Pre-conception appointment overview

prelude4ws

New member
Hey WTT! I know there’s been some discussion on what happens at a pre-conception appointment, so I wanted to give an update to mine this morning! My timeline: I’ll finish up my last week of active pills of orthotricyclen HBC this week, and will use barrier methods and track my cycles until we’re ready to try. We’ll officially start trying my first fertile window after late September. I already had a normal pap last September, so I didn’t need to get a full exam and the NP and I were able to just chat about all the questions I had.
  1. When should I start prenatal vitamins? - Now. When you're off BC and planning to TTC soon, you should be taking them just in case.
  2. How long to expect my period to return to normal? Can I take ibuprofen during my period? - Taking ibuprofen during your period is fine. They worry about ibuprofen increasing bleeding while you’re pregnant, and if AF is here, then you’re obviously not. Won’t stay in your system long enough to hurt anything. Best to avoid it during luteal phase on TTC cycles. Regarding regularity, period may take a couple months but you should have ovulatory cycles right away. Everyone is different. Temping will help you understand what your body is doing.
  3. Any other appointments I should make prior to getting pregnant? - Go to the dentist!
  4. Do I need any blood work done (iron, vitamin D, virus immunity)? - Getting rubella titer today (rubella vaccine is live, so if immunity is low, then a vaccine can be given but you’d have to push back TTC timeline 3 months...now’s a good time since we have 4.5 months until we’re TTCing! They said they usually don’t see immunity dropping off until after 35 though but shrug), other bloodwork will be done early pregnancy unless you have risk factors. Need to call insurance to see if they cover blood tests for the following blood screens: cystic fibrosis carrier, hemoglobinopathy (thalassemia), spinal muscular atrophy carrier (all of these are decently standard for people of European descent)
  5. Any additional vaccinations necessary? - Nope, unless rubella titer is low! TDAP given during pregnancy to immunize baby
  6. My BP is always slightly higher than normal but not in hypertension range (130/85)... what’s my risk for preeclampsia? -Will be monitored closely throughout pregnancy. No known risks with borderline hypertension, but healthy lifestyle so nothing too much to worry about for now, and keep doing what you’re doing. They will take urine tests in early pregnancy to get a baseline of protein in urine so they can compare it throughout the pregnancy.
  7. History of HPV/CIN - 3 colposcopies with a total of 8 biopsies; now clear, but how will this affect chances of getting/staying pregnant/overall pregnancy? - Great news that it's clear! Could have 100 biopsies and wouldn't have an effect. We're good to go.
  8. Are my current medications safe? - Yes!
  9. Worried about low CM (although could be due to HBC currently) - if it is low, thoughts on FertileCM, Preseed, Mucinex? - No real evidence either way, but it definitely won't hurt. That being said, body will likely return to normal within a few months.
  10. Fitness routines while pregnant? (Is lifting okay?) - Absolutely. Whatever you're doing now you can continue to do as long as you're comfortable.
  11. With charting and well-timed intercourse, how long should we try before calling if we’re not pregnant? What would be the protocol from there? Should DH get an SA before we start, or should we just do that if we aren’t successful after 4-6 cycles? - Most fertility doctors want you to wait 12 months, but if you’ve been timing and charting correctly, most couples should be pregnant within 6 months. If you’re still having trouble by then, give us a call. Regarding SA, most insurances won't pay for it unless you've had demonstrated infertility for at least 6 months, so no point in doing it now.
  12. When should I contact once I’ve had a positive HPT? - Call right away. First appt will be at 8 weeks for ultrasound but if you have any concerns call earlier.
  13. I asked for recommendations of OB/GYNS in the practice - the NP recommended a doctor that had delivered her baby 4 months ago.
  14. Is this something I need to choose now? - Nope! They'll assign an OBGYN (or you can request one) after your 9 week appointment. Also, it's easy to change hospitals/birthing centers/etc. mid-pregnancy, although it's not recommended to walk into a hospital you've never been in before while you're in labor. People move around all the time, and overall you get to dictate what you want out of your pregnancy and your delivery.
  15. When are the key early pregnancy checkups/ultrasounds? - 8-28 weeks every 4 weeks, 28-36 weeks every 2 weeks, 36- on every week; ultrasounds at 8 to confirm pregnancy, 12 for NT, 18 weeks for anatomy. The 8 week checkup will be with the NP!
EDIT: formatting and added a question I forgot to include :)
 
@katrina2017 She said that there's been a lot of evidence about maintaining oral health being good for pregnancy. During pregnancy, the fetus leeches a lot of Calcium and apparently that can be pretty hard on your teeth. Also, going and getting X-rays done before pregnancy helps reduce the risk of the fetus getting exposed to the rays, so having the dentist appointment before TTC can be beneficial.
 
@prelude4ws Thanks! That's funny, my coworker was just telling me today that her friend got 8 cavities while she was pregnant. O_O I wondered if it was due to loss of calcium!
 
@katrina2017 I needed a pile of dental work after my son was born. The NHS makes all dental treatment free during pregnancy and for 1 year after the due date because this is a really common thing.
 
@prelude4ws Thanks for posting this!!
Especially the bit about the biopsies! I had an abnormal pap this past year and am dreading my next one. We opted for a wait and see approach because the dysplasia was so mild and there was no HPV. I am terrified that another abnormal pap this year and I am in for months of colposcopies and biopsies and LEEPs. Funny how your brain changes when you are thinking about TTC. I don't care that my risks for cancer are now higher... only care that it might damage my TTC timeline.
Priorities, woman!
 
@prelude4ws Called my doctor's office - they said there was no need to check anything before ttc. How important is it? We're starting in August, and I have had some vitamin deficiencies in the past.
 
@pitcreature It seems some docs do them if asked and some docs won't, but it's definitely not required. I just had a lot of questions and the NP was happy to meet with me to talk about it :)
 
@cdw I only really take it during my period. In that study they started taking it in day 10, so taking it for the first couple days of your period should be fine! It doesn't hang around for very long. But good to know for muscle soreness and stuff!
 
@prelude4ws You're absolutely right! I wouldn't worry about taking it during your period. I don't think that could do enough damage for ovulation. I was posting it just in case, more for non-period related things. :)
 
Back
Top