The months before you start trying to conceive—called the preconception period—matter more than most people realize. What you do now affects not just how quickly you might conceive, but also the health of your pregnancy and your future baby.
The good news? Most preconception steps are simple and actionable. This checklist walks you through everything you need to do, why it matters, and how to get it done.
⏰ Ideal Timeline: Start this checklist 3-6 months before you want to begin trying. Some changes (like improving sperm quality or building up nutrient stores) take time to show results. But if you're ready to start now, do what you can—any preparation is better than none.
Part 1: Medical Preparation
These steps involve your healthcare providers and help identify any issues that could affect conception or pregnancy.
🏥 Healthcare Steps
1
Schedule a Preconception Appointment
Book a visit with your OB-GYN or primary care doctor specifically to discuss pregnancy planning. This isn't just a routine checkup—tell them you're planning to try to conceive so they can focus on fertility and pregnancy-related issues.
Why it matters: Your doctor can review your medical history, adjust medications that aren't safe during pregnancy, order baseline tests, and address any concerns specific to your situation.
2
Review Your Medications
Make a list of everything you take—prescriptions, over-the-counter medications, and supplements—and review it with your doctor. Some medications need to be stopped or switched before pregnancy.
Why it matters: Certain medications (like some acne treatments, specific antidepressants, and blood thinners) can cause birth defects or pregnancy complications. Safe alternatives usually exist, but switching takes time.
3
Check Your Vaccination Status
Verify you're up to date on vaccines, especially MMR (measles, mumps, rubella) and varicella (chickenpox). These infections can be dangerous during pregnancy, but the vaccines can't be given while pregnant.
Why it matters: Rubella during pregnancy can cause serious birth defects. If you need an MMR vaccine, you'll need to wait 4 weeks before trying to conceive.
4
Get a Dental Checkup
Visit your dentist for a cleaning and checkup. Address any cavities, gum disease, or needed procedures before pregnancy.
Why it matters: Pregnancy hormones increase risk of gum disease, and severe gum disease has been linked to preterm birth. Some dental procedures and x-rays are best avoided during pregnancy.
5
Manage Chronic Conditions
If you have diabetes, thyroid issues, high blood pressure, PCOS, epilepsy, or other chronic conditions, work with your doctor to optimize your health before conceiving.
Why it matters: Well-managed chronic conditions lead to healthier pregnancies. For example, keeping blood sugar controlled before and during early pregnancy significantly reduces birth defect risk.
💡 Don't Skip This
The preconception appointment is the most important item on this list. Many women skip it, assuming they only need to see a doctor once they're pregnant. But by then, critical development has already happened. Your baby's neural tube (which becomes the brain and spine) forms in the first 28 days—often before you even know you're pregnant.
Part 2: Start Your Prenatal Vitamin
This gets its own section because it's that important. Starting prenatal vitamins before pregnancy is one of the most evidence-backed things you can do.
💊 Prenatal Vitamins
6
Start a Prenatal Vitamin with Folate
Begin taking a prenatal vitamin that contains at least 400mcg of folic acid (or methylfolate) at least one month before trying—ideally three months. This is the single most important preconception supplement.
Why it matters: Adequate folate before conception reduces neural tube defect risk by up to 70%. Since the neural tube forms before most women know they're pregnant, you need to build up folate stores in advance.
Not all prenatal vitamins are equal. Here's what to look for:
Folate (400-800mcg): The star ingredient. Look for methylfolate if you have MTHFR gene variants (about 40% of the population has some variant), though folic acid works for most people.
Iron (27mg): Supports increased blood volume during pregnancy and prevents anemia.
DHA (200-300mg): An omega-3 fatty acid crucial for baby's brain and eye development. Many prenatals don't include it, so check the label.
Choline (300-450mg): Important for brain development, but often missing from prenatals. Consider a separate supplement if your prenatal doesn't include it.
Vitamin D (600-1000 IU): Many people are deficient, and vitamin D supports fertility and healthy pregnancy.
💊
Best Overall
Nature Made Prenatal Multi + DHA
USP-verified for purity and potency (meaning what's on the label is actually in the pill). Contains folic acid, iron, and DHA. Affordable and available everywhere.
