Preparing your body for pregnancy ideally starts three to six months before you try to conceive. That window gives you time to build up key nutrients, address any health issues, and create the best possible environment for a healthy pregnancy. Here’s what that preparation looks like in practice.
Start Folic Acid Early
Folic acid is the single most important supplement to start before pregnancy. It dramatically reduces the risk of neural tube defects, which are serious birth defects of the brain and spine that develop in the very first weeks of pregnancy, often before you even know you’re pregnant. The CDC recommends 400 mcg of folic acid every day for all women capable of becoming pregnant, starting at least one month before conception. If you’ve had a previous pregnancy affected by a neural tube defect, the recommendation jumps to 4,000 mcg daily.
Most prenatal vitamins contain the right amount of folic acid, so switching from a regular multivitamin to a prenatal a few months ahead of time is an easy way to cover this base. Beyond folic acid, your prenatal should include iodine. The American Thyroid Association recommends women planning a pregnancy supplement with 150 mcg of iodine daily, since your needs rise from 150 to 220 mcg once you’re pregnant. Iodine supports your thyroid, which plays a central role in fetal brain development.
Schedule a Preconception Checkup
A preconception visit is different from a regular physical. Your doctor will take a full medical history from both you and your partner and run targeted bloodwork. Expect screening for rubella and chickenpox immunity (since these infections during pregnancy can cause serious complications), hepatitis B, HIV, thyroid function, and common sexually transmitted infections like chlamydia, syphilis, and gonorrhea.
Depending on your ethnic background and family history, your doctor may also recommend genetic carrier screening. This can identify whether you carry genes for conditions like sickle cell anemia, thalassemia, cystic fibrosis, or Tay-Sachs disease. If both you and your partner carry a gene for the same condition, a genetic counselor can walk you through what that means for your future child. None of these screenings are urgent on their own, but they’re far more useful before pregnancy than after.
Review Your Medications
Some prescription and over-the-counter medications need to be stopped or switched well before you conceive. Isotretinoin, the acne medication formerly sold as Accutane, is one of the most well-known examples. It causes severe birth defects and must be out of your system before pregnancy. Certain antidepressants, lithium for bipolar disorder, and some seizure medications like phenytoin also require a supervised transition to safer alternatives.
Even common painkillers matter. Ibuprofen should be avoided during pregnancy, and aspirin is only safe when specifically prescribed. If you take any regular medication, bring it up at your preconception visit so your doctor can map out a plan. Some medications take weeks to taper safely, which is another reason to start this process months ahead.
Work Toward a Healthy Weight
A BMI between 18.5 and 24.9 is associated with the best chances of conceiving naturally and the lowest risk of pregnancy complications. Being significantly above or below that range can disrupt ovulation, making it harder to get pregnant in the first place. It also raises the risk of gestational diabetes, preeclampsia, and preterm birth.
If your weight is outside the healthy range, even modest changes help. Losing 5 to 10 percent of your body weight can meaningfully improve fertility for women who are overweight, and gaining a few pounds can restore regular cycles for women who are underweight. The goal isn’t perfection. It’s moving in the right direction before conception rather than trying to course-correct during pregnancy.
Find the Right Exercise Balance
Regular physical activity improves fertility, mood, and stamina for pregnancy, but intensity matters more than most people realize. More than an hour of vigorous exercise a day can suppress the hormones that drive ovulation, potentially causing your ovaries to stop releasing eggs. The risk increases with both duration and intensity.
If you’re at a healthy weight, there’s no need to give up running or high-energy classes. Just keep workouts to an hour or less. If your cycle becomes irregular or you haven’t conceived after a few months, scale back further. If you’re underweight and exercising five or more days a week, cutting back to three sessions may help restore fertility. If you’re overweight, aim for about 60 minutes of cardio five days a week plus some strength training, but build up gradually. Overtraining is possible at any weight.
Clean Up Your Environment
Certain chemicals act as endocrine disruptors, meaning they interfere with the hormones that regulate your reproductive system. BPA, found in some plastics and can linings, has been shown to compromise embryo implantation. Phthalates, used to make plastics flexible, show up in everything from vinyl flooring to personal care products. Flame retardants called PBDEs are common in electronics and furniture. Even low levels of lead can alter reproductive hormones in premenopausal women.
You can’t eliminate every exposure, but practical steps make a difference. Switch to glass or stainless steel food containers instead of plastic. Choose fragrance-free personal care products, since “fragrance” on a label often contains phthalates. Wash your hands before eating to reduce contact with chemical residues. Ventilate your home when using cleaning products. These changes are worth making before pregnancy, since the earliest weeks of fetal development are the most sensitive to chemical exposure.
Plan Around Your Birth Control
How quickly fertility returns depends entirely on what method you’re using. If you’re on the pill, a skin patch, or a vaginal ring, you can technically get pregnant right away after stopping. About half of women conceive within three months of quitting the pill, and most do within 12 months. With a copper or hormonal IUD, fertility typically returns with your very first cycle after removal.
The major outlier is the injectable shot (Depo-Provera). It can take anywhere from 3 to 18 months after your last injection for fertility to return. If you’re on the shot and want to get pregnant within the next year, talk to your doctor about switching to a shorter-acting method in the meantime. This is one of the easiest things to overlook and one of the most time-sensitive.
Your Partner’s Health Matters Too
Sperm quality is shaped by lifestyle choices in the two to three months before conception, since that’s roughly how long it takes for new sperm to develop. Research from the Mayo Clinic links higher BMI in men with lower sperm counts and reduced sperm movement. Smoking, heavy alcohol use, and recreational drugs all damage sperm directly.
Heat is another factor. Frequent use of saunas, hot tubs, or even sitting for long periods with a laptop can raise scrotal temperature enough to impair sperm production. Wearing loose-fitting underwear and taking breaks from prolonged sitting may help. Stress management matters as well, since chronic stress can lower sex drive and disrupt the hormones needed to produce healthy sperm. If your partner works around industrial chemicals, pesticides, or heavy metals, wearing protective equipment and avoiding direct skin contact with these substances is important during the preconception window.
Build Habits That Carry Into Pregnancy
The preconception period is also a good time to quit smoking, cut back on caffeine, and eliminate alcohol. Fetal alcohol spectrum disorders can result from drinking in the earliest weeks of pregnancy, before many women realize they’ve conceived. Getting your intake to zero before you start trying removes that risk entirely.
Focus on nutrient-dense eating: leafy greens and legumes for folate, seafood and iodized salt for iodine, red meat or beans for iron stores (your blood volume will increase significantly during pregnancy, and starting with strong iron reserves helps prevent anemia). Building these habits now, rather than overhauling your diet once you see a positive test, means your body is already in its best condition during the critical first trimester when organs are forming.