Brief Answer: Risk factors Detailed Answer: Hi, Thanks for the query. It is difficult to say the possibility of autism in next child. The possibility of autism depends on many risk factors like : - Maternal diabetes. -Increased paternal and maternal age. -Genetic factors. But it is not established which gene is responsible to cause autism. -Autoimmune diseases to mother. -Exposure to teratogenic agents. - Intrauterine infections. -Stress and strain pre conceptionally can cause by gene-environment interaction. - Hypothyroidism in mother etc. -High levels of testosterone in amniotic fluid. - Nutritional deficiency, especially folic acid deficiency. - Intake of drugs like antidepressants during pregnancy. According to your history maternal diabetes is strong risk factor here. Increased paternal age is also a risk factor due to possibility of defective spermatozoa. So, the possible steps that can be taken are : - Maintaining strict normal blood sugar levels for at least 3 months before planning for pregnancy. -Staring folic acid supplementation 1 to 2 months prior to pregnancy. -Regular antenatal checkups and ultrasound examinations during pregnancy. -Some studies recommend estimation of testosterone levels in the amniotic fluid by amniocentesis. But better to take the opinion of your gynecologist before planning for test. -Avoiding the risk factors like nutritional deficiency, teratogens etc. Hope I have answered your query. I will be available to answer followup queries. If you are satisfied with the answer, please give your review at the end of the discussion. Take care.

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Brief Answer: Investigations Detailed Answer: Hi, Before pregnancy estimation of blood sugar levels and TORCH panel to diagnose any possible infections can be done. And blood sugar levels should be strictly maintained within normal levels. We cannot investigate which sperm and ovum are going to be fertilized and they are normal or not. Estimation of testosterone levels in the amniotic fluid should be done at the time of pregnancy only. These investigations can be done in Bangalore, as good hospitals are available there. If you want any suggestions you can contact me through direct questions. I will be happy to help you. Let your wife start taking folic acid supplementation at least 2 to 3 months before planning for pregnancy. Take care.

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