Your Preconception Checklist

Trying to conceive can be an exciting, emotional, often challenging process. 

For many it requires planning and effort. If you’re thinking of getting pregnant, supporting your overall health and fertility will optimize your outcomes. 

Not sure where to start? Consider this your preconception checklist, geared towards getting your body baby-ready. 

Audit Your Cycle

It’s probably not surprising that your cycle is a main marker of your fertility. In addition to having a consistent period, you’ll also want to consider your:

• Cycle Length. A healthy cycle should be 24-36 days long (that’s period to period). If yours is longer, shorter, or irregular, you’re likely experiencing hormonal imbalances that could interfere with your ability to get pregnant. 

• Period Length and Flow. A healthy period is 3-7 days in length, with at least one medium to heavy day. That means that on those heavier days, you’re filling at least 3-5 full regular tampons or pads (or about 15-25 ml per day, if using a cup). 

  We don’t want your period to be so heavy that you’re changing products every hour, but also not so light that you could wear the same tampon all day. Periods are a reflection of hormonal health, so addressing imbalances will support a healthy pregnancy.   

• PMS and pre-period symptoms. The symptoms you feel right before and during your period should never be ignored.

“At R&R, we refuse to accept that heavy, painful periods are just an unfortunate part of life. They’re common, but shouldn’t be accepted as the norm. ”

If you’re anxious, moody, or irritable, if you find yourself crying for no reason or are having trouble sleeping the week before your period, you might have low progesterone. This hormone is essential for supporting a healthy pregnancy and for preventing miscarriages.

Heavy periods (changing period products every hour or having periods that last more than a week) and terrible cramps signal low progesterone and/or high estrogen. Balancing these two hormones will improve your quality of life and chances of conception.

Get Your Bloodwork and Fertility Markers Checked

Preconception is a great time to check on your hormones, nutrient status, overall health and ovarian health.

Here is a sample list of fertility and health markers we recommend getting checked. Bring it with you to your next doctor’s appointment and request that they check as many of these markers as possible:

• Free & Total Testosterone

• DHEA

• Estrogen

• Progesterone

• FSH

• LH

• SHBG

• B12

• Vitamin D

• Thyroid panel: TSH, Total and Free T4, Total and Free T3, Reverse T3, Anti-TPO, Anti-thyroglobulin

• Iron Panel: TIBC, ferritin, serum iron, transferrin saturation %

• Fasting glucose

• Fasting insulin

Some may benefit from getting their ovarian reserve tested in order to know how many healthy eggs they have left. This is especially important if you’ve been trying for over 6 months without success or if you’re in your mid-to-late thirties and beyond. This test includes:

• FSH

• Estradiol/Estrogen

• Anti-müllerian Hormone (AMH)

• Vaginal ultrasound (antral follicle count or AFC)

There are also other tests available – like DUTCH testing (for your hormones), stool testing (for your gut health), and nutrient deficiency testing – that will shed light on your overall health. Talk to your trusted healthcare provider about which tests are best for you. 

In terms of supplements, most women and couples benefit from taking a quality prenatal, an Omega-3 fatty acid and magnesium. These support you and your growing baby before, during and after pregnancy. 

Nutrition, Exercise and Stress

This advice seems annoyingly simple. “Eat well! Exercise! Rest!” Eyeroll. But it’s true. What you eat, how you move your body, how well you sleep and manage stress has an enormous impact on your overall health. It also has a direct impact on your fertility. 

In a culture that emphasizes thinness and dieting, a vital piece of advice often gets lost: you need to feed your body enough food. This means 3 meals a day, with snacks if needed, focusing on whole foods and adequate protein. Most women should aim for at least 100g of protein per day.

Exercise is crucial too. Focusing on building strength and muscle mass not only supports your hormones and fertility, but also your body’s resiliency throughout pregnancy and in the postpartum period. 

Optimizing sleep and reducing stress are two non-negotiables when getting your body ready for conception (or anytime, for that matter). This means getting 7-9 hours of uninterrupted sleep per night, having a relaxing evening routine, practicing daily stress relieving activities like walking, sex or other forms of intimacy, yoga, or meditation. These are fabulous ways to support your fertility. 

It’s not always clear what steps to take when preparing for pregnancy. We’re often told that some are simply abundantly fertile and that they’ll get pregnant easily, while others struggle. And though many will need interventions like IUI or IVF – through no fault of their own – there are some ways that we can work to better support our bodies in the hopes of conceiving. 

Whether you’re planning your conception or already trying, it’s never too late to think about your cycle, to reach out to your doctor, to prioritize food, movement, and sleep.