A pre-conception health check is an appointment with a doctor, ideally a few months before you start trying, to review your health, medicines, vaccinations and lifestyle. The parts that make the most difference are simple: starting folic acid, checking your medicines are safe for pregnancy, making sure vaccinations and cervical screening are up to date, and getting any long-term condition well controlled. If you are well, you rarely need a large panel of blood tests.
This guide is part of our women’s health series and explains what is worth doing, and when to ask for help sooner.
Why think about your health before pregnancy?
Many of the most important stages of a baby’s development happen in the first few weeks, often before a pregnancy test is positive. The neural tube, which becomes the brain and spinal cord, forms very early. That is why the NHS advises starting some steps before you conceive rather than waiting for a positive test.
Planning ahead also gives you time. Changing a medicine, catching up on a vaccine or stabilising a condition can take weeks to months, and is far easier done calmly beforehand.
What is genuinely worth doing?
Start folic acid before you try
The NHS recommends a daily folic acid supplement from before you conceive until the end of the first trimester. Some people are advised to take a higher dose, which a doctor prescribes. This includes people with diabetes, a BMI of 30 or above, a previous pregnancy affected by a neural tube condition, a relevant family history, or who take certain medicines for epilepsy. If any of these apply, speak to a doctor before you start trying.
The NHS also advises a daily vitamin D supplement during pregnancy and breastfeeding. Avoid supplements containing vitamin A (retinol), including fish liver oil, as too much can harm a developing baby.
Review every medicine you take
Bring a list of everything: prescribed medicines, anything bought over the counter, herbal remedies and supplements. Some medicines are fine in pregnancy, some need a switch to a safer alternative, and a few need specialist input. Please do not stop a prescribed medicine on your own. For some conditions, including epilepsy and many mental health conditions, stopping suddenly can be more harmful than the medicine itself.
Check your vaccinations and screening
- Rubella: if you are not sure you have had two doses of the MMR vaccine, it is worth checking your records. You will be advised to avoid getting pregnant for a short time after the vaccine.
- Chickenpox: if you have never had chickenpox, a vaccine can be discussed before pregnancy.
- Cervical screening: if yours is due, it is simpler to have it before you conceive.
Get long-term conditions well controlled
Diabetes, thyroid disease, high blood pressure, epilepsy, asthma and mental health conditions all benefit from planning. Good control before conception lowers risks for you and your baby. Some conditions call for specialist pre-pregnancy advice, which your NHS team can arrange.
Related readingHeavy periods: when to investigate, not just manageRead the article →Lifestyle changes that make a real difference
- Smoking: stopping is one of the most helpful things you can do. Free NHS stop smoking support is available.
- Alcohol: the UK Chief Medical Officers advise that if you are pregnant or trying, the safest approach is not to drink at all.
- Weight: a healthy weight can make it easier to conceive and lowers some pregnancy risks.
- Caffeine and food safety: worth learning the NHS guidance on caffeine and foods to avoid now, so it is second nature later.
- Your partner: smoking, heavy drinking and some medicines can affect sperm, so pre-conception health applies to both of you.
Do I need blood tests before trying?
If you feel well and have no relevant history, usually not. Blood tests are most useful when there is a reason for them, for example:
- a history of anaemia or heavy periods, where checking iron makes sense
- a known thyroid condition, or symptoms that suggest one
- risk factors for diabetes
- a family history of an inherited condition, or a family background with higher carrier rates for sickle cell or thalassaemia
- a sexual health check, if you or your partner have had new partners
You may have seen tests that claim to measure your “egg reserve”. These tests do not reliably predict your chance of conceiving naturally, and a result can cause worry or false reassurance.
When should you ask for fertility advice?
NICE advises seeing a doctor if you have not conceived after a year of regular unprotected sex. You should ask sooner if:
- you are 36 or over
- your periods are very irregular or absent
- you have a history of pelvic infection, endometriosis or significant period pain
- you or your partner have had cancer treatment or have a known fertility concern
When to see a doctor sooner
If there is any chance you are pregnant, get urgent advice from NHS 111 or your GP if you have:
- pain low down on one side of your tummy
- vaginal bleeding or brown watery discharge
- pain in the tip of your shoulder, or discomfort when passing urine or opening your bowels
Call 999 if you have severe tummy pain, feel faint or dizzy, or collapse. These can be signs of an ectopic pregnancy, which needs emergency care.
If you take regular medicines and find you are unexpectedly pregnant, contact your doctor promptly, and do not stop anything without advice.
This list is not exhaustive. If you are not sure about something, see a doctor.
How we approach this at Aarva
A pre-conception appointment at Aarva is with Dr Shivani Malhotra, a GP who leads our women’s health care. We take time to go through your health history, periods, previous pregnancies, medicines, vaccinations and family history, and check your blood pressure and weight if you would like us to. Blood tests are suggested only where they would change what we advise.
Your doctor talks you through the next steps and confirms the price of anything we recommend before it goes ahead. There is no pressure to book on the day, and if you do not need further tests, we will tell you. With your consent we can write to your NHS GP, and we will point you towards NHS maternity and specialist services where they are the right route. You can read more about what to expect at your first appointment, or explore our wider women’s health care.
Questions patients ask
How far ahead should I have a pre-conception check?
Ideally around three months before you start trying. That gives time to start folic acid, review medicines and catch up on vaccinations. It is still worthwhile if you are already trying.
Do I need a fertility test before trying for a baby?
Usually not. Tests of egg reserve do not reliably predict your chance of conceiving naturally. NICE advises seeing a doctor after a year of trying, or sooner if you are 36 or over or have a known concern.
Should I stop my medicines before trying to conceive?
Not on your own. Some medicines need changing before pregnancy, but stopping suddenly can be harmful. A doctor can review each one with you and plan any changes safely.
Should my partner have a check too?
It can help. Smoking, alcohol, weight and some medicines can affect sperm quality, so healthy changes are worth making together.
If you are planning a pregnancy and want a calm, unhurried review, you can book a consultation with our doctor, or use find your starting point if you are not sure which appointment you need.
This article is general information and does not replace a consultation with a doctor.
