Pre-conception advice (Pre-conception (preconception) care and counselling)

What is pre-conception advice?

Pre-conception advice is help to get your health in good shape before you try for a baby. The weeks and months before pregnancy, and the very early weeks afterwards, matter a great deal for both you and a future baby, often before many people even realise they are pregnant.

An appointment covers practical steps that are known to help: taking folic acid (and vitamin D), reaching a healthy weight, stopping smoking, avoiding alcohol, reviewing your medicines, checking you are protected against infections such as rubella, and planning around any long-term health conditions. It is also a chance to talk about how long it can take to conceive and when to seek help if you do not.

This is general planning advice for people who are well, not fertility treatment. If you have a known fertility problem, a previous pregnancy complication, a long-term condition, take regular medicines, or have a family history of an inherited condition, pre-conception advice is especially worthwhile, as some things are best sorted out before rather than during pregnancy.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your appointment

• Note your menstrual cycle pattern and how long you have been trying or plan to try.
• List all your medicines and supplements, including anything bought without a prescription, and do not stop prescribed medicines before the appointment.
• Write down your medical history and any previous pregnancies, including any complications or losses.
• Note your family history and your partner's, especially inherited conditions.
• Check your vaccination history, particularly whether you have had two doses of MMR (for rubella protection).
• Be ready to talk honestly about weight, smoking, alcohol and recreational drugs, as advice is tailored to these.
• Bring your questions, including how long conception can take and when to seek help.

What happens

The clinician asks about your general health, periods, any previous pregnancies, your medicines, lifestyle and family history, and sometimes your partner's health too. They may check things such as your weight and blood pressure.

You then discuss a personalised plan. This usually covers the right dose of folic acid and vitamin D for you, reaching a healthy weight, stopping smoking, avoiding alcohol, food and workplace safety, and checking vaccinations such as rubella immunity. Any long-term conditions and medicines are reviewed so they can be managed safely around pregnancy, and any family history is considered.

Some people are offered blood tests (for example to check rubella immunity, blood count or thyroid function) or vaccinations, or are referred on — for example for genetic counselling or to a specialist if they have a complex condition. You leave with clear advice and a plan, rather than a procedure.

Is this appointment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Pre-conception advice lowers some risks but cannot remove them or promise a healthy pregnancy. The most important practical points are starting the right dose of folic acid early, not stopping prescribed medicines without advice, and getting any long-term condition well controlled before trying. If you have diabetes, take certain anti-epileptic medicines, have a personal, partner or family history of neural-tube defects, a previous affected pregnancy, or a condition such as sickle-cell disease or thalassaemia, ask specifically whether you need the higher 5 mg folic acid dose — a higher BMI alone is not an indication for it.

Published figures to discuss

Pre-conception advice is itself low-risk, as it is a consultation rather than a procedure. Meaningful figures relate to preventable risks and timing, while chances of conception and miscarriage depend heavily on age, health and individual factors.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is nothing to recover from. Afterwards, the focus is on acting on your plan — starting supplements, making lifestyle changes, and arranging any tests, vaccinations or follow-up advised.

• No physical change — this is advice, not a procedure
• A to-do list of supplements, lifestyle changes and any tests or vaccinations
• Some changes, like reaching a healthy weight, taking time
• Possibly waiting for blood test results or a vaccination course to finish

Aftercare

• Start and continue folic acid at the dose advised, up to 12 weeks of pregnancy, plus daily vitamin D.
• Work towards a healthy weight with sensible eating and activity.
• Stop smoking and avoid alcohol while trying and during pregnancy, and seek support to quit if needed.
• Do not stop or change prescribed medicines without advice, and follow the plan for any long-term condition.
• Have any recommended vaccinations (such as MMR) and avoid pregnancy for the advised time afterwards.
• Follow food-safety advice and reduce caffeine as advised.
• Seek further advice if you do not conceive after about a year, or sooner if you have risk factors or are older.

