The Preconception Checkup: 7 Essential Questions to Ask Your OB-GYN

Scheduling a preconception checkup is one of the most important steps you can take before trying to conceive. This visit helps identify potential risks, address chronic conditions, and prepare your body for pregnancy. Here's what you need to know:

• Genetic Testing: Explore carrier screening for conditions like cystic fibrosis or sickle cell disease.
• Fertility Health: Discuss ways to improve ovulation, nutrition, and physical activity.
• Vaccinations: Ensure immunity against diseases like rubella and chickenpox before conception.
• Lifestyle Adjustments: Focus on maintaining a healthy weight, taking folic acid, and reducing harmful habits.
• Stem Cell Banking: Learn about preserving cord blood, tissue, and placenta for future medical use.
• Chronic Conditions: Manage issues like diabetes, asthma, or high blood pressure early.
• STI Screening: Test for infections that could impact pregnancy outcomes.

Plan your checkup at least three months before trying to conceive for enough time to make necessary changes. This proactive approach ensures you’re ready for a healthy pregnancy journey.

1. What Genetic Tests Should I Consider Before Conception?

Why Genetic Testing Matters Before Conception

Carrier screening is a routine genetic test designed to identify single-gene disorders like cystic fibrosis, sickle cell disease, spinal muscular atrophy, and Tay-Sachs disease. The good news? You only need to do this test once in your lifetime, as your genetic makeup doesn’t change - even if you’re planning multiple pregnancies.

"Carrier screening is a standard of care genetic test that should be offered to all people considering conception." - Katie Hornberger, Certified Genetic Counselor

A detailed family health history is another critical step. Sharing this with your OB-GYN helps them recommend the most relevant genetic tests for your situation. Today’s expanded carrier screening panels can assess for over 200 autosomal recessive conditions, offering a broader understanding of potential risks.

These insights provide a strong foundation for making informed decisions as you prepare for pregnancy.

How It Affects Pregnancy Outcomes

Here’s how it works: if one partner is identified as a carrier for a genetic condition, the other partner should also be tested. If both partners are carriers, there’s a 25% chance their child could inherit the condition. Knowing this risk early opens up options like preimplantation genetic testing (PGT). This process, used with in-vitro fertilization, screens embryos for genetic or chromosomal issues before implantation.

"Genetic testing definitely should be offered, this tells the couple if they are carriers for many genetic conditions. Some of them are clinically relevant, some of them are not, but for those that are very significant, different further testing options are available." - Dr. Jason Rothbart, MD, FACOG

This knowledge empowers you to plan your next steps with clarity and confidence.

Timing and Preparation

Timing is everything. Schedule your preconception counseling and genetic screening at least three months before trying to conceive. This gives you enough time to review the results, meet with a genetic counselor if needed, and explore your options. If a potential risk is identified, your OB-GYN can connect you with specialists to discuss the likelihood of passing on certain conditions and guide you through tailored reproductive choices.

Genetic testing is just one piece of the puzzle, but it’s a crucial one. Pair these insights with other preconception planning topics to set the stage for a healthier pregnancy journey.

2. How Can I Improve My Fertility Health?

Relevance to Preconception Health

Your fertility health starts with the basics: balanced nutrition, maintaining a healthy weight, and adopting positive daily habits. A diet rich in whole, nutrient-dense foods helps prepare your body for conception, while cutting back on heavily processed or fatty foods can support your reproductive system.

Weight is another key factor. A BMI over 30 can affect your ability to conceive and may increase risks during pregnancy, such as gestational hypertension or diabetes. If weight management is a concern, your OB-GYN can provide personalized advice to help you reach a healthier pre-pregnancy weight. These steps lay the groundwork for a smoother path to conception.

Impact on Pregnancy Outcomes

Certain lifestyle choices can directly impact your fertility. Smoking, alcohol, marijuana, and other drugs can interfere with hormone levels, menstruation, and ovulation. Even caffeine should be consumed in moderation - stick to one or two cups of coffee per day. Additionally, reducing exposure to environmental toxins like lead, pesticides, mercury, and asbestos is essential for protecting your reproductive health. Be mindful of food safety too: avoid undercooked meat and raw eggs to lower the risk of infections that might affect your health.

"If someone exercises regularly, even vigorously, they can continue that. If someone does not exercise at all, even just walking is helpful." - Dr. Jason Rothbart, MD, FACOG

Physical activity is another important piece of the puzzle. Regular exercise supports overall fertility health, but balance is key. If you already have a vigorous routine, feel free to stick with it. If not, start small - even daily walks can make a difference. Aim for about 150 minutes of activity each week. Staying hydrated is equally important, so drink 8–12 cups of water daily to keep your body functioning at its best.

