A preconception visit is a 30-minute appointment that can save you months of worry later. Your doctor will review your medications, check your vaccine status (rubella and varicella are critical), order baseline bloodwork (thyroid, blood type, STI screen), and address any chronic conditions. Both partners benefit from a preconception check, but the male visit is often skipped.
Why a Preconception Visit Matters
Most people skip this step and go straight to “let's stop using birth control and see what happens.” That works for many couples. But a preconception visit catches things that are much easier to address before pregnancy than during it — things like an undiagnosed thyroid issue, a medication that needs to be switched, or a vaccine gap that could put a pregnancy at risk.
Think of it as a pre-flight checklist. The plane will probably fly fine without it, but the check takes 30 minutes and can prevent serious problems.
The Checklist
Medications Review
Some commonly prescribed medications are harmful in pregnancy and need to be stopped or switched before you conceive:
- Isotretinoin (Accutane): Causes severe birth defects. Must be stopped and cleared from your system at least one month before conceiving.
- Certain antidepressants: Some SSRIs are safer than others during pregnancy. Your doctor can switch you to a pregnancy-compatible option. Do not stop antidepressants abruptly without medical guidance.
- ACE inhibitors / ARBs: Common blood pressure medications that can cause kidney damage in a developing fetus. Switch to a pregnancy-safe alternative like labetalol or nifedipine.
- Retinoids (topical vitamin A): Prescription acne and anti-aging creams containing tretinoin or adapalene. Switch to azelaic acid or other pregnancy-safe alternatives.
- Statins: Cholesterol medications should be stopped before and during pregnancy.
- Valproic acid: Seizure medication with high teratogenic risk. Needs to be switched to a safer anticonvulsant before TTC.
Vaccines
Two vaccines are critical to check before TTC because the diseases they prevent can cause devastating harm to a developing fetus, and the vaccines themselves cannot be given during pregnancy:
- MMR (measles, mumps, rubella): Rubella infection during pregnancy causes congenital rubella syndrome (heart defects, deafness, intellectual disability). If you're not immune (check with a blood test), get vaccinated and wait one month before TTC.
- Varicella (chickenpox): Chickenpox during pregnancy can cause birth defects and neonatal varicella. If you're not immune, get vaccinated and wait one month.
Other vaccines to discuss: flu shot (safe during pregnancy and recommended), Tdap (given during each pregnancy, usually week 27–36), COVID-19 (safe during pregnancy), and hepatitis B (if not previously vaccinated).
Bloodwork
| Test | Why It Matters |
|---|---|
| Complete blood count (CBC) | Checks for anemia, which is common and easily treated before pregnancy |
| Blood type + Rh factor | Rh-negative mothers need Rhogam injections during pregnancy to prevent complications |
| Rubella immunity (IgG) | Confirms vaccine protection; get MMR if not immune |
| Varicella immunity (IgG) | Same rationale as rubella |
| STI screen (chlamydia, gonorrhea, syphilis, HIV, hepatitis B) | Untreated STIs can cause fertility problems and pregnancy complications |
| TSH (thyroid function) | Subclinical thyroid issues affect ovulation and increase miscarriage risk |
| Pap smear | If due — cervical procedures are more complicated during pregnancy |
| Vitamin D level | Deficiency is linked to fertility issues and pregnancy complications; easily supplemented |
For Him
Men don't traditionally have a “preconception visit,” but they should. At minimum: review medications (finasteride for hair loss reduces sperm count; testosterone replacement shuts down sperm production entirely), stop smoking, reduce alcohol, and start a male fertility supplement stack (zinc, CoQ10, vitamin D) 2–3 months before TTC.
The conversation checklist
Bring this list to your appointment:
- All current medications and supplements
- Your menstrual cycle history (average length, regularity)
- Any prior pregnancies, miscarriages, or gynecological surgeries
- Family history of genetic conditions (cystic fibrosis, sickle cell, Tay-Sachs, etc.)
- Mental health history and current treatment
- Questions about genetic carrier screening (optional but available)
Start Your TTC Journey Informed
Understanding your body is the first step. Our complete beginner's guide walks you through everything.
Read the TTC Guide