Preconception health for females

Your preconception health is your physical and psychological wellbeing before you or your partner becomes pregnant.

Your preconception health matters because being as healthy as possible in the months before you become pregnant can improve:

• your health
• the health of your pregnancy
• your future child's health

Some chronic health conditions and aspects of your lifestyle can affect your ability to become pregnant, your pregnancy and your future child's health.

For example, being in poor health around the time you get pregnant can affect:

• your baby's growth in your womb
• your baby's growth after they are born
• labour and birth

Read more about healthy pregnancy.

Some chronic health conditions can affect your chances of becoming pregnant, including:

• Polycystic ovarian syndrome (PCOS) — most people with PCOS can still fall pregnant. It might take you longer. The best thing you can do is eat healthily, exercise regularly and look after your health.

• Endometriosis — about 3 in 10 people with endometriosis will have problems falling pregnant. Medicines and surgery can help. If you have endometriosis, see your doctor as early as possible before you try for a baby.
• Diabetes — both type 1 and type 2 diabetes can affect your chances of falling pregnant. You should talk to your doctor before you want to conceive to make sure your diabetes is under control.

Some aspects of your life can affect your chance of becoming pregnant. Some of these factors you can control, and others you cannot. These include your:

• age
• medical conditions
• lifestyle
• sexual health

Age and fertility

Your fertility starts to decline in your early 30s and declines more quickly after age 35.

From age 30, the risk of your baby having a chromosomal or genetic difference, along with the risk of miscarriage and pregnancy complications.

Read more about trying for pregnancy after age 35.

Medical conditions and fertility

Not all medical conditions affect your fertility — ask your doctor or midwife if you have a medical condition or are taking medicines that you think may affect your reproductive health.

Cancer and fertility

If you have a cancer diagnosis and you think you might want to have a baby in the future, it's important to talk to your doctor about your options before you start treatment. There are ways to preserve your fertility, such as freezing your eggs.

Weight and fertility

Being a healthy weight increases your chances of conceiving a healthy baby. Living with overweight or obesity can affect your ability to become pregnant. Being underweight can also affect your fertility — it may take you longer to become pregnant.

The best way to keep a healthy weight is to eat a nutritious diet and exercise regularly. If you are living with overweight or obesity, even losing just a few kilos will help.

Follow the Australian Dietary Guidelines and aim for a variety of healthy foods every day. Try to limit foods with added salt, sugar and fat.

Sexual health and fertility

Some sexually transmitted infections (STIs) can lead to infertility, pre-term birth or intrauterine growth restriction. Screening for STIs before you become pregnant can reduce the risk of passing an infection to your baby.

It's a good idea to see your doctor before trying for a baby. They can check your health and ask you questions about your lifestyle.

Based on your doctor's assessment they may make recommendations, which may include the following:

• Reviewing your medical history, including any chronic condition and your obstetrics history.
• Assessing your mental health.
• Screening for infectious diseases, including checking for STIs, HIV (human immunodeficiency virus), hepatitis B, hepatitis C, cytomegalovirus, toxoplasmosis and herpes simplex virus.
• Checking your medicines and supplements in case they are not recommended in pregnancy.
• Reviewing your family genetic history and referring you for genetic screening if relevant.
• Checking your vaccination history to see if you need any boosters, for example measles, mumps, rubella, varicella zoster, diphtheria, tetanus, whooping cough (pertussis), hepatitis B, influenza and COVID-19.

After some vaccinations you will be advised not to get pregnant for at least 28 days. Ask your doctor for specific advice.

Your doctor will also ask you questions about aspects of your lifestyle that can impact your future pregnancy and future child's health, including:

• your diet
• if you are physically active
• if you smoke cigarettes, drink alcohol or take substances
• environmental exposure — some chemicals in your home or work can affect your fertility

Your doctor will also check if you are up to date with preventive health care, including cervical screening tests.

Visiting your doctor before you conceive is also be a good opportunity to ask your doctor questions. Don't stop taking any medicines without speaking with your doctor.

Your doctor will recommend you start taking some vitamin and mineral supplements before becoming pregnant, including folic acid, iodine, vitamin D and iron.

Your doctor may suggest a blood test to see if you are low in any nutrients.

Folic acid

It is important you take folic acid supplements at least one month before you are pregnant and for the first 3 months of your pregnancy. Folic acid supplements can help prevent your baby having neural tube defects.

Your doctor will recommend you take between 400 micrograms (mcg) and 800 mcg of folic acid daily. If you have a family history of fetal neural tube defects, be sure to let your doctor know, as you may need a higher dose.

You can buy folic acid supplements from pharmacies and supermarkets. Folate is the natural form of folic acid. You can also get folate in foods such as:

• wholegrain bread
• green leafy vegetables
• some nuts and seeds

Read more on folate.

Read more about vitamins and supplements during pregnancy.

Foods and supplements you should avoid having before you start trying to get pregnant include:

• vitamin A supplements — they can increase the risk of miscarriage and other problems
• fish that has high levels mercury
• caffeine — limit it to about 3 standard cups of coffee per day because it can affect your baby's growth during pregnancy
• alcohol — it's best to avoid alcohol if you are trying to get pregnant

Quit smoking

There is no safe limit for smoking. It's important to quit smoking before you start trying for a baby. Your doctor can help. Even passive smoking is dangerous during pregnancy, so speak with your partner and other people you live with about the benefits of quitting.

If you smoke, you are more likely to have a:

• ectopic pregnancy
• miscarriage
• low birthweight baby
• premature baby
• baby with birth differences

If you smoke and you are already pregnant, it's not too late — get help with quitting as soon as you can.

Read more about smoking and vaping during pregnancy.

There is not enough research to know if complementary and alternative medicines can improve your fertility.

Complementary and alternative medicines include:

• acupuncture
• aromatherapy
• herbal medicines
• hypnosis
• massage

It's always best to talk to your doctor or midwife before starting any complementary or alternative therapies.

If you are worried that you or your partner have fertility issues, speak with your doctor. You do not need to go through this alone.

Infertility is defined as not conceiving after 12 months of unprotected regular sex. Infertility can affect up to 1 in 5 couples trying to become pregnant.

Your doctor will ask you questions about yours and your partner's personal and family medical history. They may refer you to a fertility specialist and recommend some medical tests as part of their evaluation of your fertility.

Read more about fertility tests and treatments.

To find a doctor, fertility specialist or counsellor near you, use the Pregnancy Birth and Baby Service Finder tool.

Learn more about planning for pregnancy with The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) factsheet.

The Royal Women's Hospital has more useful information about preparing for pregnancy.

The Fertility Society of Australia and New Zealand (FSANZ) has a collection of resources about fertility and infertility issues.

You can also visit Your Fertility for more information on female and male fertility.

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available from 7 am to midnight (AET), 7 days a week (including public holidays).

Do you prefer to read in languages other than English?

Your Fertility have translated some of their factsheets into languages other than English.

Looking for information for Aboriginal and/or Torres Strait Islander people?

You can find out more about Aboriginal and/or Torres Strait Islander pregnancy health at Stronger Bubba Born or watch the How to Have a Safer Pregnancy video.

Looking for information for sexually and gender-diverse families?

Visit Rainbow Families to find resources for sexually and gender-diverse families.