Planning Opportunities

Understanding your fertile window can increase your chances of conception. Tools like ovulation kits or tracking basal body temperature can help pinpoint the best time to try. For many healthy couples, conception happens within the first six months of trying.

Don’t overlook other aspects of preparation. Schedule a dental checkup, as oral health is linked to pregnancy wellness.  You may also want to research if cord blood banking is worth it for your family's future. Make a list of all current medications and supplements to review with your OB-GYN, ensuring everything you take is safe for pregnancy. Managing stress early on with relaxation techniques can also support your mental and physical health during this process.

3. Are My Vaccinations Current for Pregnancy?

Why Vaccination Matters Before Pregnancy

Your vaccination history is more important than you might think when planning for pregnancy. It protects not just you but also your future baby. During your preconception checkup, your healthcare provider will likely test your immunity to diseases like rubella and chickenpox by measuring antibody levels. This is crucial because some vaccines, particularly those with live viruses, can't be given once you're pregnant.

If your immunity is low, you’ll need to get vaccinated at least one month before trying to conceive. Vaccines like MMR (measles, mumps, rubella) and varicella (chickenpox) fall into this category. Dr. Ashley Wiltshire, a specialist in Reproductive Endocrinology and Infertility, highlights:

"If you're non-immune, then the preconception visit would be the perfect time to get vaccinated, as some vaccines are contraindicated in pregnancy."

Having your vaccination records on hand can make this process much easier. Addressing immunity gaps now can prevent serious complications later on.

How Vaccines Affect Pregnancy and Baby

Ensuring you're vaccinated before pregnancy can significantly reduce risks. Diseases like rubella and chickenpox are highly contagious and, if contracted during pregnancy, can lead to miscarriage or severe birth defects. That’s why confirming immunity early is so critical.

Other vaccines, such as Tdap (whooping cough), flu, and RSV, are different. These are safe to receive during pregnancy and offer dual benefits: they protect you while also passing antibodies to your baby. This early protection is vital. For instance, 7 out of 10 deaths from whooping cough occur in infants under 2 months old, a period when they’re too young for their own vaccinations. By getting the Tdap vaccine between weeks 27 and 36 of pregnancy, you help shield your baby during those critical early weeks.

Timing Is Everything

Planning your vaccinations well in advance is a smart move. Start about three months before trying to conceive. This allows time for multi-dose vaccines, like the two-dose chickenpox series. The CDC also advises getting your flu shot by the end of October to stay protected during flu season. If your pregnancy overlaps with RSV season (September through January), talk to your doctor about the RSV vaccine, which is typically given between weeks 32 and 36.

Don’t forget COVID-19 vaccines, which are safe during pregnancy and help protect against severe illness. Staying on top of your vaccinations is a key part of preparing for a healthy pregnancy.

4. What Lifestyle Changes Improve Pregnancy Outcomes?

Relevance to Preconception Health

After addressing genetic testing and updating vaccinations, focusing on lifestyle changes can further improve pregnancy outcomes.

Your diet and weight before conception play a crucial role. The first eight weeks of pregnancy are when your baby's organs begin to form, making it essential to start this phase in good health. A preconception BMI between 18.5 and 24.9 is ideal. Being underweight (BMI below 18.5) increases the likelihood of preterm birth and low birth weight, while obesity (BMI of 30 or higher) raises the risk of gestational diabetes, high blood pressure, and preeclampsia.

Incorporate folic acid supplements - at least 400 mcg daily, starting three months before conception - as they can reduce neural tube defects by up to 70%. Pair this with a fiber-rich diet, as adding just 10 grams of fiber daily can lower the risk of gestational diabetes by 26%. Replacing red meat with plant-based proteins is another step to help reduce diabetes risk.

Impact on Pregnancy Outcomes

Simple dietary tweaks can lead to meaningful benefits. Reducing processed meats and sugary drinks before pregnancy may lower the chances of developing diabetes. Keep caffeine intake under 200 mg daily (about one to two cups of coffee) and avoid undercooked meat or raw eggs to minimize risks of infections like listeriosis and salmonella, which could harm your baby.

Mental health is just as critical. Conditions like depression and chronic stress can lead to pregnancy complications, so addressing these concerns during a preconception checkup is vital. If you're on mental health medications, talk to your OB-GYN to confirm they’re safe for pregnancy. As Dr. Abby Eblen, Fertility and IVF Specialist, emphasizes:

"If your medical condition isn't well controlled, it should be stabilized before conception."

These lifestyle changes not only improve your nutrition but also lay a solid foundation for preconception planning.

Planning Opportunities

Lifestyle adjustments, much like genetic and vaccination planning, are essential to a well-rounded preconception strategy.

Begin making changes at least three months before trying to conceive. This gives you time to reach a healthy weight, improve your diet, and manage any chronic conditions. Aim for 150 minutes of moderate physical activity weekly, along with two sessions of strength training. Even small weight adjustments can significantly impact pregnancy outcomes.

