Dr. Padmaja Mohan

Hi,

I am Dr. Padmaja Mohan, Gynaecologist. Planning of pregnancy in the late 20s and early 30s. If we look back about a couple of decades, the average age of getting married was 24-26 years. Now with the women empowerment, most of the females are going out and working. The age of marriage has gone up. These days women are getting married around the age of 28-35. The planning of pregnancy has also delayed. Now with something good or bad, there are certain disadvantages of getting married a little late. Now we would be discussing, what are the disadvantages. And what e can do to rectify these problems and timely plan a pregnancy. A number of eggs in a female body are decided when a female is born. And once you start menstruating, every month you keep on losing one egg. So, by the time you reach at the age of 28-30, your ovarian reserves are decreased. By mean of this, your number of eggs are narrowed down at a very lesser number. So, in case you want to get pregnant at that period of time, you really have to think and plan the pregnancy to have a successful pregnancy. Now, what can be your questions once you get married? When should I plan my pregnancy, how should I proceed forward, what should I do to get pregnant, what will be the ideal time? Because everyone is working these days. There is a lot of stress of job and performance also, social taboo also, in case you are not conceiving. Stress has also so many deteriorating factors on your body. We will be discussing these issues one by one.

Once you are getting married little late and you are planning a pregnancy, there are certain things you need to know as a part of pre-conceptional counseling. You need to know your blood group. What is your RH type? In case, you are RH negative, you must have heard blood group A+, B+, O-, AB-, so, in case your blood group is negative, it is mandatory that you also get your husband's blood group tested. In case, both of you are negative, it is fine, nothing really too worried about. But in case, you are negative and your husband is positive, you might require certain specialized investigation and certain vaccination to prevent RH immunization complications in pregnancy. So, that was about your blood group. Then you need to discuss vaginitis with the Dr. In case, there is a family history running, you need to discuss with the Dr prior to conception. Because there are certain investigations that are done to rule out certain genetic abnormalities which are likely to run in families. A very simple blood test is thalassemia. This screening is widely available and it is a part of antenatal and as well as preconceptions premarital screening as well. You need to discuss your nutritional status, health issues. There are people who are overweight. Overweight and obesity can cause diseases very commonly PCOS. Diet-related issues also have to be discussed. There are certain screening and vaccinations are required. Of course in India, there is no mandatory protocol but in abroad, there are strict norms. In India, we also have started following WHO norms. Certain screenings are very important like rubella, hepatitis, tetanus, seasonal flu vaccines are also available. Now, this was in relation to your medical history.

Certain things which also needs to be discussed are STDs. If you and your partner is suffering any kind of STDs, it should be treated prior to your conception. Next is certain lifestyle issues. If you are on alcohol, addicted to smoking, so no to all these kind of bad addictions. If you are on any kind of medications like epilepsy, there are people who might be taking medications, so they need to discuss this thing with their Dr. As a part of pre-conceptional counseling, we start giving folic acid supplements to the patient. This is given to both husband and wife to have a good quality of eggs and sperm. It gives you a healthy baby and reduces the chances of having a birth defect to a large extent. So, if you are planning, these things have to be taken in the counter. Now, the timing of the cycle. Your mid-cycle is the most fertile part. What if you are having smaller or longer cycles. So, we calculate retrospectively. So, supposing you had your menstruation on 1st-Mar if you have a 30 days cycle you are expecting menstruation on 1-Apr, you can't back 14 days or 2 weeks. That comes to around 16-Mar. This is the presumptive date of ovulation.

Now to conceive successfully, you need to understand the life cycle of sperm and ovum. Ovum is alive for 24 hours. Sperm can go up to 3-4 days. There is a very small window period. You need to be in a relationship every alternate day. If you are planning for a pregnancy, certain things you need to have in the account which was as follows. Now, after the age of 35 years, there are certain risk factors which are more lightly to occur. It could be diabetic, rise in blood pressure. Once you are pregnant, there is a risk of developing gestational diabetes, down syndrome. Even if you are pregnant, you should regularly go to the Dr. In a nutshell, I would like to summarize, plan your pregnancy well, take folic acid supplements, have a healthy weight, discuss your medicines and diet with the Dr. Plan your pregnancy according to your desire, stay happy, keep the stress away. Last but not least, Good Luck to all of you!