- Education & Awareness
Preconception Checklist: Tests, Vaccines and Habits Before Trying to Conceive
Many of the things that help a pregnancy start well happen before the pregnancy does. A few simple steps taken in the months before you start trying, such as checking your health, updating vaccines, starting folic acid and cutting out harmful habits, can make a real difference for you and your baby. This preconception checklist covers the tests to consider, the vaccines to ask about, and the habits worth changing, for both partners.
When Should You Start?
The Short Answer
Ideally two to three months before you start trying. That gives time for tests and treatment, for vaccines (some need a gap before conceiving), for folic acid to build up, and for healthy habits to take effect. For men, sperm take about three months to develop. If you’re starting sooner, begin anyway, because every step helps.
Step 1: A Preconception Doctor Visit
A short visit before you try is the most useful single step. Your doctor can:
Review your medical history, including past pregnancies, surgeries and family history of inherited conditions.
Check long-term conditions such as diabetes, thyroid disease, high blood pressure, epilepsy, asthma and PCOS, so they are well controlled before you conceive.
Review every medicine you take. Some are not safe in pregnancy, but never stop a medicine on your own. Ask first.
Talk about your cycle. Very irregular periods are worth sorting out early.
Step 2: Tests to Consider
The right tests depend on your age and history, so treat this as a list to discuss rather than a package to buy:
Blood group and Rh status.
Haemoglobin and iron. Low iron is common and treatable.
Thyroid function (TSH).
Blood sugar, especially if you have a family history of diabetes, PCOS, or are overweight.
Vitamin D and vitamin B12, if your doctor advises, particularly for vegetarians.
Immunity to rubella and chickenpox.
Cervical screening if you are due for it.
Genetic carrier screening for conditions such as thalassemia and sickle cell disease.
For a fuller discussion of which fertility tests are and aren't worth doing, see fertility tests before marriage.
Step 3: Vaccines to Ask About
Some infections can seriously harm a pregnancy, and vaccines are ideally done before you conceive:
Blood group and Rh status.
Chickenpox (varicella), if you have never had it or been vaccinated.
Hepatitis B, if you are not immune.
HPV, if it is suitable for your age. It is not given during pregnancy.
Tetanus, to keep up to date.
Worth knowing: Rubella and chickenpox vaccines are “live” vaccines, so doctors usually advise waiting about a month after them before trying to conceive. Other vaccines, such as flu and whooping cough, are usually offered during pregnancy, and your doctor will guide you.
Step 4: Folic Acid and Supplements
Some infections can seriously harm a pregnancy, and vaccines are ideally done before you conceive:
Folic acid is commonly advised before conception and in early pregnancy to help prevent certain birth defects of the brain and spine. Ideally start a month or more before you try, at the dose your doctor recommends. Some women need a higher dose.
Iron, vitamin D or vitamin B12 only if your tests show you need them.
Avoid high-dose vitamin A supplements, and unprescribed herbal or "fertility" products. Some are unsafe in pregnancy.
Planning a Pregnancy?
A preconception consultation can turn this checklist into a plan that fits you.
Step 5: Healthy Habits for Both Partners
Some infections can seriously harm a pregnancy, and vaccines are ideally done before you conceive:
Stop smoking and all tobacco, including chewing tobacco and vaping, and avoid second-hand smoke.
Avoid alcohol and recreational drugs.
Reach a healthy weight, without crash dieting.
Eat a balanced diet.
Be active and sleep well. Gentle movement helps.
Limit caffeine, and practise safe food habits: wash fruit and vegetables, avoid raw or undercooked meat and eggs, and avoid unpasteurised milk and soft cheese.
Avoid unnecessary exposure to pesticides, solvents, lead and other workplace chemicals, and avoid X-rays unless necessary.
Look after your mental health. See can stress really affect fertility. If you take medicine for anxiety or depression, discuss it with your doctor before trying.
For Men: Your Part of the Checklist
Some infections can seriously harm a pregnancy, and vaccines are ideally done before you conceive:
Consider a semen analysis if there are any concerns.
Stop smoking, cut back on alcohol, and avoid anabolic steroids and testosterone products.
Avoid heat to the groin, such as hot baths and saunas.
Check your vaccines and health, and review your medicines with your doctor.
Start early. Sperm take about three months to mature.
Step 6: Understand Your Cycle
Pregnancy is only possible in the few days around ovulation. Note the first day of each period, and learn your fertile window. See how to calculate your fertile window and your ovulation window. Having sex every one to two days through that window is generally enough.
Practical and Emotional Preparation
Talk openly with your partner about timing, expectations and what each of you needs.
Check your health insurance and workplace leave policies.
Build a support network, and decide who you will tell and when.
Remember that conception often takes several months.
When to See a Fertility Specialist
You are 35 or older and have been trying for six months, or 40 or older and want to begin right away.
You are under 35 and have been trying for a year without success.
You have very irregular or absent periods, endometriosis, PCOS or thyroid disease.
You have had more than one pregnancy loss.
If you already know you will need fertility treatment,
Common Preconception Myths
Instead Of
Starting folic acid only after you find out you're pregnant.
Try
Starting before you try, since the brain and spine form in the first weeks, often before you know you're pregnant.
Instead Of
Believing only the woman needs to prepare.
Try
Preparing together. A man's habits and health affect sperm and the family's future.
Instead Of
Assuming vaccines before pregnancy are unsafe.
Try
Knowing that several vaccines should be given before pregnancy, with a gap of about a month for live vaccines.
Instead Of
Doing a "detox" or "fertility cleanse" before trying.
Try
Eating well, stopping harmful habits and getting your health checked. Detox plans have no proven benefit.
Instead Of
Planning to "eat for two" from now on.
Try
Aiming for a healthy weight and balanced meals before pregnancy. Extra calories aren't needed until later.
A good preconception plan isn't about perfection. It is a handful of simple, well-timed steps that give you and your baby a healthier start.
Planning a Pregnancy?
A preconception consultation can turn this checklist into a plan.
A Bright Future, Together™
Frequently Asked Questions
It is a list of steps to take before trying to conceive: a doctor visit, health tests, vaccines, folic acid, healthy habits for both partners, and understanding your cycle. The aim is to start pregnancy as healthy as possible.
Ideally two to three months before you start trying, which allows time for tests, vaccines, folic acid and healthy habits to take effect. If you are starting sooner, begin anyway, because every step helps.
Common tests include blood group, haemoglobin and iron, thyroid function, blood sugar, infection screening, rubella and chickenpox immunity, and carrier screening for conditions such as thalassemia. Your doctor will advise which are right for your age and history.
Ask about rubella (MMR), chickenpox, hepatitis B, HPV and tetanus. Live vaccines such as rubella and chickenpox usually need about a month’s gap before trying to conceive. Flu and whooping cough vaccines are usually offered during pregnancy.
Yes, it is commonly advised before conception and in early pregnancy to help prevent certain birth defects. Ideally start a month or more before trying, at the dose your doctor recommends, since some women need a higher dose.
Stop smoking, cut back on alcohol, avoid steroids and testosterone products and heat to the groin, review medicines and vaccines with a doctor, and consider a semen analysis if there are concerns. Sperm take about three months to develop, so start early.
After a year of trying if you are under 35, after six months if you are 35 or older, and straight away if you are 40 or older. See a doctor sooner if you have irregular periods, a known condition, or more than one pregnancy loss.
This article is for general educational purposes only and does not constitute medical advice. The right tests, vaccines and supplements depend on your age, health and history, so please consult a doctor before starting or stopping any medicine or supplement. It also does not constitute psychological advice.