Bring a list of all your medications and supplements to your preconception visit. Your doctor can help craft a personalized plan that includes nutrition, exercise, and overall health. Since about 85% of couples conceive within their first year of trying, preparing ahead of time can make the process smoother and safer for both you and your baby.

5. Should I Discuss Newborn Stem Cell Banking Options?

Relevance to Preconception Health

It's a good idea to bring up newborn stem cell banking during your preconception checkup. According to Cleveland Clinic:

"Preconception counseling is an appointment with your healthcare provider that helps you plan for a future pregnancy."

This visit is an opportunity for your provider to review your family medical history and connect you with resources for long-term health planning. They can also explain how preserving cord blood, cord tissue, and placental tissue works, helping you decide if these options align with your family's health goals. This conversation naturally fits into broader preconception planning, giving you a well-rounded approach to preparing for pregnancy.

Planning Opportunities

Talking about stem cell banking early allows you to plan thoroughly. Before your appointment, jot down questions about collection methods, storage options, and potential uses. Your healthcare provider might also refer you to an accredited service like Americord Registry, which offers preservation options for cord blood, cord tissue, placental tissue, and even newborn exosome banking.

Dr. Aparna Sridhar from UCLA OB/GYN highlights the importance of early planning:

"A preconception visit will help you take the necessary steps to ensure a healthy pregnancy and baby."

Aim to schedule this discussion at least three months before trying to conceive. Starting early gives you time to explore costs, learn about advanced processing methods like CryoMaxx™, and choose the service that best suits your family's needs.

6. What Chronic Conditions Need Management Before Pregnancy?

Relevance to Preconception Health

When preparing for pregnancy, it’s essential to address any chronic health conditions you may have. Your preconception checkup is the perfect opportunity to bring up issues like asthma, depression, diabetes, heart disease, high blood pressure, kidney disease, thyroid disorders, epilepsy, anemia, or allergies. According to the American College of Obstetricians and Gynecologists, this is crucial because the first 8 weeks of pregnancy are when a fetus’s major organs develop. It’s also important to share details about past abdominal surgeries, menstrual irregularities, or mental health diagnoses, as these factors can influence your ability to conceive and maintain a healthy pregnancy.

Impact on Pregnancy Outcomes

Unmanaged chronic conditions can lead to serious risks during pregnancy. For example, women with a BMI over 30 are more likely to experience complications such as gestational diabetes, gestational hypertension, and delivery challenges. On the other hand, a BMI under 18.5 increases the chances of preterm delivery and having a baby with low birth weight. Dr. Abby Eblen, a Fertility and IVF Specialist, highlights the importance of managing these conditions:

"If your medical condition isn't well controlled, it should be stabilized before conception."

Uncontrolled diabetes can result in birth defects or macrosomia (a baby weighing over 8 pounds, 13 ounces), while untreated high blood pressure raises the risk of preeclampsia and placental abruption. These examples show why addressing chronic health issues early is so important.

Planning Opportunities

Aim to schedule a preconception appointment at least three months before trying to conceive. This gives you time to adjust medications, complete necessary lab tests, and work toward optimal health. Be sure to bring all your current medications - whether prescription, over-the-counter, or herbal supplements - in their original packaging. Never adjust your treatments without consulting your healthcare provider. Your OB-GYN may also refer you to specialists, such as endocrinologists or cardiologists, to fine-tune your care plan. Taking these steps early ensures a smoother path to a healthier pregnancy.

Evidence-Based Medical Insights

If you’ve experienced complications in previous pregnancies, like gestational diabetes or preeclampsia, your risk of recurrence increases. However, proactive care can significantly reduce these risks. For women with seizure disorders, ensuring medication safety before conception is vital for both maternal and fetal health. Mental health conditions also need attention, as pregnancy can influence depression or anxiety, and vice versa. Additionally, preparing a detailed family medical history for both partners can help your provider identify genetic or chronic risks that may require extra care.

7. How Do I Screen for Sexually Transmitted Infections?

Relevance to Preconception Health

Screening for sexually transmitted infections (STIs) is an essential part of preconception care. Using blood tests and physical exams, your OB-GYN will typically check for chlamydia, gonorrhea, syphilis, HIV, and Hepatitis B, as these infections can pose serious risks during pregnancy. Beyond updating your vaccination and genetic history, addressing STIs ensures you're fully prepared for a healthy pregnancy. Dr. Aparna Sridhar, an OB/GYN at UCLA, highlights the importance of this step:

"A preconception visit will help you take the necessary steps to ensure a healthy pregnancy and baby."

Be open with your doctor about your sexual history, including any prior STIs and the number of partners. This transparency helps your provider determine which tests are most appropriate for you. Early detection and treatment of infections are key to safeguarding both your health and your future pregnancy.

