Hello, dear readers of our blog! Married couples who take a responsible approach to planning their family begin to be examined before conception, that is, they plan a pregnancy. At the same time, doctors always send for many tests and checks, one of them is mandatory fluorography of the lungs in order to identify possible pathologies in advance, but many are afraid to do this. Is it possible to do fluorography when planning a pregnancy and when is the topic of our conversation today.
When planning a pregnancy
Everyone knows how important it is to detect serious diseases in a timely manner. Medical examinations, which include fluorography, help with this. After all, it is much easier to cure a disease at an initial rather than an advanced stage.
Fluorography is a medical study that is aimed at assessing the condition and early diagnosis of many serious pathologies of internal organs. Thanks to this, it is possible to identify diseases of the lungs and cardiovascular system, bone apparatus, oncological tumors, and tuberculosis.
It is definitely recommended to undergo fluorography when planning a pregnancy, as this helps the expectant mother avoid many health problems. Moreover, fluorography before conception is mandatory not only for women, but also for men.
Is fluorography and pregnancy planning compatible? The main concerns of women are that the radiation used in the research causes serious harm to women's health and can have a detrimental effect on planned conception.
To date, there is no evidence in medical practice of the negative impact of the procedure. Many experts are absolutely sure that during the examination a person receives minimal doses of radiation, which are practically harmless. And there is scientific confirmation of this.
- During one film fluorography procedure using an old-type device, the patient receives radiation exposure in the amount of 700-800 microsieverts. This is the maximum figure, which may be less if modern equipment is used. With a digital fluorograph, the dose is an order of magnitude lower – about 60 microsieverts.
- The permissible annual rate of radiation exposure for humans is 3000-5000 microsieverts.
Accordingly, conducting one preventive study throughout the year will not cause harm to health. Fluorography before pregnancy is recommended by all gynecologists, as it allows you to detect the initial stages of diseases in time and avoid possible pathologies of the fetus.
Is it possible to do fluorography before conception?
First of all, I would like to remind you that in our country all persons over 15 years of age must undergo a fluorographic examination at least once a year. Certain categories of citizens at risk - 2 times a year. Such rules were created in connection with the high increase in the incidence of tuberculosis.
When you come to an obstetrician-gynecologist with the goal of giving birth to a healthy child, he naturally requires the parents to undergo a full examination, which includes an X-ray of the lungs.
Fluorography at the pregnancy planning stage is completely safe. Would you like me to provide you with evidence? Please:
- Firstly, all modern medical institutions are equipped with digital equipment that allows you to take pictures with minimal radiation doses.
- The radiation dose for digital fluorography is about 0.04 millisievert; for comparison, the same dose can be received when flying on an airplane, and you will receive the same radiation in a month just walking on the street. You won’t refuse to go for a walk or fly on a plane if you want to get pregnant in the near future, right?
- X-rays have a clear focus on the chest, and the uterus, even in the 1st trimester, is still significantly removed from the lungs.
- Thanks to X-rays, it is possible to detect not only pathology in the lungs, but also changes in the cardiovascular system and spine. Believe me, the presence of some diseases is much more dangerous than x-ray radiation, so the examination is carried out for both men and women.
I would like to note one more important point: modern equipment makes it possible to obtain an image instantly, the doctor immediately sees it on the screen, this allows you to avoid repeated examinations.
When can it be done
When is the best time to undergo a fluorographic examination when planning a pregnancy and can this be done on any day of the cycle?
For the woman herself, the photograph is harmless, but it can cause some harm to the fertilized egg, since the embryo is very sensitive to any influence.
The optimal period is considered to be the first week of the menstrual cycle - that is, immediately during menstruation or for several days after it. This period is considered the safest. After all, if you have your period, it means you are definitely not pregnant.
Before doing fluorography, be sure to warn your doctor that you are planning a pregnancy in the near future. In such cases, women are given a special protective apron that completely covers the reproductive organs from radiation.
Carrying out fluorography during the first week of the cycle can minimize the risk for a patient planning a pregnancy. It is recommended to use protection throughout this menstrual cycle.
