When couples ask me when they should start preparing for pregnancy, my honest answer is usually three months before you’d like to start trying. There’s nothing magical about the 90-day mark. It’s simply how long an egg takes to mature. The egg released this month started its final stage of development around three months ago, and sperm run on a similar timeline. Whatever was happening in your body across that window, the egg and sperm were part of it.
What does preconception care actually involve?
Less than people expect, honestly. For most of the women I work with, the three-month window comes down to understanding your cycle, getting the nutritional groundwork sorted, and dealing with whatever has been quietly off in the background. Often that’s iron that’s been borderline for years, or a cycle that’s never quite been regular. Things that were easy to ignore when the stakes were lower.
Why your cycle is the first thing to look at
A regular cycle with clear signs of ovulation is some of the best fertility information you can get, and it costs nothing to track. Cycle length and where ovulation falls, for a start. The signs are learnable too: cervical mucus changes across the cycle, waking temperature rises slightly after ovulation, and cheap urine LH strips can give you a yes or no if you’d rather not guess.
If your cycles are irregular, very long, very short, or your periods have changed recently, it’s worth understanding why before you start trying rather than discovering it six months in. This is probably my favourite part of preconception work. Watching a woman go from guessing at her cycle to actually reading it never gets old.
What blood tests are worth doing before pregnancy?
I don’t believe in testing for testing’s sake. But preconception is one of those times when a careful look at your bloodwork earns its place. Iron, thyroid, vitamin D and B12 are cheap to check and genuinely change what I’d recommend, and there are a few others I’ll add depending on your history.
If you’ve had bloods done in the past year, bring them. Results that came back ‘normal’ can still deserve a second read, because reference ranges are broad and the overall picture matters more than any single number sitting inside its bracket.
Does sperm health matter as much as egg health?
Short answer, yes. A male factor plays a part in around 40 to 50 per cent of couples who have trouble conceiving, and sperm are on roughly a three-month production cycle of their own. Nutrition, alcohol, sleep and stress all feed into that window, and so does heat, which tends to be the one that surprises men most. Sperm production runs a couple of degrees cooler than body temperature for a reason.
Preconception care that only looks at one partner is half a plan.
What I’d skip
The supplement aisle, mostly. There are a small number of supplements with decent evidence behind them in preconception, folate being the obvious one, but a cupboard full of bottles is not a fertility plan. I’d much rather see someone eating well, sleeping enough and understanding their cycle than taking twelve things on spec. And it gives us a clearer starting point if we do meet, instead of untangling what’s doing what.
If you’re thinking about trying in the next six months and want to know where things actually sit before you start, that’s exactly what my fertility naturopathy consultations are for.