You might think you only need to see a doctor if you struggle to get pregnant, but there are a range of tests worth considering before you even start trying. (Unsplash: Daniel Thomas / ABC Everyday: Luke Tribe)
When my husband and I decided to have a baby, we thought all it involved was having lots of sex.
I realise now after talking to two doctors, we probably should have gone about it differently.
If you're thinking about having a baby, you should "absolutely see a GP'" advises Ramya Raman, GP and Deputy Chair of the Royal Australian College of General Practitioners, Western Australia.
Government guidelines recommend seeing a GP three to six months before you become pregnant to discuss your health, any genetic conditions you may have, and any vaccines you may need.
Gino Pecoraro, President of the National Association of Specialist Obstetricians and Gynaecologists, agrees. "It's ideal," he says, "to plan a pre-pregnancy appointment with an obstetrician or GP who has an interest in women's health."
Optimal physical health for pregnancy
Dr Raman says being as healthy as you can is important for both partners when trying to get pregnant as this can impact your fertility. This includes eating a healthy diet, exercising and understanding the risks of alcohol, smoking and drugs.
"A healthy diet provides adequate amount of nutrition for the baby and mother, reducing the risk of diabetes and gestational diabetes"
Dr Raman encourages the partner who is trying to become pregnant to take a folic acid supplement to reduce the risk of spina bifida, a birth defect that effects the spine.
Dr Pecoraro also advises to be up-to-date with your Pap smears. This means you can detect any abnormalities and discuss treatment options with your doctor before becoming pregnant.
General tests for the partner planning to be pregnant
Dr Raman says doctors will tailor their advice for the patient, but there are some tests that are recommended for all women. She says risk factors will be different for each individual.
"The main tests we would test for are iron levels, vitamin D, B12, infection screening for STIs (HPV, Hepatitis B, syphilis), a urine or swab test for chlamydia or gonorrhoea," she says.
"We would also check the immunity status for varicella (chicken pox) and rubella. We would also do a blood sugar fasting test."
"There are women who are at higher risk of vitamin D deficiency, such as those that are covered by clothing or have darker skin pigmentation."
And she says she would be "particularly interested in checking B12 in a woman who is vegan or vegetarian".
Dr Pecoraro says women should consider seeing an obstetrician for more complex issues. He advises women to discuss any existing medical conditions with their doctor and "make sure that's under control".
He also suggests some additional tests you may like to consider.
"I check my patients' thyroid levels," he says.
"And if they have cats, the doctor may want to check whether the woman is immune or has been exposed to toxoplasma," Dr Pecoraro says.
"Cats are the natural host for taxoplasmosis and infect humans via their faeces.
"If you get toxoplasma for the first time while pregnant, it can cause congenital malformations in the baby."
New South Wales Health also recommends getting a dental check-up, as pregnancy hormones and morning sickness can increase the risk of having dental problems.
Should you consider genetic tests?
Dr Pecoraro says some gene tests are recommended, but they can be expensive as there is no rebate for them.
A gene test can check for a range of hereditary conditions including cystic fibrosis, Fragile X syndrome, and spinal muscular atrophy.
He says there are gene panels that can test up to 500 conditions, and can be considered if you have a family history of a particular condition.
"Patients can choose whether to get them," Dr Pecoraro says.
"For the baby to have a chance of getting the disease, both parents have to be carriers, that's why, if the mum isn't a carrier, it doesn't matter so much whether the father is a carrier and we don't test all couples.
"If men have inheritable or genetic conditions in their families, some of them might want to see if they are a carrier for it.
"If you carry the genes, we can send you to a genetic counsellor. You may be advised to have other tests and discuss your situation with your doctor."
Are there any tests men should get?
Dr Raman says there are no particular pre-pregnancy tests recommended for men, but they should make sure they have a healthy diet, participate in regular exercise, control their alcohol intake and avoid illicit drugs.
"Too much alcohol can reduce a man's fertility," she says.
Dr Pecoraro agrees. "Generally speaking, we tell the men not to smoke or consume excessive alcohol. Steroids also effect sperm."
"It's to your advantage to be in peak physical health. Sperm takes 72 days to make, so think about the sperm you created 72 days ago."
Dr Pecoraro also suggests men take an STD test. It may be the first time a couple has practised sex without a condom and, if he is asymptomatic and infected, he could transmit an infection.
Also consider your mental health
Becoming pregnant, and for some women and men, trying to become pregnant, can bring on a range of emotions.
Dr Nicole Highet, Founder and Executive Director of Centre of Perinatal Excellence (COPE), says, "there are ways to prepare physically, mentally and emotionally".
"It's also a good opportunity to evaluate whether you may be at greater risk of mental health problems at this life stage and discussing this with your health professional."
If you have been trying for a while
It is important to see a doctor for further testing if you are having problems becoming pregnant.
"The rule of thumb is, for women under the age of 30, try for 12 months. If you are over the age of 30, I think it would be prudent to see a GP after six months," Dr Raman says.
Dr Raman says investigations for women would include further blood tests and scans, such as an ultrasound of the ovaries and uterus.
Investigations for men would include a semen analysis and blood tests.
Dr Pecoraro advises couples see their doctor for a full examination. He says the doctor may discuss menstruation regularity and whether the couple is having sex when the woman is ovulating.
Further medical testing would look for signs of endometriosis, hormones, and ovulation.
"We would run a semen test for him to make sure he has normal sperm and can ejaculate into the right place," Dr Pecoraro says.
Dr Pecoraro adds some couples may need to consider assisted reproductive technology to help them have a baby.
This is general information only. For detailed personal advice, you should see a qualified medical practitioner who knows your medical history.
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Kate Dorrell is a Sydney-based freelance writer and health communications consultant. Connect with her on Twitter @katedorrell