Preconception Preparation: A Medical Approach to Planning Pregnancy

Planning a pregnancy starts long before conception. During this period, it is important to assess the health of both the woman and the man, identify risk factors, and adjust those that might influence the course of the pregnancy and the development of the fetus in advance. In medicine, this stage is called pre-conception preparation.

Pre-conception preparation includes consulting a doctor, assessing chronic diseases, blood tests, and other examinations selected according to the couple’s age, medical history, and reproductive health. Some conditions are easier and safer to adjust before pregnancy occurs than during it, especially in the early stages when the main organs of the future child are forming.

In this article, we discuss why pre-pregnancy preparation is necessary, who needs extensive examinations, where to start consultation with an obstetrician-gynecologist, and which measures actually reduce the risk of complications. We will pay special attention to lifestyle, physical activity, and folic acid intake as basic steps for women planning pregnancy.

What is pre-pregnancy preparation and why is it necessary

Pre-conception preparation is a stage of medical support conducted before pregnancy, aimed at reducing risks for the woman and the future child. It begins as part of pregnancy planning and helps to assess health status in advance, identify factors that can affect conception and the course of pregnancy, and adjust them before the planned conception. This approach is especially important for couples who want to approach pregnancy consciously and without haste.

Preparing for pregnancy is considered a task for both future parents. Men and women participate equally in this process, as the health of each partner affects the quality of conception and the development of the future child. There is no universal pre-pregnancy preparation: the scope of examinations and recommendations depends on age, medical history, the presence of chronic diseases, and the reproductive history of the couple.

It’s optimal to start preparing for pregnancy a few months before the intended conception. This time frame allows for a calm approach to consultations, necessary examinations, and, if needed, adjustments to treatment or lifestyle before pregnancy occurs. Several issues, including medication intake, vaccination, and control of chronic conditions, are safer and easier to address at this stage rather than after conception, when intervention options are limited.

The primary goal of preconception care is to create conditions for normal conception and the birth of a healthy child. In practical terms, it is aimed at ensuring pregnancy occurs under the most favorable conditions and develops without complications.

The following objectives are usually addressed in preconception care:

• assessment of the health status of both women and men before pregnancy;
• identification of risk factors that may affect conception and fetal development;
• modification of lifestyle and medical conditions before planned conception;
• development of an individual pregnancy preparation plan for the couple.

This approach allows future parents to move from abstract pregnancy planning to specific and well-grounded steps aimed at maintaining health and ensuring the successful birth of a healthy child.

Who Needs Advanced Preparation: Risk Factors and Chronic Diseases

The extent of preconception preparation directly depends on health status and risk factors. For some couples, a basic plan that includes a doctor’s consultation and standard examinations is sufficient. However, there are situations where preparing for pregnancy requires a more attentive and comprehensive medical approach.

This is primarily relevant for women and men with chronic conditions. Cardiovascular diseases, carbohydrate metabolism disorders, thyroid disorders, and other chronic conditions can affect conception, pregnancy progression, and fetal development. In such cases, it is important to assess in advance how well the condition is managed and, if necessary, adjust treatment before pregnancy occurs.

Couples with a history of pregnancy complications or miscarriages are also considered at risk. Previous cases of missed miscarriage, spontaneous abortions, preterm births, or complicated pregnancies require separate analysis of the causes. In these situations, extended preconception preparation is aimed at identifying risk factors that could have played a role before and their correction, which reduces the risk of complications recurring.

Another important factor is the age and overall health of the couple. As a woman’s age increases, the likelihood of comorbidities and complications during pregnancy rises, and men may accumulate factors affecting sperm quality. In such cases, a doctor assesses the health condition comprehensively and selects the scope of preparation individually, taking into account the timing of pregnancy and reproductive plans.

Extended pre-pregnancy preparation may be recommended based on indications if the couple has:

• chronic diseases requiring ongoing treatment;
• risk factors for congenital defects or fetal developmental abnormalities;
• complications in previous pregnancies;
• conditions that may affect the course of pregnancy.

An individual approach not only allows better preparation for conception but also increases the likelihood of a favorable pregnancy outcome. Correcting identified risk factors prior to conception reduces the risk of complications and creates more favorable conditions for fetal development and the birth of a healthy child.

First visit: what the doctor does and how the couple’s plan is structured

Preconception preparation begins with a consultation with a doctor. Most often, the first specialist is an obstetrician-gynecologist, who assesses the woman’s reproductive health and helps formulate a general preparation plan for the couple. This visit is not limited to ordering tests: its main task is to understand the initial situation and determine what extent of medical assistance is truly necessary.

Initially, the doctor discusses the medical history in detail with both the woman and the man. Information is clarified about past diseases, surgeries, features of previous pregnancies and births, medication intakes, and the presence of chronic conditions. Special attention is given to lifestyle, work conditions, harmful factors, and infections that can be sexually transmitted. At this stage, it is important to honestly explain the current health status, even if some symptoms seem insignificant.

Then the doctor assesses risk factors and discusses how they might affect conception and the course of pregnancy. For women and men, this conversation may differ in focus, but the goal is the same — to determine whether basic or advanced preconception preparation is needed. If necessary, the doctor clarifies the vaccination status and the safety of the medications that the patient is taking in terms of pregnancy planning.