How long before you can get pregnant after fluorography? Throughout the entire menstrual cycle, during which fluorographic examination was carried out, many doctors recommend abandoning planning. In their opinion, you should wait at least 4 weeks before conceiving a child. But there is another position: if the procedure was carried out at the beginning of the cycle, then it is not harmful to future conception.
Harm from fluorography
The main reason why fluorography or x-rays are dangerous is the radioactive radiation that penetrates the human body. Old fluorography machines, which are still found in clinics, emit a higher dose of radiation than new digital ones. If you have the opportunity to choose, it is better to do this examination using modern equipment.
Most doctors agree that the benefits of lung fluorography are greater than the harm, because the dose of radiation is small, and the result makes it possible to identify lung diseases, including dangerous tuberculosis, at an early stage.
The frequency of routine lung examinations is once every 1 or 2 years, depending on the degree of contact with people. If you do not do fluorography more often, it will not cause harm to the body. Is it necessary to do fluorography before conceiving a child? Currently, this diagnosis is included in the mandatory when planning pregnancy and is always prescribed by the local gynecologist, often to both spouses:
I didn’t know I was pregnant and had a fluorography done
But what to do if after the study a woman finds out that she is already pregnant? It is worth noting that pregnancy is considered a contraindication to fluorography; the procedure is especially dangerous in the first trimester of pregnancy. If there are serious indications, the examination can be carried out in the second and third trimester.
But don’t panic - timely medical genetic consultation and constant medical supervision will help ensure the health of the fetus. In addition, modern equipment used for fluorography emits minimal doses of radiation, so the likelihood of radiation damage to the baby is extremely low.
To date, the connection between fluorography and conception, as well as various anomalies in fetal development, has not been definitively established. Therefore, expectant mothers should not worry. By passing all the necessary tests and genetic screenings, you can ensure the health and full development of the baby.
How long before pregnancy can fluorography be done?
Now I would like to tell you at what period it is better to undergo a fluorographic examination. The ideal time to conduct the study is the first week of the cycle. Let me explain, the cycle begins on the 1st day of menstruation, i.e. The picture is taken during it and another 2-3 days after. At this moment you can be sure that there is no pregnancy.
As for future fathers, they are examined at any time before conception. There is no evidence that irradiation affects sperm composition or sperm motility. For those who are especially vigilant, it is recommended to undergo fluorography approximately 2.5 months before the planned conception. You remember that 72-82 days is the total time for the formation and maturation of sperm? That is why, if you do not want to “irradiate your sperm” before planning, get examined after conception or, as I mentioned above, ~ 2.5 months before.
Do you want to know how a fluorographic examination will affect your unborn child? After all, there are moments when a woman did not know that she was already pregnant and took a photo. I think you are glued to the screens with even more curiosity?!
The opinion of doctors on this issue is unanimous: fluorography is contraindicated for pregnant women. It is especially dangerous to do it in the first three months of pregnancy, at this time all the organs and systems of the baby are formed; it is not yet protected by the placenta from adverse factors.
During the interaction of X-rays with body tissues, special compounds are formed - free radicals, which can disrupt cell division. Adults have very few dividing cells and short-term exposure to X-rays is not dangerous for them, which cannot be said about the fetus. In the first three months in the womb, the embryo grows precisely through the formation of new cells. Such influence can lead to various violations:
- chromosomal mutations;
- developmental defects;
- changes in blood composition;
- frozen pregnancy;
- tumor formations;
- disorders of mental and physical development.
Radiation with a dose of 1 millisievert is especially dangerous; in this case, there is a high risk of giving birth to a sick child or miscarriage. But don’t be alarmed, to get such a dose you need to take about 50 pictures in a short period of time.
Comment from an obstetrician-gynecologist
Obstetrician-gynecologist Elena Artemyeva answers patients’ questions about fluorography when planning pregnancy.
– My husband and I are planning to conceive. But I had a toothache and had to undergo fluorography, otherwise they wouldn’t give me a ticket at the clinic. The picture was taken on the fifth day of the cycle. What to do? Is it possible to plan to conceive in this cycle or is it better to wait a month?
