I understand your concern and I will do everything I can to answer your question. Accutane is the oral form. Accutane has been linked with birth defects and most dermatologists are very careful using Accutane pills in women that might become pregnant (most of them make you sign an informed consent form stating that you know you CANNOT become pregnant while taking Accutane). Accutane falls into FDA category X - absolutely to be avoided before and during pregnancy. The topical or gel form has not been linked to birth defects because it is not absorbed from the skin very well and doesn t get into your system but to be on the safe side, we recommend that you stop isotrexin, retinoic acid or isoretinoin before conception. Topical tretinoin falls under FDA category C - no significant risk in the research so far, but safest is to avoid it if you are planning pregnancy. I found a link that discusses some of the research http://www.drugs.com/pregnancy/tretinoin-topical.html I hope that helps and best of luck to you