Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO. Last updated: 16 July 2026.
Information on this page is educational and does not replace a medical consultation. Outcomes depend on individual clinical factors.
Note: this page is for couples planning a pregnancy — it is not about urine pregnancy-test kits or confirming an existing pregnancy. If your pregnancy test is already positive, see prenatal (antenatal) care.
What does a before-pregnancy checkup with a gynaecologist cover?
A preconception visit reviews medical and pregnancy history, current medicines and supplements, vaccinations, nutrition and lifestyle, family and genetic history, and any condition that should be better controlled before conception (ACOG–ASRM Committee Opinion No. 762, 2019). It is appropriate for anyone considering pregnancy — not only couples who have had difficulty conceiving.
There is no single fixed "package" of tests for everyone. Your history and risk factors determine which examinations, blood tests, infection screens, carrier tests, or referrals are actually indicated (ACOG–ASRM 2019). In Chandrapur, Dr. Shweta Agarwal, MBBS, DGO — a lady gynaecologist (चंद्रपूरमधील महिला स्त्रीरोगतज्ज्ञ) — conducts this review at Aansh Hospital & IVF Center, a government-registered Level-2 ART clinic (verify our registration).
When should pregnancy planning start?
Start planning when pregnancy is being considered — beginning at least one month before trying allows folic acid to be started and any indicated live-vaccine waiting interval to pass (WHO; FOGSI-ICOG 2024). Couples with a chronic disease, regular medicines, a previous complicated pregnancy, or known genetic risk should come earlier. "Exactly three months before" is a useful planning window, not a medical rule.
Preconception care vs antenatal (ANC) care — what is the difference?
Preconception care happens before pregnancy and aims to identify and manage modifiable risks; antenatal care starts after pregnancy is confirmed and monitors mother and baby through delivery. A preconception visit does not replace ANC — once your test is positive, book antenatal care early.
| Preconception care (गर्भधारणापूर्व काळजी) | Antenatal / prenatal care (ANC) | |
|---|---|---|
| When | Before you start trying to conceive | After pregnancy is confirmed |
| Focus | Folic acid, vaccines, medicines review, chronic-condition control, family/carrier history | Pregnancy monitoring, growth, maternal health |
| Tests | Risk-based — decided from your history | Scheduled per pregnancy stage |
| Page | This page | Prenatal care, high-risk pregnancy |
How much folic acid should I take before pregnancy?
For women at usual risk, WHO recommends 400 micrograms (400 μg / 0.4 mg) of folic acid daily from the time you begin trying to conceive through the first 12 weeks of pregnancy. India's Anaemia Mukt Bharat guidance (MoHFW/NHM) advises the same 400 μg daily dose in the preconception period through the first trimester.
Folic acid taken correctly in this window reduces the risk of neural-tube defects — it does not prevent all birth defects, and no supplement guarantees a particular outcome. High-dose folic acid (for example, WHO advises 5 mg daily after a previous neural-tube-defect-affected pregnancy, and NICE NG3 specifies 5 mg/day through 12 weeks for women with pre-existing diabetes) is a prescription decision, not something to self-start. मराठीत: फॉलिक अॅसिड कधी सुरू करायचे? — गर्भधारणेचा प्रयत्न सुरू करण्यापूर्वी, डॉक्टरांच्या सल्ल्याने.
Which tests are needed before planning pregnancy?
There is no mandatory identical panel for every couple. Depending on your history, the clinician may check haemoglobin/CBC, blood group and Rh, blood sugar or HbA1c, thyroid function, immunity or infection status, or carrier status — and may reasonably order none of these for a healthy person with no risk factors (ACOG–ASRM 2019). AMH, pelvic ultrasound, broad infection panels, and genetic panels are not automatic tests for everyone.
| Situation | Evidence-based next step |
|---|---|
| No known illness, planning pregnancy | Start 400 μg folic acid; review vaccines, medicines/supplements, lifestyle, and family history; the clinician decides whether any tests are due |
| Known diabetes | Preconception diabetes/obstetric review — HbA1c target, medicine and complication review, prescribed high-dose folate where applicable (NICE NG3) |
| Known hypothyroidism on levothyroxine | Check and optimise TSH before conception; the 2026 ATA guideline considers 0.5–2.5 mU/L a reasonable target |
| Anaemia symptoms or history of low Hb | CBC/haemoglobin assessment and cause-based management before pregnancy (Anaemia Mukt Bharat) |
| No MMR/varicella immunity or record | Clinician reviews whether vaccination is indicated; avoid conception for at least four weeks after MMR/varicella (FOGSI-ICOG 2024) |
| Family history of sickle cell/thalassaemia, or connection to a high-prevalence community/area | Risk-based haemoglobinopathy testing; partner testing if one partner is positive; genetic counselling (NHM National Sickle Cell Programme; ICMR) |
| Trying without success | Fertility assessment at 12 months if under 35, 6 months if 35+, sooner with risk factors (ASRM 2021) |
गर्भधारणेपूर्वी तपासणी — थायरॉईड, साखर, हिमोग्लोबिन यांसारख्या तपासण्या प्रत्येकासाठी नाहीत; तुमच्या इतिहासानुसार डॉक्टर ठरवतात.
Do I need vaccines before trying to conceive?
