There is a particular moment, somewhere between deciding you would like a baby and actually starting to try, where most women think: is there something I should be doing first?
It is a good instinct, and the answer is yes, though probably less than the internet suggests and more than your GP will mention unprompted. So here is a practical, realistic checklist for the months before you start trying, organised by when to do what.
None of this is compulsory, and please do not read it as a list of ways to fail. Take what is useful and leave the rest.
Why three months matters
Almost everything in this checklist works best if you start around three months before trying, and there is a genuine biological reason for that number.
The egg you release in any given cycle began its final stage of maturation roughly ninety days earlier. Sperm take a similar seventy-two to ninety days to develop fully. So the nutritional and lifestyle environment you create over the next three months is quite literally the environment in which the egg and sperm that might become your baby are developing.
This is genuinely empowering rather than pressuring. It means preconception care is an active window where your choices count, not a passive wait.
If you are reading this and already trying, please do not worry. Start now. Everything here still helps, and there is no deadline you have missed.
Three months before: supplements
Folic acid, 400 micrograms daily. This is the one genuinely non-negotiable item. It substantially reduces the risk of neural tube defects like spina bifida, and because the neural tube closes by around week six of pregnancy, often before you know you are pregnant, taking it beforehand is what makes it effective. The NHS recommends starting before conception and continuing until twelve weeks.
A higher dose of five milligrams is recommended for some women, including those with diabetes, epilepsy on certain medications, a BMI over thirty, coeliac disease, sickle cell, or a previous pregnancy affected by a neural tube defect. Your GP can prescribe this, so do ask if any apply to you.
Some women choose methylfolate, the active form, particularly if they have a known MTHFR gene variant affecting folate conversion. The evidence on routine MTHFR testing is genuinely mixed and it is not standard NHS practice, but methylfolate is a reasonable choice and does no harm.
Vitamin D, 10 micrograms daily. The NHS recommends this for all UK adults through autumn and winter, and year-round for many of us. Deficiency is genuinely widespread here, and vitamin D is linked with hormonal balance, immune regulation and pregnancy outcomes.
A dedicated preconception multivitamin, optionally. These bundle folic acid and vitamin D with other useful nutrients. If you choose one, check it contains no vitamin A in retinol form, which is not safe in high doses in pregnancy.
Omega-3, particularly DHA. Worth considering, especially if you rarely eat oily fish. DHA supports hormone production and blood flow to the reproductive organs beforehand, and becomes important for your baby’s brain and eye development once pregnant. If you choose a fish oil, look for one tested for heavy metals, or an algae-based version if you do not eat fish.
CoQ10, worth a conversation. Every egg requires a great deal of energy to mature, produced by structures called mitochondria that rely on CoQ10. Levels decline naturally with age, and many practitioners suggest it from the mid-thirties onwards. The evidence is promising rather than definitive, and it is not standard NHS advice, so it is one to discuss rather than assume.
Iodine, if your diet is low in it. Your thyroid needs iodine to make its hormones, and requirements rise in pregnancy. Dairy, eggs and white fish are good sources. If you avoid all of these, it is worth discussing, though please avoid kelp and seaweed supplements, which can contain wildly variable and sometimes harmful amounts.
What to avoid. High-dose vitamin A or retinol supplements, and any supplement containing herbs unless you have checked them specifically. Many hormonal herbs, vitex in particular, are not recommended when trying to conceive without practitioner guidance. Be wary too of “fertility blend” products with long ingredient lists, since they often combine herbs at unclear doses without the safety data to back them.
On buying supplements. Look for products carrying a recognised quality mark, and be sceptical of anything making dramatic claims. A basic preconception multivitamin from a reputable brand does the job; the expensive fertility-branded versions are rarely meaningfully better.
Three months before: tests worth asking for
Not everyone needs all of these, and your GP may not offer them proactively, so it is worth knowing what exists.
Ferritin, not just a full blood count. Ferritin shows your iron stores rather than what is currently circulating, and you can have a normal full blood count with genuinely depleted stores. Iron matters for ovulation, energy and building your blood volume in pregnancy. Worth asking for specifically.
