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Preconceptual care


There is now a good deal of evidence that suggests that smoking is harmful both to male and female fertility. Put into real terms, if a woman smokes 20 cigarettes per day she reduces her natural fertility by over 20%.

Smoking is also harmful to the developing fetus both in the short term during the course of the pregnancy, and recent evidence would suggest in the long-term as well with an increased risk of heart attacks and strokes in mid-life.

Finally there is good evidence that a smoker in the family increases the risk of a cot-death. Therefore it is advisable to stop smoking prior to trying for a family.


Alcohol in excess can again cause problems with both male and female fertility. A modest alcohol intake is reasonable (less than 6 units per week for women and 12 units per week for men).

Again, high alcohol intake in pregnancy can result in fetal abnormality.

Prevention of spina bifida and other neural tube defects

There is evidence that a small dose of folic acid (400mcg) is helpful in lowering the incidence of fetal abnormalities such as spina bifida.

All women planning a pregnancy should consider taking this small daily dose of folic acid before commencing treatment.

Please note that any women on anti-epilepsy drugs should take an increased dose of 5mgms available on prescription.

Rubella (German Measles)

It is worth checking to make sure that you are immune to German Measles. Although most women were vaccinated whilst at school, the vaccine occasionally is not effective.

If you are not immune to Rubella and you contract the disease in pregnancy, it can have a disastrous effect on the fetus. A simple blood test will confirm your rubella status. This can be organised either through the hospital clinic or your GP.

Cervical smears

Regular cervical smears lower the incidence of cervical cancer. On the Isle of Man women routinely have smears performed every 3 years.

If you are close to requiring a repeat smear it is advisable to have this performed before you start on treatment.


Obesity is a major factor in fertility problems. Not only does it upset the normal mechanism of egg production, it also reduces response to treatment making fertility drugs less effective.

In addition, obesity in pregnancy is a major concern as it increases the mother’s risk of developing diabetes, having a thrombosis, having a difficult delivery or needing a Caesarean Section.

Diet and exercise are the only treatment options that are effective and require motivation and self-discipline.

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