Before Pregnancy: A Health Checklist for You and Your Partner
Key message: Preconception care helps identify medicine, health, vaccine and lifestyle issues before pregnancy begins. It is useful…
Key message: Preconception care helps identify medicine, health, vaccine and lifestyle issues before pregnancy begins. It is useful for both partners and should be individual rather than a standard package of unnecessary tests.
Arrange medical review before trying: Seek preconception advice early if you use anti-seizure, diabetes, blood-pressure, anticoagulant, acne or mental-health medicine; have a chronic disease; had a previous neural-tube defect or major pregnancy complication; or face chemotherapy, radiotherapy or surgery affecting fertility. Do not stop prescribed medicine on your own.
When should preconception planning begin?
Ideally begin at least 3 months before trying, and earlier when medicine changes, vaccine timing, chronic disease control, fertility preservation or weight and lifestyle support need more time.
An unplanned pregnancy should not cause panic: contact a clinician promptly and continue essential prescribed medicine until reviewed.
How much folic acid is recommended?
Do not rely on food alone to provide the recommended supplement.
- Most people should take 400 micrograms daily before pregnancy and through the first 12 weeks.
- A prescribed 5 mg dose is used for selected higher-risk situations, including a previous or family history of neural-tube defect, diabetes, some anti-seizure or folate-antagonist medicines, and selected haematological conditions.
- BMI of 25 or above by itself is no longer a reason for more than 400 micrograms in current NICE guidance unless another higher-risk factor is present.
Which medicines and supplements need review?
- Prescription and over-the-counter medicines, inhalers, creams and injections.
- Herbal remedies, bodybuilding products, weight-loss products and high-dose vitamins.
- Vitamin A/retinol-containing supplements, which should be avoided in pregnancy unless specifically prescribed.
- Medicines that may need substitution or dose optimisation before conception.
- Medicines that must continue because stopping them would create a greater risk.
Which health conditions should be optimised?
- Diabetes, high blood pressure, thyroid disease, epilepsy and kidney, heart or autoimmune disease.
- PCOS/PMOS, irregular periods, endometriosis or previous fertility treatment.
- Anaemia, obesity, underweight or nutritional deficiency.
- Depression, anxiety, bipolar disorder, eating disorder or previous postpartum psychiatric illness.
- Previous pre-eclampsia, preterm birth, recurrent miscarriage, caesarean complications or fetal anomaly.
Which vaccines and infection issues matter?
- Check rubella/MMR status before pregnancy; avoid pregnancy for one month after an MMR dose.
- Review varicella immunity when history is uncertain and local testing or vaccination is appropriate.
- Discuss hepatitis, influenza, COVID-19 or other vaccines according to medical risk, work and local recommendations.
- Arrange STI testing when there is exposure, a new partner, symptoms or previous infection.
- Review travel plans, mosquito-borne infection risk and food/animal exposure.
What lifestyle changes help?
- Stop smoking and avoid recreational drugs; ask for support rather than relying on willpower alone.
- Avoid alcohol while trying and during pregnancy.
- Keep caffeine within pregnancy-safe limits once trying.
- Aim for regular activity, sleep and a sustainable eating pattern rather than crash dieting.
- Review occupational chemicals, radiation, excessive heat and infection exposure.
What should the partner review?
- Smoking, alcohol, recreational drugs and anabolic steroids or testosterone.
- Medicines, testicular disease, surgery, infection or fertility concerns.
- Family history and genetic or carrier testing when ancestry or history makes it relevant.
- Vaccines, infection risk and support for shared nutrition and lifestyle changes.
Which tests are not automatically needed?
Not every couple needs a broad hormone panel, AMH, immune tests, inherited-thrombophilia tests or genetic screening. Tests should answer a clinical question based on age, cycle pattern, family history, medical conditions and how long pregnancy has been attempted.
Cervical screening should be up to date according to the national programme, but it is not a fertility test.
What information should you bring to the visit?
- A full medicine and supplement list with doses.
- Vaccination records and previous pregnancy or operation reports.
- Family history of genetic conditions, congenital anomalies, thrombosis or early disease.
- Cycle dates and any fertility assessment already completed.
- Your preferred pregnancy timing and any concerns about work, travel or support.
Frequently asked questions
Should everyone take 5 mg folic acid?
No. Most people need 400 micrograms. The 5 mg dose is prescribed for specific higher-risk situations.
Should I stop my medicine before trying?
No. Some medicines need changing, but sudden stopping can be dangerous. Arrange a planned review.
Do both partners need a check-up?
Partner health, medicines, smoking, testosterone use, infections and family history can affect pregnancy planning.
Do I need AMH before trying?
Not routinely. AMH is useful for selected fertility questions and is not a general prediction of natural pregnancy.
How long after MMR should pregnancy be avoided?
Current NHS guidance advises avoiding pregnancy for one month after MMR vaccination.
Your next step
Book a preconception review with medicine and vaccine records, medical and pregnancy history and both partners’ concerns. Start folic acid now if pregnancy could occur, but use the higher 5 mg dose only when prescribed.
Medical and content review: Dr Mohamed Abdelghany, Obstetrics & Gynecology Specialist, MRCOG (UK), MSc Obstetrics & Gynecology – Kasr Al-Ainy, Cairo University.
Last reviewed: 23 August 2026.
This information is for general education and does not replace individual medical assessment.