Vitamin D. Simple, and given how common deficiency is here, genuinely useful to know rather than guess.
Thyroid function, ideally including antibodies. Thyroid problems affect ovulation and miscarriage risk, are common in women, and are highly treatable. Standard testing often only covers TSH, so it is worth asking for free T4 and thyroid antibodies too, since antibodies are associated with miscarriage risk even when TSH is normal.
Rubella immunity. If you are not immune, you can be vaccinated before conceiving, but not during pregnancy, and rubella in pregnancy can cause serious harm. This is a genuinely important one to check in advance.
Cervical screening. If yours is due or overdue, get it done before conceiving, as it is more straightforward to do outside pregnancy.
A sexual health check. Untreated infections including chlamydia can affect fertility and pregnancy, and many cause no symptoms at all.
Anything relevant to your history. Existing conditions, medications that may need reviewing for pregnancy safety, or a family history worth discussing. Never stop a prescribed medication yourself; ask your GP to review it.
Three months before: food and lifestyle
The genuinely useful version, not the punishing one.
Build meals around protein, fibre and healthy fats. Steady blood sugar supports hormone balance and ovulation more than almost any single food. This is the foundation everything else sits on.
Eat a Mediterranean-style pattern. The eating pattern most consistently linked with fertility: plenty of vegetables, whole grains, legumes, olive oil, oily fish, nuts and seeds. Notably, full-fat dairy and generous healthy fats are associated with better outcomes than low-fat versions, so this is not a season for restriction.
Prioritise iron and folate from food alongside your supplement, with lentils, dark leafy greens, chickpeas and pumpkin seeds, paired with vitamin C to help absorption.
Reduce alcohol. There is no established safe amount in pregnancy, and heavy drinking affects fertility for both partners. Cutting back before you conceive means you are covered in those early weeks before a positive test. If those early weeks bring nausea, this is what genuinely helps.
Stop smoking and vaping. This genuinely matters for both of you, affecting egg quality, sperm quality and pregnancy outcomes. Your GP can help.
Look at caffeine. Current guidance suggests keeping to around 200mg daily in pregnancy, roughly two mugs of instant coffee. Easing down beforehand makes it less of a shock.
Move gently and regularly, walking, swimming, yoga, Pilates. Very intense, high-volume exercise can disrupt ovulation, so this is a season for moderate movement.
Protect your sleep. Melatonin, produced in darkness, is a powerful antioxidant that protects developing eggs, and sleep regulates the cortisol rhythm underlying everything else.
Three months before: your partner
This gets skipped constantly, and it should not, since male factor is involved in around half of fertility difficulties.
Sperm take seventy-two to ninety days to develop, so his three-month window matters exactly as much as yours. Worth him focusing on zinc, selenium, CoQ10, folate, omega-3 and antioxidants, mostly from food, with a decent men’s supplement as backup.
Practically: avoiding excessive heat from hot baths, saunas and laptops on laps; reducing alcohol; stopping smoking; and moderate rather than extreme exercise. If there is any history of concern, a semen analysis is a simple, non-invasive test that is very often left far too late.
Doing this together also makes the whole thing feel shared rather than like one more thing on your list alone.
Three months before: the practical and emotional groundwork
The parts of preconception that nobody puts on a checklist, but which genuinely matter.
Dental care. Gum disease has associations with pregnancy complications including preterm birth, and dental treatment is more straightforward before pregnancy than during it. NHS dental care is free while pregnant and for a year after birth, so it is worth registering if you are not already.
Review your medications with your GP. Some common medications are not suitable in pregnancy and need switching to alternatives, and this is genuinely better done in advance than in a panic at six weeks. This includes some antidepressants, epilepsy medication, acne treatments including isotretinoin, and certain blood pressure medications. Please never stop anything yourself; the risks of untreated conditions are often greater than the medication.
Consider your workplace exposures. Some occupations involve exposure to chemicals, radiation or heavy lifting that warrant adjustment. If this applies to you, knowing your rights in advance is useful.
