Why Preconception Planning Matters

Your health before conception influences:

• Ease of conceiving

• Ovulation and sperm function

• Implantation and embryo development

• Pregnancy outcomes such as miscarriage, pre-eclampsia, and gestational diabetes
  

The 3–6 months prior to conception are particularly important for:

• Improving egg and sperm quality

• Balancing hormones

• Creating a healthy uterine environment

• Supporting early placental development
  

Small, targeted changes can create meaningful improvements in fertility for both partners.

Preconception Health Check

For Women

A preconception review includes:

• Cycle length, ovulation patterns, menstrual regularity

• Consider specific causes of fertility delay such as issues with ovulation, tubal function, uterine anomalies (polyps, fibroids), hormonal and genetic imbalances. 

• Past pregnancies or fertility treatments

• Medical conditions:

• PCOS

• Thyroid disease

• Endometriosis

• Diabetes

• Autoimmune conditions

• Medication review

• Immunity screening: rubella, varicella, hepatitis B, C, HIV

• Ensuring chronic conditions are optimised

• Baseline fertility testing if appropriate (AMH, hormones, ultrasound)

For Men

Male factors contribute to 40–50% of fertility challenges.

A preconception check involves:

• Semen analysis (simple, inexpensive, high value)

• General health assessment

• Review of lifestyle factors

• Screening for conditions such as varicocele or hormonal imbalance

• Reviewing workplace exposures (heat, chemicals, solvents)

• Consider testicular, ejaculatory and genetic concerns. 

Start Prenatal Supplements Early

For Women

Begin at least 1 month before conception.

• Folic acid 400–500 µg daily (Higher dose for elevated BMI, diabetes, epilepsy, or increased NTD risk)

• Iodine 150 µg daily

• Vitamin D, iron, B12, omega-3

• Consider:

• CoQ10 for mitochondrial support

• Probiotics for vaginal and gut microbiome balance

For Men

Evidence supports supplements such as:

• Zinc

• Selenium

• CoQ10

• Vitamins C & E

• Omega-3 fatty acids

• L-carnitine

These can improve sperm motility, morphology, and DNA integrity.

Lifestyle Optimisation

Nutrition

A Mediterranean-style diet supports fertility in both men and women, it improves:

• Ovulation rates

• Sperm motility and DNA integrity

• Implantation and pregnancy outcomes

Focus on:

• Colourful vegetables, whole grains, olive oil, legumes, fish, nuts

• Minimising refined and ultra-processed foods

Weight and Metabolic Health

Both underweight and overweight ranges can disrupt fertility.

• BMI >30: impaired ovulation, reduced sperm quality, increased pregnancy risks

• BMI <18.5: suppressed ovulation and hormonal disruption

Optimising metabolic health - including insulin resistance, blood pressure, and lipids — is central to preconception care.

Exercise and Movement

Aim for 150 minutes per week of moderate exercise plus strength training.

Excessive endurance exercise may:

Suppress ovulation in women

• Reduce testosterone and sperm production in men

We tailor guidance if you are an athlete or highly active.

Alcohol, Smoking, Vaping, Caffeine

• Avoid smoking and vaping entirely

• Limit alcohol to <5 drinks/week

• Keep caffeine <200 mg/day (~1-2 small coffees)

Sleep, Stress, and Travel

Chronic stress and poor sleep interfere with hormonal rhythms and reproductive function. Helpful strategies:

• Mindfulness, meditation, yoga

• Cognitive behavioural therapy

• Consistent sleep routine with 7-8 hours nightly

Travel may cause temporary cycle changes (traveller’s amenorrhoea) due to melatonin disruption and altered routines.

Environmental Toxins

Reduce exposure to endocrine disruptors such as BPA, phthalates, and pesticides. Practical steps:

• Use stainless steel or glass containers

• Avoid microwaving plastics

• Choose low-tox skincare and cleaning products

• For men: avoid prolonged high-heat exposure; use PPE around chemicals or solvents

Understanding Ovulation Timing

Natural conception relies on timing the fertile window:

• The fertile window = the 5 days before ovulation + ovulation day

• The egg lives 12-24 hours

• Sperm live up to 5 days

• Ovulation occurs 24-36 hours after the LH surge

Ovulation tracking options include:

• Cycle charting

• LH urine kits

• Ultrasound tracking

• Mid-luteal progesterone