preconception

Preconception is the period before fertilization when individuals or couples plan for pregnancy. It focuses on optimizing health, reducing risks, and making informed choices. Preconception care can be offered by primary care clinicians, obstetricians, or fertility specialists.

Key elements include medical history review and medication assessment for teratogenic risks, and management of chronic conditions such as diabetes, hypertension, thyroid disease, or autoimmune disorders. Providers may also discuss reproductive history and prior pregnancies to identify potential factors affecting future pregnancies.

Infectious disease screening and vaccination are commonly recommended. This typically includes testing for HIV, hepatitis B, and syphilis, and confirming immunity to rubella and varicella with vaccines as indicated. Immunization status is updated as appropriate to protect both the parent and the future child.

Nutrition and supplements are emphasized, especially folic acid at 400–800 micrograms daily before conception to help prevent neural tube defects. Additional goals include achieving a healthy weight, avoiding tobacco and illicit drugs, limiting alcohol, and moderating caffeine intake while staying physically active and avoiding hazardous exposures.

Genetic risk assessment and planning for fertility may be part of preconception care. Carrier screening for conditions such as cystic fibrosis, sickle cell disease, or thalassemias can be discussed, along with review of family history and options for genetic counseling.

For some individuals, particularly those of advanced maternal age or with chronic conditions, a preconception visit several months before trying to conceive can help optimize outcomes. Overall, preconception care aims to reduce complications and improve pregnancy health.