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🌿
Premium Choice
Ritual Essential Prenatal
Features methylfolate (the active form of folate), traceable ingredients, and delayed-release capsule to reduce nausea. Subscription model ensures you never run out.
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🧪
Clinically Tested
Theralogix TheraNatal Core Preconception
Specifically formulated for the preconception period. Third-party tested, developed with reproductive endocrinologists. Includes optimal nutrient forms.
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Part 3: Lifestyle Optimization
Your daily habits directly affect fertility—both yours and your partner's. These changes can improve your chances of conceiving and set the stage for a healthier pregnancy.
🌱 Lifestyle Changes
7
Quit Smoking (Both Partners)
If you or your partner smoke, now is the time to quit. Smoking affects fertility in both men and women, and exposure during pregnancy causes serious harm.
Why it matters: Smoking reduces fertility by up to 50%, increases miscarriage risk, and causes low birth weight, preterm birth, and developmental issues. Secondhand smoke also harms pregnancy outcomes.
8
Limit Alcohol
Reduce alcohol consumption significantly. There's no known safe amount during pregnancy, so many experts recommend stopping entirely once you start trying.
Why it matters: Alcohol can affect fertility in both partners. During pregnancy, it can cause fetal alcohol spectrum disorders. Since you might not know you're pregnant for several weeks, reducing intake before conception protects early development.
9
Moderate Caffeine Intake
Aim to keep caffeine under 200mg per day (about one 12oz cup of coffee). You don't need to eliminate it completely, but heavy caffeine use may affect fertility and pregnancy outcomes.
Why it matters: High caffeine intake (over 300-500mg/day) has been linked to delayed conception and increased miscarriage risk in some studies. Moderate amounts appear safe.
10
Achieve a Healthy Weight
Work toward a BMI in the healthy range (18.5-24.9) if possible. Both underweight and overweight can affect ovulation and fertility.
Why it matters: Being significantly underweight can stop ovulation. Being overweight increases risk of ovulation problems, gestational diabetes, and pregnancy complications. Even modest weight changes can improve fertility.
11
Start Exercising (Moderately)
Establish a regular exercise routine if you don't have one. Aim for 150 minutes of moderate activity per week. If you're already very active, consider scaling back intense training.
Why it matters: Regular moderate exercise supports fertility and prepares your body for pregnancy. However, excessive intense exercise can disrupt ovulation in some women.
"The preconception period is a window of opportunity—the healthier you both are going in, the better your chances of conceiving and having a healthy pregnancy."
Part 4: Learn Your Cycle
Understanding your menstrual cycle is fundamental to timing conception. Start tracking before you officially begin trying.
📊 Cycle Tracking
12
Track Your Periods
Start noting when your period begins each month. Use an app or simple calendar. After 2-3 cycles, you'll know your average cycle length—essential for predicting ovulation.
Why it matters: Knowing your cycle length helps predict your fertile window. Irregular cycles may indicate ovulation problems worth investigating before you start trying.
13
Learn to Identify Ovulation Signs
Familiarize yourself with ovulation signs: cervical mucus changes (becomes clear and stretchy like egg whites), mild pelvic pain, and slight temperature rise after ovulation.
Why it matters: Recognizing these signs helps confirm you're ovulating and identifies your most fertile days. This knowledge dramatically improves your conception timing.
14
Get Ovulation Predictor Kits Ready
Purchase OPKs (ovulation predictor kits) so you're ready when you start trying. These detect the LH surge that occurs 24-36 hours before ovulation.
Why it matters: OPKs take the guesswork out of timing. A positive test means ovulation is imminent—your most fertile time. Having them on hand means you're ready to start tracking immediately.
📊
Best Value
Easy@Home 50 Ovulation Test Strips + 20 Pregnancy Tests
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📱
Premium Digital
Clearblue Advanced Digital Ovulation Test
Identifies your 4 most fertile days each cycle by tracking both estrogen and LH. Clear smiley face results eliminate guesswork. Best for those who prefer digital confirmation.
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Calculate Your Fertile Window
Once you know your cycle length, use our calculator to predict your most fertile days.
Ovulation Calculator →
Part 5: Partner Preparation
Conception takes two. Your partner's health matters just as much as yours, especially since sperm takes about 74-90 days to fully develop. Changes made now won't fully show in sperm quality for about 3 months.