After this, the couple’s course of action is formed. Depending on the initial data, consultations with other specialists such as a general physician, endocrinologist, geneticist, or urologist may be necessary. This approach helps prevent overloading the examination and directs patients to specialists only based on medical indications. The obstetrician coordinates this process and helps establish the sequence of steps.

Only after an initial assessment and discussion of risks are screenings appointed. This helps avoid unnecessary tests and focus on those examinations that are truly important for reproductive health and a safe pregnancy.

Examination and Tests Before Conception

The examination before conception is not conducted just for the sake of formal testing, but to identify factors that may affect conception, the course of pregnancy, and the condition of the future child. The volume of studies is tailored individually: some tests are appointed for most couples, while the rest are conducted based on indications, deriving from history and identified risks.

As part of the basic preconception preparation, the general state of the body is usually assessed. Blood and urine tests help identify hidden inflammatory processes, anemia, and other changes that may not have pronounced symptoms but can affect the course of pregnancy. Blood types and Rh factors are also determined in advance to assess possible immunological risks and avoid uncertainty in the future.

Special attention is paid to the examination of the pelvic organs. Examination and ultrasound of the pelvis help assess the condition of the uterus and ovaries, identify changes that may affect conception or pregnancy development. During preventive examinations, the condition of the cervix is assessed, and, if necessary, the breasts are examined. These tests help identify conditions that may require monitoring or treatment before conception.

Some tests and studies are prescribed based on indications. This applies to sexually transmitted infections, hormonal disorders, and other conditions that may be associated with pregnancy complications. Often, such problems can persist asymptomatically for a long time, and complaints may be minimal or absent altogether, so examination allows for the identification of risks before the appearance of clinical manifestations.

This approach allows for the formation of a well-founded conception preparation plan. Research results help the doctor understand which factors may affect the pregnancy and make decisions that increase the chances of its favorable course and the birth of a healthy child.

Lifestyle and folic acid intake: what can be changed in advance

During the preconception phase, adjusting one’s lifestyle can reduce the impact of factors that may complicate conception and early stages of pregnancy. It involves measures with proven benefits that create more stable conditions for the reproductive system and enhance the body’s adaptive capabilities.

In clinical practice, attention is paid not only to individual habits but also to their cumulative impact. Even moderate deviations (irregular sleep, significant weight fluctuations, or excessive physical activity) can affect hormonal balance and reproductive function. Therefore, during the preparation phase for pregnancy, a doctor evaluates the lifestyle comprehensively and offers adjustments based on the couple’s actual living conditions.

When assessing lifestyle before pregnancy, the following signs of the body’s readiness are typically considered:

• a stable sleep routine without significant chronic sleep deprivation;
• tolerance to daily physical activity without feeling exhausted;
• absence of regular alcohol and tobacco consumption;
• body weight that does not require emergency correction before conception.

This approach allows you to understand if changes are needed and to what extent, without turning pregnancy preparation into a rigid system of restrictions.

A separate and fundamentally important element of preconception preparation remains the intake of folic acid. Folates are involved in the formation of the fetal neural tube and cell division processes. A folic acid deficiency in early pregnancy is associated with an increased risk of congenital developmental defects, so its preventive intake is part of basic medical recommendations.

For most women, taking folic acid begins 1–3 months before planned conception and continues in the first weeks after pregnancy occurs. The specific regimen is selected individually, taking into account health status and risk factors. This measure has proven effectiveness and reduces the risk of complications related to early fetal development.

Vaccination and Medications: What to Check in Advance

The final stage of pre-conception preparation is the review of medication therapy and assessment of immune status. These issues are directly related to the safety of early pregnancy stages and require attention even before planned conception, when there are more possibilities for adjustments and lower risks.

Medications and Ongoing Therapy

During the family planning stage, the doctor will definitely clarify which medications the woman and man are taking on a regular basis. This includes not only prescription drugs but also those often perceived as neutral: pain relievers, blood pressure medications, and treatments for chronic conditions. Some medications are undesirable during pregnancy or in its early stages due to possible effects on fetal development. Therefore, any changes in treatment regimens are allowed only after consulting a doctor. Self-cancellation or substitution of medications can worsen health and create additional risks.

Vaccination and Immunity

Assessing vaccination status is an important part of preparing for pregnancy. Before pregnancy occurs, a doctor may recommend checking immunity to a number of infections and, if necessary, administering vaccinations as indicated. This is particularly relevant if there is no vaccination record or past infections are uncertain. Some vaccines are not administered during pregnancy, so it’s more rational to address immunity in advance as part of preparation.

Timing and Planning
Pregravid preparation is always time-bound and should not be prolonged without reason. In most cases, the focus is on a period of several months before the planned conception. This timeframe allows for the completion of preventive measures related to vaccination and therapy adjustments, and to assess how the body reacts to changes. The minimum interval is often around 3 months, but specific timing depends on the initial health condition and the extent of necessary measures.

Readiness is assessed not by the formal completion of examinations, but by the stability of the condition. It is important that chronic diseases are treated, the treatment plan is safe for pregnancy, and preventive measures are completed. If additional risk factors are identified during preparation, the timing may be adjusted, but this decision is made on an individual basis.

Thus, the planning stage allows for transitioning into pregnancy without haste and uncertainty. When the main medical issues are addressed in advance, conception occurs under more predictable conditions, and the risk of early-stage complications is reduced. This is the practical outcome of pre-gravid preparation—not perfect tests, but the body’s readiness for pregnancy and giving birth to a healthy baby.