Before Is Better: Innovative Multidisciplinary Preconception Care in Different Clinical Contexts

Abstract

Context: Implementation of pre-conception care units is still very limited in Italy. Nowadays, the population’s awareness of the reproductive risks that can be reduced or prevented is very low. Purpose and main findings: We presented a new personalized multidisciplinary model of preconception care aimed at identifying and possibly reducing adverse reproductive events. We analyzed three cohorts of population: couples from the general population, infertile or subfertile couples, and couples with a previous history of adverse reproductive events. The proposal involves a deep investigation regarding family history, the personal histories of both partners, and reproductive history. Principal conclusions: Preconception care is still neglected in Italy and under-evaluated by clinicians involved in natural or in vitro reproduction. Adequate preconception counseling will improve maternal and fetal obstetrical outcomes.

Dietary Patterns and Fertility

“…(1) role in endometrial function (2) anti-inflammatory function (3) increased sperm motility, concentration, and volume (4)…”

“…(1) altered sperm motility and capacitation (2) reduced energy metabolism of spermatozoa (3) ovulation disorders SFA e TFA:…”

“…(1) a high glycemic index is associated with insulin resistance and hyperinsulinemia (2) hyperinsulinemia leads to a reduction of sperm motility and metabolism (3) hyperinsulinemia leads to hyperandrogenism and ovulatory disorders…”

“…(1) white rice has high glycemic index (2) higher risk of hyperinsulinemia and hyperglycemia (3) increased risk of T2DM…”

“…Lifestyle seems to have a major impact on reproductive health, in terms of body weight, body composition, physical activity, and nutrient intake [2,3]. Specifically, both quantitative and qualitative dietary characteristics affect fertility.…”