Pregnancy Planning: Tests, Preparation, and What You Need to Know
Pregnancy planning is not just about "stopping contraception." It's a period when both partners can prepare their bodies for conception and pregnancy, identify hidden problems in advance, and reduce risks for the future child. Most doctors recommend starting preparation 3–6 months before the planned conception. This article is a practical guide: what tests to have, who to see, and what to change in your lifestyle.
Where to start: first steps
The first step is a visit to a gynaecologist. This isn't just a formality: the doctor will assess the state of your reproductive system, identify possible contraindications, order the necessary tests, and give lifestyle recommendations. If you have chronic conditions (diabetes, hypertension, thyroid disease, epilepsy) — first achieve good control of these conditions and discuss the safety of a planned pregnancy with the relevant specialist.
At the same time, start taking folic acid — 400–800 mcg per day. This should begin at least 1 month before conception (ideally 3 months). Folic acid reduces the risk of neural tube defects in the baby (spina bifida, anencephaly) by 50–70%. This is one of the few measures with proven effectiveness. Women with certain genetic variants (MTHFR mutation) may be prescribed a higher dose or methylfolate by their doctor.
Tests for women before pregnancy: a complete list
The standard set of investigations when preparing for pregnancy includes:
General tests and screening:
- Full blood count — assessing haemoglobin, detecting anaemia;
- Blood group and Rhesus factor — important for both partners to know;
- Urinalysis;
- Biochemical blood panel (glucose, ALT, AST, creatinine, urea);
- Coagulation screen (blood clotting).
Infections:
- TORCH screen: toxoplasmosis, rubella, cytomegalovirus, herpes (IgG and IgM);
- HIV, hepatitis B (HBsAg), hepatitis C (anti-HCV);
- Syphilis (VDRL/RPR);
- Cervical smear for flora and cytology (Pap smear);
- PCR for chlamydia, mycoplasma, ureaplasma (as indicated).
Hormones and thyroid:
- TSH (thyroid-stimulating hormone) — subclinical hypothyroidism impairs conception and raises miscarriage risk;
- AMH (anti-Müllerian hormone) — assessment of ovarian reserve (egg supply), especially after age 35;
- FSH, LH, oestradiol, prolactin — for cycle irregularities or suspected hormonal problems.
Imaging:
- Pelvic ultrasound — assessing the uterus and ovaries, detecting fibroids, cysts, polyps;
- Chest X-ray (if not done in the past year);
- ECG.
Genetic counselling is recommended when:
- the woman is 35 or older;
- there are genetic conditions in the family;
- there have been previous miscarriages or missed pregnancies;
- a child with developmental abnormalities has been born in the family.
Partner assessment: the male factor
The male factor accounts for approximately 40–50% of infertility in couples who cannot conceive. This means that testing only the woman is not enough. The partner is recommended to have:
- Semen analysis (spermogram) — the main test, assessing the number, motility, and morphology of sperm. Performed after 3–5 days of abstinence. WHO (2021) reference values: concentration at least 16 million/mL, motility at least 42%, normal morphology at least 4%.
- Infection tests: HIV, hepatitis B and C, syphilis, PCR for chlamydia and other STIs.
- Blood group and Rhesus factor — Rhesus incompatibility (mother Rh-negative, father Rh-positive) requires preventive management.
- Hormones (FSH, testosterone) — for abnormal semen analysis or suspected hormonal problems.
If the semen analysis shows abnormalities, don't panic: many are correctable. The next step is a consultation with an andrologist or urologist-andrologist.
When to see a fertility specialist
A reproductive endocrinologist (fertility specialist) specialises in treating infertility and assisted reproductive technologies (IVF, IUI). It's worth seeing one if:
- pregnancy has not occurred after 12 months of regular unprotected intercourse (for women under 35);
- pregnancy has not occurred after 6 months — for women aged 35 and over;
- there have been two or more miscarriages or missed pregnancies;
- one partner has a significant problem (blocked tubes, severely abnormal semen analysis, absent ovulation).
Don't wait a year if you already have known risk factors — seek help sooner. Our doctor-routing service can help you determine which specialist to see in your situation.
Lifestyle and preparing your body
The lifestyle of both partners affects egg and sperm quality, as well as the course of pregnancy. What matters:
- Stop smoking. Smoking reduces fertility in both partners and raises the risk of miscarriage, ectopic pregnancy, and birth defects. Both partners should quit — ideally before conception, not after.
- Alcohol. There is no safe level of alcohol during pregnancy. It's best to stop drinking entirely when planning and during pregnancy.
- Weight. Both excess weight (BMI over 25) and underweight (BMI below 18.5) disrupt ovulation and reduce fertility. Normalising weight before conception improves the chances.
- Physical activity. Moderate regular exercise is beneficial. Avoid exhausting training — it can disrupt the menstrual cycle.
- Stress. Chronic stress disrupts hormonal balance. Relaxation techniques, adequate sleep, and psychological support are not luxuries — they're part of preparation.
- Medications. Some drugs are contraindicated in pregnancy. Discuss all medications you take (including supplements and herbal remedies) with your doctor before conception.
If you have symptoms or questions during preparation, describe them to our assistant — it will help you decide whether to see a doctor.
Frequently asked questions
How long does pregnancy preparation take?
At minimum, 1–3 months: to complete tests, receive results, start folic acid, and adjust your lifestyle. Ideally, 3–6 months. If problems are found that require treatment, longer. Don't delay starting preparation, especially if you are 35 or older.
Do I need vaccinations before pregnancy?
Yes, if you don't have immunity to rubella and chickenpox. These infections during pregnancy are dangerous for the baby. Live vaccines (rubella, chickenpox) cannot be given during pregnancy, so they must be done in advance — at least 3 months before conception. Immunity can be checked with a blood test for IgG antibodies.
Can I get pregnant with an irregular cycle?
An irregular cycle often means irregular or absent ovulation. This reduces the chances of conception but doesn't make it impossible. Causes of irregular cycles include PCOS (polycystic ovary syndrome), hormonal disorders, stress, and sudden weight changes. A gynaecologist consultation and hormonal testing are needed.
Does the man's age affect the chances of conception?
Yes, though to a lesser extent than the woman's age. After 40–45, men experience declining sperm quality and increased DNA fragmentation in sperm. This raises the risk of miscarriage and some genetic abnormalities in the child. A semen analysis with DNA fragmentation testing can help assess the situation.
Should I take iodine when planning pregnancy?
In iodine-deficient regions, doctors recommend 150–200 mcg of iodine per day when planning and 250 mcg during pregnancy and breastfeeding. Iodine is essential for normal development of the baby's thyroid gland and brain. Discuss the dosage with your doctor — iodine is contraindicated in some thyroid conditions.
What if one partner has a chronic illness?
Most chronic conditions are not absolute contraindications to pregnancy, but they require careful preparation. Diabetes, hypertension, autoimmune conditions, epilepsy — all require achieving good control and adjusting treatment before conception. Be sure to discuss planning with the relevant specialist, not just the gynaecologist.
Symptomatica is an informational reference service. Not a medical service; does not diagnose or prescribe treatment. For any symptoms, please consult a doctor.