– During fluorography, the reproductive organs are protected by a special screen; only the heart and lungs are irradiated. The procedure was done at the beginning of the cycle, and therefore it cannot have negative consequences for conception. However, it is better to be on the safe side, especially if you have had your tooth treated using any medications. Therefore, I advise you to use contraception during the current cycle.
– I injured my arm, I had to do fluorography and x-rays in two projections. We put on an apron. This happened in the middle of the cycle, before ovulation. And now it turns out that I am pregnant. What to do? Terminate the pregnancy? I am very afraid to give birth to a sick child.
– I understand that you are worried, but there is no need to panic. Exposure to x-rays is undesirable during the period of conception, but this is not an indication for abortion. Usually the “all or nothing” principle applies in this case. That is, either there was a harmful effect, and then the pregnancy will not occur or will be terminated at an early stage. Either the pictures did not cause you any harm, and then everything will be fine, the baby will be born healthy.
In what cases is a photograph still necessary?
I think it will not come as a revelation to you that there are certain situations in which fluorography is necessary even during gestation.
Doctors prescribe examination in the following cases:
Carriers of tubercle bacilli in the close environment of a pregnant woman pose a serious threat to both the expectant mother and the fetus. Reduced immunity during this period increases the risk of infection, so the woman is at risk.
In this regard, doctors advise doing fluorography specifically in preparation for conception. Let me remind you that the procedure is voluntary and a woman has the right to refuse it. But whether it’s worth risking your health is up to you to decide.
How harmful is fluorographic diagnosis?
In accordance with the recommendations of the World Health Organization, a fluorographic examination is carried out for preventive purposes, during which the level of human radiation exposure is up to 5 mSv per year.
With scanning digital fluorography, the average radiation dose is 0.02-0.05 mSv, which is almost 37 times less than the permissible dose.
For comparison:
The average radiation dose per inhabitant of the planet is 2.5 mSv; in Russia it is higher and amounts to 3.42 mSv per year.
Therefore, if you resort to the method of digital fluorography, where there are fewer X-rays than on film, where the dose is 0.1-0.3 mSv. Annual surgery is recommended to monitor the progression of pulmonary tuberculosis.
On what day of the cycle is HSG performed?
An HSG is done approximately in the middle of the cycle. Taking into account the fact that the positive effect of hysterosalpingography does not last long, of course, it is better not to miss the opportunity to conceive a child. However, your gynecologist may recommend that you hold off on conceiving for a while, from a few days to a week or two, until your next cycle begins. This may be due, for example, to a high dose of radiation if the study uses radiography rather than ultrasound.
Another factor is the use of various medications that are incompatible with pregnancy. The fact is that the HSG procedure carries some risks of developing inflammation, so sometimes the gynecologist after the examination prescribes anti-inflammatory drugs or antibiotics. In some cases, painkillers are required. Taking these medications can negatively affect your pregnancy, so your doctor may recommend that you use contraception for some time.
Thus, in case of incomplete obstruction of the fallopian tubes, hysterosalpingography increases the likelihood of pregnancy. In other cases, it serves as a diagnostic procedure that allows you to determine the cause of infertility. After the examination, it is advisable to discuss with your doctor the need for contraception for some time and further pregnancy planning.
Pregnancy with ART after COVID-19
Previous Covid-19 is not an obstacle to in vitro fertilization. Before the start of the protocol, both spouses undergo PCR diagnostics and also donate blood to determine the level of antibodies to coronavirus (IgM and IgG). When recovery is confirmed clinically and laboratory, the doctor will admit patients to the ART program.
How long do you have to wait after illness to start an IVF protocol? Reproduction specialists recommend waiting 3 months. This is associated with the risk of developing thromboembolic complications in pregnant women and the teratogenic effect of the drugs used on the fetus.
In addition, before in vitro fertilization, doctors recommend vaccination. You can enter into the protocol when stable immunity has been formed (approximately 21 days after the introduction of the second component of the vaccine).