Impact on Pregnancy Outcomes

Untreated STIs can lead to serious complications for both you and your baby. UCLA Health underscores the risks:

"The CDC warns that STIs can have debilitating effects for parents and the fetus."

Infections like chlamydia and gonorrhea can impact fertility, while conditions such as HIV and Hepatitis B may be passed to your baby during pregnancy or delivery. Early detection allows for treatment, reducing these risks significantly.

Planning Opportunities

It's best to schedule STI screening at least three months before you plan to conceive. This timeline provides enough room for testing, treatment, and any necessary follow-up care. Including your partner in the screening process adds an extra layer of protection, ensuring comprehensive risk assessment. With nearly half of all pregnancies being unplanned, many individuals miss the chance for early STI screening. If you're preparing intentionally, proactive testing is a crucial step.

Evidence-Based Medical Insights

If you've traveled to regions affected by the Zika virus, inform your doctor, as additional screening may be required due to the potential risks to fetal development. A Pap smear is often included in the preconception pelvic exam to check for cervical abnormalities or cancer, giving you a full picture of your reproductive health before trying to conceive.

Comparison Table

When considering Americord Registry's stem cell banking plans during your preconception checkup, it's important to understand the options available. Each plan builds upon the previous one, adding more preservation choices to support long-term health possibilities. This table breaks down the differences in services, costs, and storage durations to help you choose what works best for your family.

The Essential Plan starts at $3,779 for 30-year storage or $5,979 for lifetime storage and includes cord blood banking. All plans feature Americord's CryoMaxx™ Processing, a manual method designed to recover more stem cells compared to automated systems. Plus, cord blood is stored in 5-compartment bags, so you can use portions for multiple treatments instead of depleting the entire sample at once.

Plan	Cord Blood	Cord Tissue	Placental Tissue	Newborn Exosomes	Maternal Exosomes	30-Year Storage	Lifetime Storage
Essential	Yes	No	No	No	No	$3,779	$5,979
Advanced	Yes	Yes	No	No	No	Varies*	Varies*
Complete	Yes	Yes	Yes	No	No	Varies*	Varies*
Ultimate	Yes	Yes	Yes	Yes	No	Varies*	Varies*
Maximum	Yes	Yes	Yes	Yes	Yes	Varies*	Varies*

*Multi-service plans qualify for 15% off 30-year storage and 30% off lifetime storage as of May 2026.

There’s a $280 enrollment fee for all plans, which includes a $199 collection kit and $81 shipping. Be sure to order your kit 5–7 business days before your due date to avoid the additional $189 AmeriRush fee. Payment options include HSA, FSA, or HRA funds if your healthcare provider confirms the medical necessity. For the most comprehensive coverage, the Maximum Plan preserves both newborn and maternal stem cells, offering greater potential for regenerative medicine treatments.

Conclusion

A preconception checkup gives you the opportunity to take charge of your pregnancy journey. By addressing these seven key questions, you're covering everything from genetic factors and chronic conditions to lifestyle changes and vaccination updates. This proactive step ensures potential concerns are identified early, when they’re easier to address.

This visit also sets the stage for both a healthy pregnancy and your family's future well-being. Scheduling it about 3–4 months before you start trying to conceive allows enough time to make any necessary lifestyle changes or complete recommended tests.

Looking beyond the immediate pregnancy, planning ahead helps protect your family’s long-term health. For example, newborn stem cell preservation with Americord Registry provides an option to safeguard your family’s future health, offering flexible plans tailored to your needs.

"The best start to a healthy pregnancy is knowing how to have one well before you get that positive result." - Cleveland Clinic

FAQs

Do I need genetic carrier screening if I have no family history?

Genetic carrier screening can reveal if you carry genetic mutations that might impact your future children, even if there's no family history of such conditions. Since most carriers are healthy and unaware of their carrier status, this type of screening serves as a valuable resource for making well-informed choices when planning for a family.

What medications or supplements should I stop before trying to conceive?

Certain medications, such as isotretinoin (commonly known as Accutane), methotrexate, tetracycline, valproic acid, and ACE inhibitors, are generally advised to be discontinued before attempting to conceive. It's essential to consult your doctor for tailored advice. They can guide you in safely adjusting or substituting medications and supplements to suit your individual health requirements.

How do I decide whether newborn stem cell banking is worth it for my family?

Deciding if newborn stem cell banking is the right choice means weighing its potential uses against the costs and limitations. Cord blood is rich in stem cells that can be used to treat specific conditions, such as blood disorders and certain types of cancer. To make the best decision, think about your family’s medical history, possible future health needs, and the financial commitment involved. Speaking with your OB-GYN and reaching out to a trustworthy cord blood bank can provide guidance that fits your family’s situation.