👫 For Your Partner
15
Male Fertility Optimization
Your partner should quit smoking, limit alcohol, maintain healthy weight, and consider a male fertility supplement with zinc, folate, and CoQ10. Avoid heat exposure to testicles (hot tubs, laptops on lap, tight underwear).
Why it matters: About 40% of infertility involves male factors. Sperm quality is highly responsive to lifestyle changes—but those changes take 3 months to show in mature sperm.
🧬
For Him
FertilAid for Men - Male Fertility Supplement
Contains L-Carnitine, CoQ10, zinc, and other nutrients shown to support healthy sperm count, motility, and morphology. Doctor-developed formula.
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⚡
Premium Male Formula
Theralogix ConceptionXR Motility Support
Clinical-grade male fertility formula with CoQ10, L-Carnitine, zinc, and antioxidants. Third-party tested for purity. Developed with reproductive urologists.
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Bonus: Educate Yourself
Knowledge is power when trying to conceive. Understanding how conception works, what affects fertility, and what to expect helps you make informed decisions and reduces anxiety.
One book stands out as the gold standard for fertility education:
📚
Must-Read Book
Taking Charge of Your Fertility by Toni Weschler
The definitive guide to understanding your cycle, tracking fertility signs, and optimizing conception timing. Over 3 million copies sold. Essential reading for anyone trying to conceive.
Check Price on Amazon →
🥚
Egg Quality Focus
It Starts with the Egg by Rebecca Fett
Science-based guide to improving egg quality through supplements, diet, and lifestyle. Especially valuable for women over 35 or those with diminished ovarian reserve. Extensively researched.
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Your Printable Checklist Summary
✅ Quick Reference Checklist
Medical:
☐ Schedule preconception appointment
☐ Review all medications with doctor
☐ Update vaccinations (especially MMR)
☐ Get dental checkup
☐ Optimize chronic conditions
Supplements:
☐ Start prenatal vitamin with folate (400-800mcg)
Lifestyle:
☐ Quit smoking (both partners)
☐ Limit alcohol
☐ Moderate caffeine to <200mg/day
☐ Work toward healthy weight
☐ Establish moderate exercise routine
Tracking:
☐ Start tracking periods
☐ Learn ovulation signs
☐ Get ovulation predictor kits
Partner:
☐ Partner follows same lifestyle changes
☐ Consider male fertility supplement
The Bottom Line
Preparing for pregnancy isn't about perfection—it's about giving yourself and your future baby the best possible start. You don't need to complete every item on this list before trying, but addressing the major ones (prenatal vitamins, preconception visit, stopping smoking) makes a meaningful difference.
The preconception period is your opportunity to optimize. Use it wisely, and you'll enter the trying-to-conceive phase feeling prepared, informed, and ready for whatever comes next.
Frequently Asked Questions
How long before trying should I start preparing?
Ideally, 3-6 months before you want to start trying. This gives you time for preconception appointments, building up nutrient stores with prenatal vitamins, making lifestyle changes, and allowing sperm quality to improve. But if you're ready to start sooner, do what you can—any preparation helps.
Do I really need a preconception appointment?
It's highly recommended, especially if you have any chronic health conditions, take regular medications, haven't had a checkup recently, or are over 35. Even if none of these apply, a preconception visit can identify issues you weren't aware of and ensure you're set up for success.
What if I'm already pregnant and haven't done these things?
Don't panic! Start prenatal vitamins immediately if you haven't already. Schedule your first prenatal appointment. Stop smoking and limit alcohol. Most babies turn out fine even without extensive preconception preparation—these steps just optimize your chances.
Should my partner see a doctor too?
It's a good idea, especially if he has health conditions, takes medications, or has any concerns about fertility. At minimum, he should adopt the same lifestyle changes (no smoking, limited alcohol, healthy weight) and consider a male fertility supplement.
Which prenatal vitamin is best?
Look for one with at least 400mcg folate, iron, and ideally DHA. Beyond that, the "best" one is the one you'll actually take consistently. If a prenatal causes nausea, try a different brand or take it with food or at bedtime. Third-party verified (USP, NSF) brands offer quality assurance.