Planning for a Baby? Expert Warns Overlooking This Crucial First Step

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For many couples, the idea of "preparing" for pregnancy begins once they actively start trying to conceive. Preconception is often seen as a passive phase, a waiting period before the real journey begins.

In reality, it is anything but passive.

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Preconception is one of the most critical stages in the fertility journey, influencing not just the chances of conception but also the health of the pregnancy and the long-term well-being of the child. Yet, it remains one of the most overlooked. We spoke to Dr Nilesh Unmesh Balkawade, MBBS, MS, DNB, MNAMS, FIAGE, FRM, Regional Medical Head and Fertility Specialist, who explained things to keep in mind before conceiving.

How Preconception Shapes Fertility

The months leading up to conception directly influence egg and sperm quality-two key determinants of successful fertilisation and healthy embryo development.

"Lifestyle habits such as diet, sleep, stress, smoking, alcohol consumption, and overall metabolic health can affect reproductive function. Studies show that smoking and heavy alcohol intake are associated with reduced sperm quality, including lower motility and concentration and increased DNA damage," said Dr Balkawade.

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Underlying health conditions such as PCOS, thyroid disorders, diabetes, and nutritional deficiencies can also interfere with ovulation and hormonal balance. These are often easier to identify and manage before conception rather than after pregnancy has begun.

Research also suggests that higher stress levels during the preconception phase may negatively affect the likelihood of achieving a live birth, underlining the importance of emotional well-being alongside physical health.

Impact Beyond Conception

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Preconception health does not just affect whether a pregnancy occurs, but also shapes how it progresses.

According to the World Health Organisation, folic acid supplementation before and during early pregnancy significantly reduces the risk of neural tube defects. "Even deficiencies in nutrients such as iron, vitamin D, iodine, and folate have been linked to risks, including maternal anaemia, pregnancy complications, and low birth weight as well. However, the evidence for associations between stress, nutrition, and reproductive outcomes is not definitive; folic acid remains the clearest evidence-based supplement," added Dr Balkawade.

Emerging research also shows that a parent's health before conception can influence the child's long-term risk of metabolic disorders through alterations in gene expression due to environment and lifestyle factors-and these are only a few examples.

This goes to show that preconception is a crucial phase, shaping the health trajectory of the next generation.

The Indisputable Contribution of Men

Fertility preparation is often viewed as a woman's responsibility, but the male partner's health is equally important.

"As previously stated, lifestyle factors such as smoking and alcohol consumption significantly influence sperm quality and reproductive outcomes. Evidence suggests that paternal health, including a father's diet and metabolic health before conception, can impact a child's risk of conditions such as obesity and metabolic disease," explained Dr Balkawade.

This reinforces that fertility preconception healthcare is a shared responsibility between both partners.

The Psychological Advantage

Preconception can be a valuable window for reducing future stress.

"Couples who use this time for early assessment, counselling, and lifestyle adjustments often feel more prepared and in control. By taking proactive steps early, couples can reduce anxiety later in the journey and avoid the emotional strain that often comes with unexpected fertility challenges," said Dr Balkawade.

What Preconception Care Looks Like

A well-planned preconception phase focuses on optimising health for both partners:

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• Health screenings, including hormones and metabolic health
• Nutritional support, including folic acid and vitamin D
• Lifestyle improvements, such as a balanced diet, exercise, and avoiding smoking and alcohol
• Stress management and informed planning
• Preconception is not just what happens before pregnancy; it is the foundation of fertility.

Bottomline

Dr Balkawade concluded, "By treating this phase as an active and intentional period, aspiring parents can identify risks early, make informed changes, and improve their chances of a healthy pregnancy and life for the baby. Because in fertility, what happens before conception often matters more than we think."