Essential Pre-Marital Health Checks for Couples Planning Pregnancy

Pre-marital health checkup

Hello, Dr.
Tsai.
I got married this April and plan to conceive after the end of the year.
Since my husband is 41 years old and I am considered a geriatric pregnancy, we did not undergo health checks before marriage.
Although both of our companies conduct annual health examinations for employees, I do not believe that a general health check is sufficient for nurturing a healthy new life.
There are many health check institutions out there, and their fees can be quite high.
I would like to ask you, Dr.
Tsai, if my husband and I have already undergone basic health checks each year, what specific tests should we focus on for fertility purposes?

Rachel, 30~39 year old female. Ask Date: 2007/11/26

Dr. Cai Mengru reply Family Medicine

Dear Ms.
Rachel,
Regarding your inquiry, the standard premarital examinations include:
A: Tests for both parties:
1.
Blood glucose test
2.
Urinalysis (primarily to check for proteinuria, hematuria, and other issues)
3.
Complete blood count (to check for anemia, especially the possibility of thalassemia)
4.
Hepatitis screening (Hepatitis B and C)
5.
HIV antibody test (AIDS)
6.
VDRL (syphilis)
7.
Comprehensive family medical history consultation (to assess for cancer, major illnesses, cardiovascular diseases, mental health disorders, and genetic conditions, etc.)
B: Tests specifically for the female:
1.
Rubella antibody test
2.
Rh blood type (negative or positive)
C: Additional tests based on individual circumstances:
1.
Chest X-ray
2.
Electrocardiogram (ECG)
3.
Lipid profile and cholesterol levels
4.
Uric acid levels
5.
Liver and kidney function tests
6.
Additional tests based on medical history as needed.
Due to the chaotic nature of the health examination market, many clinics often promote unnecessary tests for profit, particularly cancer markers, which can lead to confusing false-positive results, causing significant psychological distress for the individuals tested.
I recommend consulting with a family medicine specialist at a major hospital to determine which tests are necessary, to avoid unnecessary expenses and emotional strain.
Wishing you peace and health.
Sincerely,
Dr.
Tsai Meng-Ju
Attending Physician, Family Medicine Department
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2007/11/26

More Info

When planning for pregnancy, especially for couples where one or both partners are of advanced maternal age (defined as 35 years or older), it is crucial to undergo specific pre-marital health checks to ensure the best possible outcomes for both the mother and the baby. Given your situation, where both you and your husband are approaching or have reached this age threshold, a targeted approach to health screenings is advisable.

Essential Pre-Marital Health Checks
1. Genetic Carrier Screening: This is particularly important for couples planning to conceive. It involves testing for genetic disorders that could be passed on to the child. Common tests include screening for cystic fibrosis, spinal muscular atrophy, and Tay-Sachs disease, among others. This is especially relevant if there is a family history of genetic disorders.

2. Blood Tests: Comprehensive blood tests should include:
- Complete Blood Count (CBC): To check for anemia and overall health.

- Blood Type and Rh Factor: Important for understanding potential complications during pregnancy.

- Infectious Disease Screening: Tests for syphilis, HIV, hepatitis B and C, and rubella immunity. For rubella, if you are not immune, vaccination is recommended before pregnancy.

3. Hormonal Assessments: For women, checking hormone levels can provide insights into ovarian function and fertility. Tests may include measuring levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol.

4. Thyroid Function Tests: Thyroid disorders can affect fertility and pregnancy outcomes. A simple blood test can assess thyroid-stimulating hormone (TSH) levels.

5. Ovarian Reserve Testing: This may include an ultrasound to assess the antral follicle count and blood tests for anti-Müllerian hormone (AMH) levels, which can indicate the health of the ovaries.

6. Pelvic Exam and Pap Smear: A routine gynecological exam is essential to check for any abnormalities in the reproductive system and to ensure that cervical health is maintained.

7. Lifestyle Assessments: Discussing lifestyle factors such as diet, exercise, alcohol consumption, and smoking is crucial. Both partners should aim for a healthy lifestyle to optimize fertility.

8. Counseling on Prenatal Vitamins: It is recommended that women start taking prenatal vitamins with folic acid at least three months before conception to reduce the risk of neural tube defects.

Costs and Accessibility
The costs for these tests can vary significantly depending on the healthcare provider and location. It is advisable to consult with your healthcare provider about which tests are essential based on your health history and family background. Many insurance plans cover some of these tests, so checking with your insurance provider can help manage costs.

Conclusion
While general health checks are beneficial, targeted pre-marital health screenings are essential for couples planning to conceive, especially those in the higher age brackets. These screenings can help identify potential risks and allow for early interventions, ultimately leading to healthier pregnancies and babies. It is advisable to schedule an appointment with a healthcare provider specializing in reproductive health to discuss your specific needs and concerns, ensuring that you are well-prepared for the journey ahead.

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