Fertility Assessment Preconception Health

Evidence-based advice to maximise your chances of conceiving before you even start trying.

Preconception Health

Laying good foundations for conception and a healthy pregnancy starts in the family planning stage, ideally at least three months before you actively start trying to conceive. For men and those assigned male at birth, preconception care can improve your sperm health. For women and individuals with a uterus, the preconception stage involves preparing your body for conception and pregnancy. 

Why is preconception care important?

Many aspects of your health before conception can influence fertility, embryo development, pregnancy outcomes, and the long-term health of your future child.

For women and those with a uterus, preconception care focuses on supporting ovulation, hormone balance, reducing inflammation, and facilitating a healthy pregnancy environment. For men and those assigned male at birth, it aims to optimise sperm health, which can be influenced by lifestyle, medical conditions, age, and environmental exposures.

Preconception care may support:

  • Fertility and reproductive health
  • Healthy ovulation and sperm production
  • Reduced risk of pregnancy complications
  • Healthy foetal development
  • Improved physical and emotional wellbeing during pregnancy

For some people, preconception care may be relatively simple and focus on lifestyle optimisation. Others may benefit from more detailed assessment and management of known medical or fertility concerns.

Preconception health for women and individuals planning to carry the pregnancy

Female fertility is influenced by factors such as age, ovulation, hormone balance, body weight, and general health. Intentionally preparing for pregnancy before conception may help improve fertility and support a healthy pregnancy.

Nutrition and supplements

A balanced diet plays an important role in reproductive health. Women planning pregnancy are generally advised to begin taking folic acid ideally three months before trying to conceive, as this helps reduce the risk of neural tube defects in a developing baby.

Depending on your health, diet, and medical history, Dr Anna may also recommend supplements such as iodine, vitamin D, or iron.

Healthy weight and exercise

Both underweight and overweight women may experience changes in ovulation and hormone function that can affect fertility. Regular physical activity and maintaining a healthy weight may improve your reproductive health and pregnancy outcomes.

Managing medical conditions

Conditions such as polyendocrine metabolic ovarian syndrome (formerly polycystic ovary syndrome or PCOS), endometriosis, thyroid disorders, diabetes, and autoimmune conditions can affect fertility and pregnancy. Optimising these conditions before conception may help reduce complications and support a healthier pregnancy.

Reviewing medications

Some prescription and over-the-counter medications may not be suitable during pregnancy or while trying to conceive. A preconception consultation provides an opportunity to review your medications and discuss safer alternatives if needed.

Smoking, alcohol, and recreational drugs

Smoking, excessive alcohol intake, and recreational drug use can negatively affect fertility and increase the risk of pregnancy complications. Avoiding these substances before pregnancy is strongly recommended. NHMRC guidelines recommend no alcohol consumption in pregnancy.

Vaccinations and health screening

Preconception care may include blood tests or screening to check immunity to infections such as rubella and chickenpox, as well as screening for sexually transmitted infections or genetic conditions where appropriate.

Preconception health for men and those assigned male at birth

Male fertility contributes to around half of all fertility challenges experienced by couples. Healthy sperm production is influenced by overall health, lifestyle, age, and environmental factors.

Because sperm take around three months to develop, making positive lifestyle changes before you and your partner start trying to conceive may improve fertility outcomes.

Supporting sperm health

Healthy sperm need to be present in adequate numbers, move effectively, have normal structure, and contain healthy DNA to improve the chances of fertilisation. Positive lifestyle changes may help improve sperm quality and reproductive health.

Nutrition and weight

A balanced diet, regular exercise, and maintaining a healthy weight may support hormone function and sperm production as obesity can affect testosterone levels and sperm quality.

Smoking, alcohol, and recreational drugs

Smoking, alcohol use, vaping, anabolic steroids, testosterone supplements, and recreational drugs may all reduce sperm quality, sexual function, and general fertility. Though not all studies concur on the impact of these behaviours, it’s best to reduce or avoid these substances altogether before trying to conceive.

Heat and environmental exposures

Frequent exposure to high temperatures, radiation, and toxins found in common everyday objects (such as plastic bottles, cans) may affect sperm production. This can include regular sauna or spa use, long distance cycling, chemicals including pesticides and herbicides, or occupational radiation exposure.

Managing medical conditions

Conditions such as diabetes, hormone disorders, infections, and previous surgery involving the reproductive organs may affect fertility. Preconception assessment can help identify any issues that may benefit from treatment or further investigation.

When should you seek preconception advice?

You may benefit from preconception care if you:

  • Are planning pregnancy in the next 12 months
  • Have known fertility concerns
  • Have irregular periods or ovulation problems
  • Have a medical condition requiring ongoing care
  • Have experienced more than one miscarriage or pregnancy complications previously
  • Are over the age of 35
  • Are taking regular medications
  • Want to better understand your fertility and reproductive health

Even if you are not planning pregnancy in the near future, a preconception consultation can help you make informed decisions about your future fertility and family planning goals.

Frequently Asked Questions

It’s ideal to start preconception care at least three months before trying to conceive. This gives you time to optimise your health, review medications, begin recommended supplements such as folic acid for women, and address any medical concerns that may affect your chances of conceiving or a healthy pregnancy.

Yes. Male reproductive health plays an important role in fertility and pregnancy outcomes. Factors such as smoking, alcohol use, BMI, medical conditions, and environmental exposures can all affect sperm quality. Healthy lifestyle changes before conception may help improve sperm health and fertility.

A preconception consultation usually involves reviewing your medical history, lifestyle, medications, reproductive health, and any existing fertility concerns. Dr Anna may also recommend blood tests, screening, or specific fertility investigations depending on your individual circumstances.