2025\2026 update
What is preconception care? ANS>> provision of biomedical, behavioural and social health
interventions to women and couples before conception occurs. Aim is to improve maternal and child
health in short and long term
What maternal events influence adult onset of diseases ANS>> Maternal nutrition
- Mother: excess weight gain contributes to future obesity, risk of CVD
- Malnourishment: LBW results in poor growth trajectory during childhood --> many influence brain,
composition, size of baby and metabolism
- Dietary factors - affect occurrence of pre-eclampsia
- Fetal over nutrition adverse health outcomes in childhood and adolescence --> intergenerational cycl
of obesity, HT and metabolic syndrome
What adverse birth outcomes can be reduced when optimising health during pregnancy? ANS>> Neur
tube defects
Premature birth
Congenital anomalies
Infant mortality
Health initiatives in preconception period provide immediate and long term benefits of women/men bu
child also
What factors affect conception? And what can be done to assist them? ANS>> Genetic disorder
-preconception screening for genetic disorders can assist in decision making (CF)
- ART can provide counselling and donors
Endocrine disorders
- conditions that affect fertility (diabetes, thyroid)
Obesity and underweight
,Male: erectile dysfunction, low/poor sperm count
Age: both male and female (18-25)
What would be present on a preconception checklist? ANS>> DIET - nutrition requirements eg. folic ac
WEIGHT - BMI
EXERCISE - 150/week or 30 mins/day
PREG HX - screen for modifiable risks
GENETIC SCREENING - indicated from personal/family history, ethnic background
SMOKING/ALCOHOL/ILLICIT DRUGS - asses intake and provide advice
PSYCHOSOCIAL ASPECTS - screen for dv, mental health conditions
MEDICAL CONDITIONS - r/v current disease status and medications, referral if required
ENVIRONMENTAL - asses work, home, recreational environments
BREAST EXAMINATION
DENTAL HEALTH CHECK
SCREENING 4 STI'S AND OTHER - measles, mumps, rubella, HIV, hep b, cervical screening
What are the roles of the midwife? ANS>> Fertility clinics
Postnatal
Continuity of care
What is IVF in terms of criteria and regulations? ANS>> In vitro fertilisation
- implantation rates >50%
- regulated by Reproductive Technology Accreditation Council Code of Practice
- critical criteria (donor, key personnel, multip pregnancy rates, adverse event reporting)
Access to care - fed gov funding, PBS, private health insurance
What is the age factor? - infertility ANS>> Chance of conceiving decreases with age.
@ 30 chance per cycle 20%
@ 40 chance per cycle is 5%
Affects sperm quality
- 5-fold increase in time to fall preg if male over 45
- risk of miscarriage 2x as high if male over 45
What are the major causes of infertility in females? ANS>> - lifestyle (weight, smoking, alcohol, toxins)
- Poor egg quality (age)
- Ovulation problems (timing)
- Polycystic Ovary Syndrome
- Endometriosis
, - presence of sperm antibodies
- sexual dysfunction
- lifestyle (weight, drugs, alcohol, smoking)
--> sperm problems: semen analysis
1. Motility
2. Density
3. Morphology (appearance)
4. DNA damage
--> sperm antibodies:
- sperm coated with antibodies, find it difficult to penetrate the egg
- may be as a result of testicular injury or vasectomy
Treatments for infertility? ANS>> 1. OVULATION INDUCTION
- simple, least invasive, low $$, risk of multip preg
2. INTER-UTERINE INSEMINATION
- monitoring for ovulation
- preparing semen then inseminating
- may use ovulation induction if not ovulating
3. IVF
- ovarian stimulation, monitoring (bloods, scans)
- trigger injections
- oocyte pick up
- semen sample
- fertilisation, embryo growth and transfer
4. GIFT (Gamete Intra Fallopian Transfer)
- egg and sperm tferred to fallopian tube b4 fert
- fertilisation occurs naturally
- may be an option when religious beliefs preclude IVF
- not used as often
5. ICSI (IntraCytoplasmic Sperm Injection)
- used when issues with male fertility
- has been responsible for increased reliability/success rates
- direct injection of sperm into egg
- need whole sperm inc. flagellum
- fertilised egg tferred to uterus