A preconception visit reviews your vaccination record and relevant immunity history — it does not mean every woman needs every vaccine. FOGSI-ICOG (2024) recommends MMR for women who have not previously received it and advises avoiding pregnancy for at least four weeks after MMR; the same four-week interval applies after varicella vaccine where neither prior infection nor vaccination is documented. MMR and varicella are live vaccines and are not given during pregnancy. Hepatitis B vaccination is recommended before pregnancy for women at risk; other vaccines depend on age, prior doses, health conditions, and the current Indian schedule (FOGSI-ICOG 2024; CDC).
I have diabetes or a thyroid condition — what should I do before pregnancy?
Diabetes: arrange a preconception review with your diabetes/obstetric team before stopping contraception. NICE NG3 advises aiming for HbA1c below 48 mmol/mol (6.5%) where safely achievable without problematic hypoglycaemia, and strongly advises avoiding pregnancy while HbA1c is above 86 mmol/mol (10%). Good control reduces risk — it does not eliminate it, and your individual target and medicine plan must be agreed with your treating clinician. Never stop diabetes or blood-pressure medicines on your own.
Thyroid: the 2026 American Thyroid Association guideline finds insufficient evidence to recommend thyroid testing for every woman planning pregnancy. Testing is reasonable with known thyroid disease, symptoms, or risk factors; for women already taking levothyroxine, ATA considers a preconception TSH of 0.5–2.5 mU/L a reasonable target. A TSH within the normal range in a healthy untreated woman is not, by itself, a fertility problem (ATA 2026).
The same principle applies to all regular medicines, non-prescription products, herbal preparations, and supplements: bring the full list to the visit for a clinician-led review (ACOG–ASRM 2019). Relevant conditions link onward to high-risk pregnancy care and PCOS.
Who should consider sickle-cell or thalassaemia carrier testing before pregnancy?
Carrier testing is risk-based, not universal. It is especially relevant if either partner has a known trait or disease, a family history of thalassaemia or sickle-cell disease, an affected child or relative, unexplained severe anaemia, consanguinity, or a connection to a high-prevalence community or area. Maharashtra is among the high-prevalence focus states in India's National Sickle Cell Disease Control Programme, which recommends pre-marital and preconception screening with genetic counselling in tribal and other high-prevalence areas — relevant for families connected with the Gadchiroli belt near Chandrapur (MoHFW/NHM; ICMR Standard Treatment Workflow).
If one partner tests positive, the other partner is tested and the couple is offered non-directive genetic counselling. Where both partners carry a variant for the same recessive condition, each pregnancy carries a 25% chance of an affected child, 50% carrier, 25% neither — resetting with every pregnancy (NHM genetic-counselling materials). लग्नाआधी किंवा गर्भधारणेपूर्वी सिकल सेलची तपासणी झाली आहे का? — कुटुंबात इतिहास असल्यास डॉक्टरांना जरूर सांगा.
Carrier screening and any genetic testing at Aansh concerns inherited disease risk only. Sex determination and sex selection are illegal under the PCPNDT Act and are not performed or facilitated at Aansh Hospital & IVF Center in any form.
When should pregnancy planning become a fertility consultation?
Fertility evaluation is generally advised after 12 months of regular unprotected intercourse when the woman is under 35, after 6 months at age 35 or older, and more promptly above 40 or when a known infertility-associated condition exists (ASRM Practice Committee, 2021). Earlier assessment is appropriate with irregular or absent cycles, suspected endometriosis or tubal disease, a male-factor concern, or prior gonadotoxic treatment.
A proper assessment looks at ovulation, the reproductive tract and tubal patency, and a semen assessment of the male partner where indicated — AMH testing is not a general fertility screen for women who do not meet these criteria (ASRM 2021). Pregnancy planning does not automatically mean IVF; IVF is one possible pathway after a proper couple fertility assessment. See also: when to see a fertility specialist — the 12-month rule and what to expect at your first fertility consultation.
References
- ACOG + ASRM. Prepregnancy Counseling, Committee Opinion No. 762 (2019). https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/01/prepregnancy-counseling
- WHO. Periconceptional folic acid supplementation to prevent neural tube defects (eLENA). https://www.who.int/tools/elena/interventions/folate-periconceptional
- MoHFW/NHM. Anaemia Mukt Bharat guidelines (2026). https://nhm.gov.in/images/pdf/guidelines/nrhm-guidelines/index1.php?lang=1&level=3&lid=797&sublinkid=1448
- FOGSI-ICOG. Good Clinical Practice Recommendations: Vaccination in Women (2024). https://www.fogsi.org/wp-content/uploads/2024/08/Binder_Vaccination-in-Women.pdf
- NICE. Diabetes in pregnancy: management from preconception to the postnatal period (NG3). https://www.nice.org.uk/guidance/ng3/chapter/recommendations
- American Thyroid Association. 2026 Guidelines for Thyroid Disease in Preconception, Pregnancy, and Postpartum. https://doi.org/10.1177/10507256261445624
- ASRM Practice Committee. Fertility evaluation of infertile women (2021). https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/
- MoHFW/NHM. National Sickle Cell Disease Control Programme. https://sickle.nhm.gov.in/sickle2.0/home/about
- ICMR. Standard Treatment Workflow: Sickle Cell Disease. https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf