PREGNANCY
Women’s Health; Fertility and Pregnancy
Community pharmacy involves dealing with topic areas such as fertility and pregnancy on a regular basis. Becom- ing pregnant is a challenge for many couples and they should have access to sound pharmaceutical and lifestyle advice where appropriate
of substandard foetal nourishment alongside unideal foetal exposure to medicines, chemicals and foods in the fi rst stages of development. Queries on topics such as fertility and pregnancy require sensitivity and delicacy on address1
A .
. There are many different causes, but female infertility is most commonly due to anovulation. The World Health Organisation has classed anovulation into three categories. WHO Group I anovulation is characterised by hypothalamic-pituitary failure and NICE recommends that increasing BMI in
INFERTILITY Conception and pregnancy depend on a complex combination of anatomical, physiological and immunological factors1
38 - SCOTTISH PHARMACIST
s many as 50% of pregnancies are unplanned, which is potentially disadvantageous in terms
women who have a BMI of 19 or less, or moderating exercise in those who are very active, can increase chances of conception and uncomplicated pregnancy1
. Treatment includes
gonadotrophin releasing hormones or gonadotrophins with luteinising hormone activity, which stimulate ovulation. WHO Group 2 anovulation is mostly made up of Polycystic Ovary Syndrome (PCOS). Patients with PCOS who have a BMI of 30 or more should be advised to lose weight- this alone may help to trigger ovulation, improve response to ovulation-inducing agents and have an overall positive impact on pregnancy outcome. Treatments can include clomifene, metformin, or a combination of the two. WHO Group 3 anovulation is usually as a result of genetic or iatrogenic disorders. Patients with Group 3 anovulation may be offered IVF but are unlikely to conceive without a donor egg.
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