The American College of Obstetricians and Gynecologists (ACOG) now recommends that before you start trying to conceive, you see your gynecologist or gynecological nurse practitioner for a preconception checkup. This checkup not only allows her to do a thorough medical exam, it is also a good opportunity for you to talk to her about the best way to conceive quickly and to start a pregnancy in the best of health.
If possible, see your health-care provider six months before you begin trying to conceive. This will allow time to get any needed vaccinations, stop taking medications that could affect your pregnancy, and begin getting enough folic acid.
An important part of the preconception exam is your medical history. Your health-care provider will want to get details on your medical and lifestyle history. He will also need information about your family health history, with a particular emphasis on any genetic diseases in your or your partner's family. Your health-care provider will be particularly interested in your menstrual history including length of periods, regularity, and when the last one occurred.
Before your preconception appointment, try to put together a complete family medical history, gathering information about how relatives died and any chronic or genetic diseases they had during their lives. It is easier to gather this information in advance than to try to rack your brain for it while sitting in the office.
Your health-care provider will want to know about any of the following in your history:
Chronic diseases you have, such as asthma or diabetes
Sexually transmitted diseases
Pelvic inflammatory disease episodes
Abnormal Pap smears
Previous pregnancies, including ectopic, and ones that ended in miscarriage, stillbirth, and abortion
Information about previous births, including type of delivery and any problems, including birth defects
Previous surgeries you have had
Your partner's health
Your provider will probably ask you some questions about your lifestyle, including whether you drink or smoke or take any drugs (prescription, over the counter, or illegal). Your health-care provider may ask about a history of domestic violence or multiple partners. She may ask about what kind of exercise you get, and how often you get it, and your weight may be discussed if it is above or below average.
Your health-care provider may offer you some tips on figuring out your most fertile days each month and how often to have intercourse when you are trying to get pregnant. This is your opportunity to ask questions, so don't feel shy or embarrassed. Reproduction is an important part of life, and your health-care provider has lots of information that can be helpful to you.
The preconception checkup includes a urine sample and a recording of your height, weight, and blood pressure. Your health-care provider will do a pelvic exam, including a speculum examination of your cervix and vagina and a manual exam of your uterus, ovaries, and cervix. If you are due for a Pap smear, one will be taken. Your health-care provider may also take a similar smear to test for sexually transmitted diseases. A breast exam is also commonly part of the exam.
If you have not had or become immune to chicken pox and rubella (immunity can be checked with a blood test), you need to get vaccinated before conceiving since both of these diseases can have implications for your unborn child should you contract them. If you are at risk for hepatitis B, you should also be vaccinated for this.