What is Preconception Care?
💡 Preconception care = health optimisation before trying to conceive. Start 3–6 months before TTC. Key steps: folic acid 400–800 mcg/day (NTD prevention), vitamin D, thyroid check, rubella immunity, BMI optimisation, stop smoking, medication review. Critical for IVF patients: optimised health improves implantation rates.
Preconception care is the proactive optimisation of both partners' health before attempting conception. It encompasses nutritional supplementation, chronic disease management, vaccination review, medication safety, and lifestyle modification. Ideally started 3–6 months before trying to conceive, it reduces miscarriage risk, birth defect risk, and improves IVF outcomes.
🇮🇳 India Context: Preconception Care is widely assessed and treated across major Indian fertility centres including Chennai, Mumbai, Bangalore, Delhi, and Hyderabad.
What are the key characteristics of Preconception Care?
- Ideally initiated 3–6 months before beginning TTC — earlier if chronic medical conditions present
- Folic acid 400–800 mcg/day: reduces neural tube defect (NTD) risk by 70%; high-dose 5mg/day if prior NTD, diabetes, or anti-epileptics
- Vitamin D: highly prevalent deficiency in India (70–80% of population); supplement 1,000–2,000 IU/day; check serum 25(OH)D
- Thyroid function: hypothyroidism is the most common correctable cause of subfertility and miscarriage in Indian women; TSH target <2.5 mIU/L pre-conception
- BMI optimisation: BMI >30 reduces fertility, IVF response, and implantation rates; BMI <18.5 disrupts HPO axis (hypothalamic amenorrhoea)
- Smoking cessation: smoking accelerates egg aneuploidy and reduces ovarian reserve; both partners should stop
- Alcohol: no proven safe level in pregnancy; UK/Indian guidelines recommend abstinence when TTC
- Vaccination review: rubella (if not immune), varicella, hepatitis B, COVID-19 — all safe before conception; MMR must be given ≥4 weeks before TTC
How does Preconception Care work?
Why does Preconception Care matter in fertility?
Preconception care is under-utilised in India — the majority of couples begin TTC without any health optimisation. This matters clinically: undetected hypothyroidism (TSH 4–8 mIU/L) is a correctable cause of both subfertility and miscarriage that can be identified with a single blood test. Vitamin D deficiency impairs folliculogenesis and endometrial receptivity. Folic acid started at conception rather than before may be too late for neural tube closure (which occurs at 28 days post-conception, before most women know they are pregnant). For IVF patients, preconception optimisation — particularly thyroid normalisation and BMI reduction — directly improves stimulation response, egg quality, and implantation rates.
What are related terms to Preconception Care?
Trying to Conceive (TTC)
Trying to Conceive (TTC) is a widely used lay term describing the active effort …
Fertility Clinic
A fertility clinic is a specialised medical centre that evaluates and treats inf…
REI Specialist (Reproductive Endocrinologist)
An REI specialist (Reproductive Endocrinologist and Infertility specialist) is a…
FSH (Follicle-Stimulating Hormone)
FSH (Follicle-Stimulating Hormone) is produced by the pituitary gland. In women,…
AMH Test (Anti-Müllerian Hormone)
The AMH Test is a simple blood test that measures the level of Anti-Müllerian Ho…
FAQs about Preconception Care
When should I start taking folic acid before pregnancy?
Start folic acid at least 1 month before trying to conceive — ideally 3 months before. Neural tube closure occurs at 28 days after conception, before most women know they are pregnant. Standard dose: 400 mcg/day (available OTC). High dose 5 mg/day prescribed if: prior neural tube defect, diabetes, anti-epileptic medication, BMI >30, or malabsorption condition.
Should I check my thyroid before trying to get pregnant?
Yes — strongly recommended. Hypothyroidism (even subclinical TSH 2.5–5.0 mIU/L) is associated with reduced conception rates, implantation failure, and increased miscarriage risk. Highly prevalent in Indian women (iodine deficiency, autoimmune thyroiditis). A simple TSH blood test identifies it. Target TSH pre-conception and in early pregnancy: <2.5 mIU/L. Levothyroxine supplementation is safe, inexpensive, and highly effective.
Does weight affect fertility?
Yes — significantly in both directions. BMI >30 (obesity): disrupts HPO axis, reduces ovarian response, impairs implantation, lowers IVF success rates, and increases miscarriage risk. Even modest weight loss (5–10% of body weight) restores ovulation in many overweight women with PCOS. BMI <18.5: causes hypothalamic amenorrhoea (absent periods, no ovulation) — reverses with weight restoration. Target BMI 19–25 for optimal fertility.
What vaccinations should I get before trying to conceive?
Check immunity before TTC: Rubella (German measles) — if not immune, MMR vaccine required; must wait ≥4 weeks after vaccination before TTC. Varicella (chickenpox) — if not immune, varicella vaccine; wait ≥1 month. Hepatitis B — if not immune, 3-dose course (can conceive after). COVID-19 — no evidence of fertility harm; complete course before conception. All these vaccines are live or inactivated; timing depends on type.
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