1. Is it necessary to take folic acid supplements 2-3 months before planning a pregnancy? Expectant mothers often ask this question. The human body does not synthesize folic acid, and it is correct to start taking folic acid before pregnancy mainly to prevent neural tube defects in the fetus. However, if you do have an unplanned pregnancy or do not take extra folic acid supplements during pregnancy, it does not necessarily mean that there is something wrong with the fetus. Folic acid is one of the b vitamins, which is a water-soluble vitamin. It is found in animal liver and green leafy vegetables, and is mostly consumed in our daily meals, so most people are not deficient in folic acid; on the other hand, excessive folic acid intake will only be excreted through the urine, so excessive folic acid will not cause toxicity. So we recommend 2 months before pregnancy can be supplemented daily 0.4-0.8mg of folic acid, but even if not supplemented, the mother-to-be do not have to be overly alarmed, or even because of the lack of supplemental folic acid required abortion. In addition, folic acid is also involved in blood production, so anemia during pregnancy is not necessarily caused by a lack of iron, folic acid, vitamin B12, these are important raw materials, in the case of stubborn anemia should also review whether there are other problems. 2, whether the pre-pregnancy need to check the husband’s semen, his wife’s tubal fluids and ovulation test? These are not required routinely, and we recommend that patients with infertility should have the above tests. There are also couples who request semen tests because of recurrent miscarriages. There is no evidence that semen tests help reduce the rate of miscarriages or can be improved by taking medication. Fluids or imaging or even laparoscopy are invasive tests and are not routinely performed. Ovulation monitoring itself is not invasive and can be helpful in guiding couples to have intercourse to increase conception rates, while basal body temperature is simple but not always easy to perform, and can be difficult to do on a daily basis. Newlyweds can consider ovulation test paper to monitor ovulation if needed, and there will be ovulation in about 12 hours after a positive test, thus guiding coitus. Meanwhile, for mothers-to-be who may have ovulation disorders such as irregular menstruation, ovulation testing or blood progesterone testing in the second half of menstruation can also be considered at the initial consultation. Infertile patients even if ovulation test paper or basal body temperature suggests “ovulation”, it is still recommended to carry out at least one cycle of ultrasound to monitor ovulation, in order to rule out the possibility of unruptured follicle luteinization. 3.Do I need routine screening for TORCH (Toxoplasma gondii, Rubella virus, Cytomegalovirus, Herpes simplex virus) during or before pregnancy? This should be the most asked question, but we do not recommend routine screening for TORCH, only for those who are at high risk, preferably pre-pregnancy, followed by early pregnancy. All parents don’t want their babies to have malformations, so this test is fairly common both preconception and during pregnancy, not to say that it’s not possible, but it doesn’t mean as much as one might think. First of all, screening during pregnancy, the serological examination of pregnant women has certain false positives, and a positive test cannot determine the time of infection of the pregnant woman, nor can it know whether the fetus is infected or not, and fetal infection does not necessarily have abnormalities, and abnormalities are not necessarily caused by this viral infection, and even if the pregnant woman is positive, it cannot be used as a sign of termination of pregnancy, and there is also a lack of effective interventions for the infection, on the contrary, it is emphasized that the positive results of TORCH will increase the anxiety of prospective parents. On the contrary, if we emphasize TORCH, the positive result will increase the anxiety of parents-to-be, so it is not impossible to check, but there should be such communication between doctors and patients before checking, and parents-to-be should have such awareness. Pre-pregnancy screening TORCH is recommended for high-risk groups, again, not to say that you can not check, one is treated separately, and the second is that the pre-pregnancy does not mean that the immune status of the pregnancy, is it necessary to each or every few menstrual cycles did not conceive on the check again, which is also unreasonable. Toxoplasma gondii high-risk group is mainly feline contact or raw meat, taking into account the increase in gestational weeks of maternal-fetal transmission rate increases but fetal damage decreases, based on this characteristic, low-risk group of fetal abnormalities is not high, so may not do routine screening, if positive before pregnancy can be considered sulfadiazine treatment. In addition, cats are the final host of Toxoplasma gondii, contact with cat feces may be infected with Toxoplasma gondii, but for others such as dogs, pigs, cows, these are intermediate hosts, there is meat but not feces, unless the dog licked and ate the cat’s feces and then kissed the human being, or eat raw meat or kitchen utensils raw and cooked are not separated to have a greater chance of infection, so it is not a pregnancy can not have pets again. Cytomegalovirus is a lifelong infection, and pre-pregnancy infection can delay pregnancy, with no specific treatment options. Rubella virus positive no specific treatment, can delay pregnancy, negative can consider line or not vaccination, but rubella vaccine is attenuated vaccine, short-term contraception is needed after vaccination. Herpes simplex virus is a lifelong carrier once infected, coupled with the low probability of intrauterine transmission, screening is of little significance. 4. Can I get pregnant with hepatitis B? I can’t help but say that we have always been prejudiced against Hepatitis B, even a few years ago I myself was the same. For hepatitis B carriers with normal liver function, pregnancy can be normal, but during pregnancy, we should pay attention to liver function and bile acids, and if necessary, we can consider antiviral treatment with tibivudine or tenofovir (not available in China, need to be purchased in Hong Kong) for pregnancy B. However, there is no end point for antiviral treatment, and once the medication is administered it is currently believed that it is necessary to take the medication for the rest of one’s life. It is controversial whether asymptomatic carriers should be antiviral or not, and there is no conclusive evidence that antiviral is more beneficial. Hepatitis B immunoglobulin treatment during pregnancy does not reduce the rate of mother-to-child transmission, nor does cesarean section reduce the rate of mother-to-child transmission. Newborns should be given active immunization (hepatitis B immunoglobulin injection) and passive immunization (vaccine) after birth. Because the current evidence does not support breastfeeding as increasing the rate of infection in newborns, I do not advocate checking breast milk DNA or denying the right to breastfeed. 5. What tests should be performed before pregnancy? In the absence of underlying disease, there are no tests that must be performed before pregnancy. However, I still recommend the following tests: (1) blood test (to know whether there is anemia or iron deficiency and other blood diseases, if both parties may have anemia, genetic testing is recommended, and if the fetus may have severe anemia, the patient should be informed of the risk of the occurrence of the PGD if possible); (2) liver and kidney function; (3) urine routine; (4) fasting blood glucose (menstrual abnormality or obesity can be done with insulin) (5) thyroid function; (6) cervical cancer screening; (7) gynecological ultrasound. In fact, it is a routine physical examination of the project, so the physical examination is very important, do not think of getting pregnant to give birth to a healthy baby to do the routine examination, once a year the physical examination is more important.