Amos Grünebaum, MD FACOG
Obstetrician & Gynecologist and Maternal-Fetal Medicine Specialist

The Dr.Grünebaum Top Ten PeriConception Checklist
for Couples Planning a New Baby

If you are planning to have a baby, and before you undergo IVF (In-Vitro Fertilization) getting ready begins even before you become pregnant. By following the suggestions on this checklist before you conceive, you can help to ensure a healthy pregnancy and a healthy, happy baby. 
Start PeriConception care at least 2-3 months before getting pregnant

A visit with your doctor
Before you are starting trying to conceive (TTC), visit your obstetrician or health care provider at least once. Discuss your medical history, ask questions, and find out if any tests are recommended. This pre-conception visit is especially important if you have had problems with a previous pregnancy. You also should find out if you could have problems with fertility. Do you have regular menstrual periods and are you ovulating regularly? Does he have enough sperms? Many couples who have been unsuccessfully trying to get pregnant for some time were very frustrated when they eventually found out  that the cause of their problem was his low sperm count.

Vitamins, Folic Acid, Omega-3
Studies have shown that birth defects of the spine and brain, such as spina bifida and anencephaly as well as cardiac malformations and Down syndrome, can occur if the mother does not get sufficient folic acid immediately before and during the first few weeks after conception.  Make sure to get enough of the B vitamin folic acid on a daily basis and start taking a daily prenatal vitamin supplement with folic acid at least 1-2 months before you start TTC.

Birth control
You need to stop using birth control before you are starting to TTC. If you have been using birth control pills, it's safe to get pregnant as soon as you stop taking them. Birth control pills will not cause birth defects, however, no matter how close to conception you stop using them. If you have been using an IUD, have it removed before trying to conceive. If pregnancy occurs with an IUD in place, it can be harmful.

Stop doing bad things-Watch your food
Stop smoking, drinking alcohol, or taking street drugs. There is scientific evidence that all of these substances can cause problems with fertility, the pregnancy and even birth defects, whether they are used by the mother or the father. If you are taking herbal or other supplements, and prescription or over-the-counter drugs, be sure to tell your doctor. Avoid toxic substances, chemicals, and radiation at home or at work. Exposure to these by either partner can make it more difficult to become pregnant and can harm the fetus.

Any genetic issues?
Ask your family (e.g. parents, siblings) if there is a family history of problem pregnancies or birth defects. If you have reason to be concerned about a genetic disorder or inherited disease, or if you belong to a high-risk ethnic group, you may want to consult a genetic counselor.

Your best weight
Try to achieve your normal weight before attempting to conceive. It's important not to be underweight or overweight during pregnancy. Underweight women tend to have smaller babies-- who have more problems during labor and after delivery. Overweight women are more likely to develop high blood pressure or diabetes during pregnancy. Don't diet during pregnancy, however, or while you are trying to become pregnant.

Medical conditions and medications
If you have a medical condition such as diabetes, make sure it is being treated. Although women with insulin-dependent diabetes have a higher risk of miscarriage and of having a baby with a birth defect, if the blood sugar is controlled before and during pregnancy, chances for delivering a healthy baby are excellent.

Vaccinations etc
If you have never had rubella or chickenpox and you were never vaccinated, it may be advisable to be vaccinated prior to becoming pregnant. If you do get vaccinated, you should delay trying to get pregnant for three months. You should not get vaccinated during pregnancy. If contracted during pregnancy, rubella can cause birth defects.

Cat litter
Avoid eating undercooked meat or handling cat litter. These are known sources of toxoplasmosis, a parasitic infection that can seriously affect the fetus.

Infections
If you are exposed to little children during pregnancy discuss with your doctor whether you should get tested to see if you are immune to the parvovirus (Fifth disease) and CMV (cytomegalovirus) 

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Source: Patient education material from the American College of Obstetrics and Gynecology was used as a source of information to develop the content for this topic.