“What [a high-risk pregnancy] may do is suggest the next pregnancy would be high-risk as well,” explains Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine. “For example, the No. 1 risk factor for preterm labor and delivery is indeed previous preterm labor.” Minkin also notes that prior gestational diabetes produces a greater risk of developing repeat gestational diabetes. However, as Minkin points out, this concern can be addressed in advance. “If a woman is overweight and loses the weight, she will reduce her risk.”
Other previous conditions that could serve as warning signs for future pregnancies include a uterine septum (a malformation of the uterine cavity), an incompetent cervix (cervical inefficiency) and fibroids, which can become progressive.
Getting a boost
Once you have ruled out possible medical concerns, experts recommend a number
of ways to actively boost your chances for another positive pregnancy test. For starters, add at least 400 micrograms of folic acid to your diet before conceiving. “It minimizes the chances of neural tube defects,” says Minkin.
Another tip? Maintain your body weight as best you can. “Both too high and too low [weight] can make women not ovulate well,” Minkin says. A sensible, balanced diet is also key to providing your body with essential vitamins and nutrients.
Making important lifestyle changes in fitness and sleep can help improve your chances for conception. “Fertility rates decline at a rate of 2 to 3 percent per month which, over time, becomes a significant barrier to fertility,” explains Chenette. He advises cutting down on your alcohol intake, quitting smoking and getting plenty of rest, along with keeping your BMI under 30. “If you feel you need to lose weight, seek guidance from an experienced nutritional consultant, and balance exercise and calorie intake to keep your body in check,” he adds.
A variety of prescreening options can alert women to possible fertility issues in advance. “Blood tests [can] check for ovarian reserve and function, but [they] have not been proven to reliably predict the possibility of becoming pregnant,” cautions Hechtman.
Alternatively, doctors may recommend a complete fertility assessment, which Chenette believes is “critical to determining treatment routes.” This includes a semen analysis, ultrasound, physical exam and blood test for ovarian reserve, and prepregnancy health screening.
For those looking to take matters into their hands, consider purchasing an at-home ovulation predictor test kit (to determine how well you are ovulating) and/or a fertility kit. “This gives a ballpark idea of how the ovaries are, with active eggs available,” says Minkin. “If that [test] shows that ovarian reserve is somewhat diminished, I would encourage a woman to speak to her gynecologist.” Your doctor can offer tailored advice on how best to proceed.