3. Determine fitness for pregnancy and identify co-morbidity. Determining a woman’s health and fitness for pregnancy before attempting pregnancy is important for the reduction of maternal and perinatal morbidity and mortality. Ideally it should be done in all women who are at risk of pregnancy. Women who have co-morbidities which make pregnancy unsafe should have their health optimized before further infertility management is undertaken.
Women should have a general examination to exclude any acute or chronic illness, which affects their current health or puts them and their baby at risk in pregnancy. Screening tests such as screening for HIV infection, syphilis or cervical cancer should be conducted in keeping with local guidelines. Assessment for cardiovascular, hypertension and respiratory disease as well as obesity and diabetes mellitus should be performed. (ASRM, 2014; ASRM, 2008e)