Look at your household products. This one gets overstated online, so I will keep it proportionate. There is reasonable evidence around reducing exposure to certain endocrine-disrupting chemicals, particularly BPA in plastics and phthalates in fragranced products. Simple swaps like not heating food in plastic and choosing fragrance-free where easy are sensible without becoming another source of anxiety.
Talk about the actual practicalities. Money, leave, childcare, where you might live, how you will divide things. These conversations are considerably easier before you are pregnant and hormonal and tired.
Think about your support. Who would you tell early. Who would you want around after the birth. Whether you have people nearby or need to build that. This sounds premature, but the women who fare best postnatally are usually the ones who arranged support before they needed it.
One to two months before: learning your cycle
Start tracking, so that when you begin trying you already understand your own pattern rather than guessing.
Cervical mucus is the most useful natural sign, becoming clearer, wetter and stretchier as you approach ovulation. Basal body temperature, taken each morning before getting up, confirms ovulation has happened through a small sustained rise. Ovulation predictor kits detect the LH surge twenty-four to thirty-six hours beforehand.
Your fertile window is roughly the five days before ovulation plus the day itself, since sperm survive up to five days. Knowing this saves a great deal of guesswork later.
If you have recently come off hormonal contraception, give yourself a few months for your natural rhythm to re-establish, and lean on your actual daily signs rather than assuming a textbook cycle length.
The month you start trying
Keep going with your folic acid and vitamin D. Have sex every two to three days across your cycle rather than trying to time it perfectly, since this covers your fertile window without the pressure of precision timing, and is genuinely as effective.
Know that most couples conceive within a year, and around a third within the first three months. Do not measure yourself against a single cycle.
And know when to ask for help: after a year of trying, or six months if you are thirty-six or older, or sooner if your cycles are very irregular or absent, you have a known condition, or you have had recurrent miscarriage. Asking early is sensible, not impatient.
A note on the two week wait. The stretch between ovulation and when you can test is genuinely hard, and it does not get easier with practice. Early pregnancy symptoms and premenstrual symptoms are largely indistinguishable, because both are driven by progesterone, so symptom-spotting tends to cause more distress than clarity. Testing too early gives unreliable results; most tests are accurate from the day your period is due, and waiting until then, while nearly impossible, does save a great deal of confusion over faint lines.
What is genuinely normal. Around eight in ten couples conceive within a year of trying, and around nine in ten within two years. A month where it does not happen is overwhelmingly likely to be ordinary chance rather than a sign of a problem, since even in perfect conditions the chance of conceiving in any given cycle is roughly one in four.
If it takes longer than you expected, that is not a failure of your preparation. Plenty of women do everything in this article and still need help, and plenty do none of it and conceive immediately. Preconception care improves your foundations; it does not control the outcome, and holding that distinction protects you from a great deal of self-blame.
The version if you only do three things
If the full list feels like too much, this is the honest short version.
Take folic acid and vitamin D daily. Eat regularly, with protein at every meal. And get your thyroid, ferritin and rubella immunity checked.
Everything else is genuinely helpful, but those three cover the highest-value ground, and doing three things properly beats doing fifteen things anxiously.
A gentle last word
Preparing for pregnancy is not a test to pass, and there is no gold star for perfect preparation. Some months you will do all of this beautifully and some months you will manage the vitamin and an early night, and that is entirely fine.
Your body is not waiting to be optimised. It is already remarkable. This is simply about giving it good raw materials and a bit of care while it does something extraordinary.
A gentle note
This article is for gentle, supportive education and is not medical advice. Please discuss supplements, tests and any existing medication with your GP, and never stop prescribed medication without medical advice. If you have been trying to conceive for over a year, or over six months if you are 36 or older, please ask about investigation.
If you would love someone to walk this with you, rather than working through it alone, that is exactly what I do. I offer warm, personalised preconception coaching, building a plan around your body, your results and your real life.
Written by
Brydee Thomas
Holistic health coach and founder of Radiant Bloom, supporting women through trying to conceive, pregnancy and the postpartum months. Evidence-based guidance, no programmes and no generic plans.