Preconception Guidance

The American Society for Reproductive Medicine (ASRM) provides detailed guidance for individuals and couples preparing for pregnancy. Key recommendations, focusing on both general preconception health and fertility considerations, are summarized here.

Schedule a Preconception Visit

Meet with your OB/GYN or reproductive specialist to review medical history, medications, vaccinations, and lifestyle.

Prenatal Vitamins and Folic Acid

Take 400–800 mcg (0.4-0.8 mg) of folic acid daily starting at least one month before conception to prevent neural tube defects. Most over-the-counter prenatal vitamins contain this amount of folic acid. Some women may need more (e.g., those with epilepsy, diabetes, or a previous child with a neural tube defect). Speak with your OB/GYN or reproductive specialist for specific recommendations.

Healthy Lifestyle

• Nutrition: Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein.
• Exercise: Maintain regular physical activity. It is highly encouraged and scientific research reveals completing high intensity work-outs of 30 minutes three times a week have no ill effects on pregnancy.
• Weight: Being underweight or overweight can affect ovulation and fertility. Aim for a healthy BMI (18.5–24.9). There is considerable scientific information about the effect of obesity in not only infertility outcomes but also pregnancy outcomes.  Your BMI (Body Mass Index) is easy to calculate. If you are in the overweight, obese or extremely obese categories, weight loss is strongly encouraged to help you get pregnant and carry a healthy pregnancy. The CDC online calculator for BMI can be found at: www.cdc.gov/bmi/adult-calculator/index.html
• Substance Use: Quit smoking, alcohol, and recreational drugs. These can negatively affect fertility and fetal development.
• Limit exposure to toxic substances like pesticides, heavy metals, and certain cleaning products.

Medical Conditions and Medications

Conditions like diabetes, thyroid disorders, hypertension, asthma  should be well-controlled before conception. Mental health is also important—seek support if needed for anxiety, depression, etc.

Review all current and recent medications with your OB/GYN or reproductive specialist. Some prescription and over-the-counter medications or herbal supplements may not be safe during pregnancy. The organization, “Mother To Baby”, can provide guidance on the safety of medications in pregnancy and when trying to conceive. More information can be found on their website: www.MotherToBaby.org 

Genetic Conditions 

All couples should consider screening for being a carrier of cystic fibrosis.  Specific ethnic groups may consider specialized testing including:

• Ashkenazi Jews (Tay-Sachs disease, Canavan disease, Gaucher disease)
• Mediterranean and Asians (alpha and beta thalassemias)
• African-American (sickle cell disease & other hemoglobinopathies)

Immunizations

Ensure vaccinations are up-to-date, particularly for rubella, varicella, Tdap, hepatitis B, COVID-19, and influenza.

Reduce Stress

Chronic stress can impact fertility and overall well-being. Consider mindfulness, yoga, therapy, or whatever works best for you.