2020 Family Planning Checklist: 10 Things to Know

A new year, with new beginnings...and perhaps a bigger family?

Whether you’ve been trying for a baby or are just about to get things going, you can get a head start on your future plans with some simple planning. Taking these steps can help save a lot of time and support in fast-tracking your pregnancy goal.

You already may be doing many of the suggestions on the list, others you may not have considered, and a handful can be completed easily on your next visit with your primary care physician. Be sure to review with your partner as this checklist will require some planning from both of you.

Review updated healthcare info
Along with the New Year comes updates and changes to individual insurance coverage. Up to 20% of patients will have coverage for infertility services designated as ‘diagnostic only’. This means that only testing will be covered, but not treatment. In these patients, it is very important to complete all testing before any treatment is started, such as ovulation induction with clomiphene citrate. After treatment has started, no further testing will be covered. With diagnostic only coverage, the patient is considered self-pay for all infertility treatment.

Assess the reproductive health of both partners

Don’t assume a fertility issue lies with one partner. Fertility diagnoses are split with one-third being attributed to the female partner, one-third being with the male partner, and another third attributed to both partners or unexplained. Completing a Fertility Awareness Checkup for only $90 is an affordable way to assess the reproductive potential of both partners. The checkup includes a blood test for women to evaluate ovarian reserve and function, and a semen analysis for men to assess sperm count, morphology, and motility.

Review existing medication
There are medications that can interfere with conception or pregnancy. We recommend both partners speak with their doctor to learn if any medication impacts (male or female) fertility or is dangerous for a developing baby. Where possible, a safe alternative can be chosen.

Complete genetic carrier screening
There are a number of common genetic diseases people may not realize they carry. The American College of Obstetrics and Gynecology recommends everyone consider screening for Cystic Fibrosis and several other disorders. It is not widely known that one in 50 Americans is a genetic carrier of Spinal Muscular Atrophy. Depending on your family history and background, your doctor may want to screen for other conditions as well. If you are found to be at risk of transmitting a genetic disease, you can learn more about options such as genetic screening of embryos during IVF.

Assess Body Mass Index and create a weight goal
Excess weight can impact fertility in both women and men by causing hormonal imbalance. Being underweight can also interfere with a woman’s monthly cycles. It’s best to assess BMI and set a weight goal to get as close to the normal range as possible.

Test blood type and blood count
Not only is knowing a mother’s blood type is important for pregnancy management, but a normal blood count can also reduce pregnancy complications. We recommend the evaluation and treatment of anemia prior to TTC. A woman with an Rh-negative blood type will need special medication during pregnancy, or if she has a miscarriage, in order to prevent antibodies forming against the baby’s blood cells. To provide a strong building block for new blood produced during pregnancy, it’s best to take a daily prenatal vitamin with iron.

Boost Vitamin D levels
Healthy Vitamin D levels help with embryo implantation and decrease pregnancy complications. With the shorter winter days ahead, most people become deficient and need supplementation due to the lack of sunlight. Patients can take a Vitamin D supplement or add tuna, mushrooms, milk and egg yolks to their diet.

Complete all necessary vaccinations
There are many viruses that can cause devastating birth defects if an infection occurs during pregnancy. While some viral infections cannot be prevented, it’s important to be checked for immunity to Varicella (Chicken Pox) and Rubella (German Measles, part of the MMR vaccine) which can both lead to serious birth defects. About 5% of people will need a booster for these. If it’s flu season, get a flu shot - pregnant women are more susceptible to influenza complications.

Stock up on prenatal vitamins and folic acid
Being on folic acid supplements at the time of conception decreases the risk of neural tube defects (spinal cord abnormalities such as spina bifida). The American College of Obstetricians and Gynecologists recommends a minimum of 400 mcg of folic acid daily for all women who may become pregnant. Almost all prenatal vitamins contain folic acid, and most have more than 400 mcg.

Manage chronic conditions
If you have any chronic medical conditions such as diabetes, high blood pressure, or a history of cancer, it is best to see your doctor to address and manage these conditions prior to pregnancy.

If reading this checklist brings about any questions, we encourage you to reach out to your physician or book a consultation with our team.

We wish you the best of luck in achieving your future family plans!

Author Bio: Dr. John J. Rapisarda, M.D. places emphasis on respectful, compassionate treatment for all his patients. He strives for high success rates through a special interest in the treatment and management of PCOS.