Preparing to Get Pregnant: Evidence-Based Fertility Tips

Folic acid supplementation, taken at least one month before conception and continuing through the first trimester, reduces the risk of neural tube defects by up to 70 percent, according to research that led to widespread public health recommendations for this practice (Centers for Disease Control and Prevention, 2022). This represents one of the most well-established, evidence-backed interventions available to those preparing to conceive.

A daily supplement containing 400 to 800 micrograms of folic acid is generally recommended for anyone planning pregnancy, since neural tube development occurs very early, often before pregnancy is even confirmed. Prenatal vitamins typically include this amount alongside other nutrients such as iron and vitamin D, addressing several nutritional needs relevant to early pregnancy simultaneously.

Both significantly low and significantly high body weight are associated with reduced fertility and increased pregnancy complications. Body weight affects hormone levels, including those governing ovulation, meaning that weight within a healthier range for a given individual can support more regular ovulation and improve conception odds. This does not mean a specific number on a scale is required, but rather that significant deviation from a healthy range in either direction carries measurable fertility implications.

Smoking has been linked in multiple studies to reduced fertility in both men and women, along with increased risk of pregnancy complications, making cessation a clearly evidence-supported step before conceiving. Alcohol consumption should generally be reduced, and many clinicians recommend eliminating it entirely once actively trying to conceive, given that pregnancy can occur before it is confirmed and early alcohol exposure carries developmental risks.

Conditions such as diabetes, thyroid dysfunction, and high blood pressure benefit from being well controlled before conception, since poorly managed chronic conditions are associated with higher rates of pregnancy complications and, in some cases, reduced fertility itself. A preconception visit with a primary care provider or obstetrician allows for review of current medications, some of which may need adjustment before pregnancy due to safety considerations.

Certain vaccinations, including those for rubella and varicella, are recommended to be up to date before pregnancy, since these infections can cause serious harm to a developing fetus if contracted during pregnancy, and some vaccines cannot be safely administered during pregnancy itself.

Research on caffeine and fertility has produced mixed results, though some studies suggest that very high caffeine intake, generally defined as more than 500 milligrams daily, roughly five cups of coffee, may be associated with modestly reduced fertility (Practice Committee of the American Society for Reproductive Medicine, 2017). Moderate intake, generally considered up to 200 to 300 milligrams daily, has not shown a consistent negative association in the research.

Preconception planning is about more than fertility timing. Folic acid, medication review and general health are important too.