Are you Looking to Become Pregnant, Ever?

Seedling in soil

If you are considering conceiving, either within three months or three years, making a preconception plan can help maximize your fertility and achieve a healthy pregnancy. Of women aged 25-44, 12%-13% have impaired fertility. Discussing your fertility goals and plans for conception with your naturopathic primary care physician can help put a plan in place now to support a healthy pregnancy and delivery in the future. A preconception care plan should include a lifestyle and nutritional status assessment, screening for chronic disease and infectious disease, family history review, and environmental toxin exposure.

Lifestyle and Nutritional Status Assessment

Leading a healthy lifestyle can foster optimal fertility. Discussing with your physician your smoking history, alcohol intake, sleep quality, stress, and exercise may just be the beginning. A detailed plan should be provided that outlines folic acid intake, healthy macronutrient recommendations, and identifying any micronutrient deficiencies. According to an article in the Lancet, dietary patterns up to three years before pregnancy, characterized by high intake of fruit, vegetables, legumes, nuts, and fish and low intake of red and processed meat, are associated with reduced risk of gestational diabetes, hypertensive disorders of pregnancy, and preterm birth.

Screening for Chronic and Infectious Disease

Identifying risks and providing early prevention to chronic diseases such as diabetes, thyroid disease, and hypertension will help achieve a healthier pregnancy and better health overall. Your health care provider may also conduct screening for sexually transmitted infections at a preconception visit. These infections would increase risks for poor fertility, miscarriage, or disease transmission from mother to baby.

Screening for Familial Diseases and Carrier Risk

As the popularity of home DNA testing increases, providers are becoming savvy with assisting patients with interpreting their results. More and more tools are becoming available to individuals and couples to help assess their risk for familial disease. Tools like 23andme, AncestryDNA, FamilyTreeDNA, or the My Family Health Portrait tool, created as an initiative in 2004, helps to increase awareness of familial linked diseases. My Family Health Portrait helps create a database of your family health history that can be updated and given to your provider. Discussing options for genetic carrier screening for women and couples should occur during a preconception visit if risk factors are present. 

Assessing Environmental Toxin Exposure

An article posted by the American College of Obstetrics and Gynecologists demonstrates that there is a vast amount of evidence showing reproductive and pregnancy risks linked with environmental pollutants, workplace chemicals, and endocrine disruptors. Exposure to pesticides, plastics like bisphenol-A, solvents from dry cleaning, lead paint, and asbestos can impact fertility and pregnancy. Reducing your exposure and finding ways to assist the body in eliminating these toxicants will be a priority in your plan.

A woman’s health at the time of conception significantly increases her pregnancy success for a healthy pregnancy and child. It is important to discuss your fertility goals with your primary care physician now to create a plan for your health and your babies, even if your conception is in the distant future.  For November, Be Well Medical Primary Care is encouraging women to be seen for a preconception visit by offering a discounted appointment package. Call our office at (480) 219-9900 to inquire about this package and schedule your first visit. 


  1. Chandra, A., Copen, C.E., & Stephen, E.H. (2013). Infertility and Impaired Fecundity in the United States, 1982-2010: Data From the National Survey of Family Growth. National Health Statistics Reports, 67, 1-19. Retrieved February 7, 2018, from
  2. Stephenson J, Heslehurst N, Hall J, et al. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health [published correction appears in Lancet. 2018 May 5;391(10132):1774]. Lancet. 2018;391(10132):1830-1841. doi:10.1016/S0140-6736(18)30311-8
  3. Pregnancy counseling, ACOG Committee Opinion No 762. American College of Obstetrics and Gynecologists. Obstet Gynecol 2019; 133:e78-89.
Nichole Shiffler, NMD Dr. Nichole Shiffler is a naturopathic primary care physician and medical director of Be Well Medical Primary Care. Dr. Shiffler focuses her practice on women's and pediatric medicine. Dr. Shiffler also has an extensive history of treating irregular menstrual cycles, thyroid disease, menopause, acne, PCOS, and diabetes. She utilizes nutrition and herbal medicine to deliver an effective treatment plan to her patients. Dr. Shiffler is available for patient care at Be Well Medical Primary Care. Call (480) 219-9900 to schedule an appointment with Dr. Shiffler.

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