Preconception Care

Most people come to us the month they decide to start trying. There's no wrong time to walk in, but if you have a few months up your sleeve, there's a lot we can do with them.

Preconception care is the quiet, unglamorous work of getting your body and your questions in order before you're pregnant. Bloods, cycles, screening, medications, your partner's health.

It isn't about being perfect. It's about starting from a known position rather than a guess.

Why the months before matter

An egg takes roughly three months to mature from a dormant follicle to ovulation. Sperm take about the same. The health you carry through autumn shows up in the cells you conceive with in summer. It's one of the few parts of fertility you can genuinely influence, and it's the part most often skipped.

Preconception care uses that window. We look at what's already going on, correct what's correctable, and give you a clear picture before there's a pregnancy in the middle of it. If something needs investigating, whether a thyroid that's drifting, iron stores that are low or a cycle that isn't behaving, it is far easier to sort out now than at ten weeks.

What we actually look at

A preconception appointment is mostly conversation and history-taking, followed by a targeted set of tests. Depending on your history, that usually includes:

• Baseline bloods: thyroid function, iron studies, vitamin D, blood group and antibodies
• Immunity to rubella, chickenpox and other vaccine-preventable infections
• Cervical screening, if you're due
• A proper look at your cycle: length, regularity, bleeding, pain, and how you're tracking ovulation
• Carrier screening for conditions such as cystic fibrosis, spinal muscular atrophy and fragile X
• A review of every medication and supplement you take, including the ones you'd never think to mention

We'll also talk about folate and iodine, alcohol, smoking and vaping, sleep, weight and movement, without the lecture. Dr Miranda Myles works pathology-first, on a "test, don't guess" principle, and can go further into nutrition and hormonal support alongside your medical care.

Partners are half of this

Roughly a third of fertility difficulty is male-factor, and another third involves both partners. A semen analysis is a simple test and it's worth doing early rather than after a year of trying and wondering. We'll also ask about medications, alcohol, heat exposure, past surgery and family history. Both of you are welcome at every appointment, and most couples find it easier that way.

Some situations shift the timeline, and it's worth coming in sooner rather than waiting for a tidy three-month run-up. Book earlier if you:

• are 35 or older, or your partner is over 45
• have irregular or absent periods, or heavy and painful ones
• have known endometriosis, PCOS, fibroids or a thyroid condition
• have had two or more miscarriages, or a previous preterm birth
• have had chemotherapy, pelvic surgery, or a family history of early menopause
• take regular medication for a chronic condition, as some need reviewing before pregnancy

If you're not ready yet

Preconception isn't only for people trying this year. If you know you want children but the timing isn't right, this is the appointment where egg freezing gets discussed honestly: what the process involves, what ovarian reserve testing can and can't tell you, and what age does to the numbers. We won't push you towards it. We'd rather give you the information while it's still useful to you.

Whatever you decide, you'll leave with a written plan and a clear sense of what happens next.