, bleeding disorders, thrombosis (including for those with a family history).