• Folic acid at the right dose, started before trying
• Daily vitamin D
• A plan for stopping smoking and avoiding alcohol
• A list of medicines reviewed with a clinician
• Vaccinations (such as MMR) checked and arranged
• Any blood tests or referrals booked
• Knowledge of when to seek help if you do not conceive

⚠ Get urgent help if…

• Heavy or unusual vaginal bleeding, or severe pelvic or tummy pain (get this checked, and seek urgent care if you might already be pregnant)
• Symptoms of a long-term condition becoming poorly controlled while planning pregnancy
• A high temperature or rash after contact with someone with a viral illness, if you are not immune (for example to rubella)
• Severe low mood, anxiety or thoughts of harming yourself — seek help promptly
• A positive pregnancy test while taking a medicine you were told is not safe in pregnancy — contact your clinician rather than stopping suddenly
• Signs of a possible early pregnancy problem, such as bleeding with one-sided pain and feeling faint

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good outcome is going into pregnancy as healthy and well-prepared as possible, with supplements started, lifestyle improved, medicines and conditions sorted out, and immunity checked. It cannot promise that you will conceive quickly or that a pregnancy will be straightforward, but it gives you the best foundation and flags anything that needs attention beforehand. The plan is personal and may change as your circumstances do.

Advice may need updating if your health, weight, medicines or circumstances change, or if time passes before you conceive. Folic acid and vitamin D are continued into pregnancy as advised. If you are managing a long-term condition, the plan should be reviewed regularly, and again once you are pregnant.

Related tests, treatments or support

Pre-conception advice often sits alongside other care — a medicines review, optimising a long-term condition with the relevant specialist, vaccinations, and sometimes genetic counselling or carrier testing. For people with known fertility concerns, it may lead on to fertility assessment or treatment, which is a separate pathway.

Follow-up & long-term care

Follow-up depends on what is found. Some people need only the one appointment and act on the plan; others need blood tests, vaccinations, a medicines review or specialist referral, with appointments arranged accordingly. If you have a long-term condition, expect ongoing review before and during pregnancy. You should know when to seek help if you do not conceive.

• Continue folic acid (at the advised dose) until 12 weeks of pregnancy, and take daily vitamin D
• Maintain a healthy weight and healthy habits while trying
• Keep any long-term condition well controlled and reviewed
• Complete recommended vaccinations and any follow-up tests
• Seek timely advice if you do not conceive within the expected time

Repeat, follow-on and what comes next

• The plan may need updating if your health, weight, medicines or circumstances change.
• Some recommendations (such as reaching a healthy weight or completing a vaccination) take time before trying.
• If you do not conceive within the expected time, the plan may move on to a fertility assessment.
• Long-term conditions need ongoing review before and during pregnancy.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear, personalised written plan covering supplements, lifestyle, vaccinations and medicines.
• Arranged follow-up for any tests, vaccinations or referrals identified.
• A safe plan for managing medicines and long-term conditions before and during pregnancy.
• Clear advice on when and how to seek help if you do not conceive or if problems arise.
• Communication with your GP so your care is joined up.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Length and type of appointment, and whether it is a one-off or includes follow-up
• Any blood tests arranged (such as rubella immunity, blood count or thyroid function)
• Vaccinations if needed
• Whether a partner is assessed at the same time
• Referral for genetic counselling, carrier testing or a specialist condition review
• Any letters or reports to your GP or another clinician

• The clinician's fee for the appointment and any follow-up
• Whether blood tests are included or charged separately
• Whether vaccinations are included or charged separately
• Whether a partner can be seen, and any extra cost
• The cost of any referrals, genetic counselling or carrier testing
• The cost of letters or reports
• What happens, and what it costs, if further appointments or tests are needed

On the NHS? Pre-conception advice is available on the NHS through your GP, who can review medicines, arrange tests or vaccinations and refer where needed; private clinics offer longer or quicker appointments using the same core advice.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• What dose of folic acid is right for me, and do I need the higher 5 mg dose?
• Are any of my medicines a concern, and do they need changing before I try?
• Am I protected against rubella, and do I need any vaccinations first?
• Does my weight, or any health condition, need attention before pregnancy?
• Given my family history, should I consider genetic counselling or carrier testing?
• When should I seek help if I do not become pregnant?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my appointment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this appointment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for pre-conception advice

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Planning your pregnancy RCOG — Healthy eating and vitamin supplements in pregnancy NICE CKS — Pre-conception advice and management NICE NG247 — Maternal and child nutrition (recommendations 1.1.4–1.1.6, folic acid) WHO — Periconceptional folic acid supplementation Folic acid and neural tube defect prevention — NCBI Bookshelf

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.