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Conception, cerclage, and clinical counseling

      Procreative specialists have unique opportunities for primary prevention. The Barker hypothesis (
      • Barker D.J.
      • Osmond C.
      Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales.
      ), where the intrauterine environment results in epigenetic influences beyond those contributed by maternal and paternal DNA, has important implications for preconception and antepartum care. Accordingly, reproductive endocrinologists counsel mothers-to-be regarding weight optimization, hypertensive control, diabetic management, and more because these can yield lifetime benefits for the future embryo and fetus. The Barker hypothesis reminds us of the birth mother’s importance for donor egg and gestational carrier scenarios.
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