Preconception Testing: Lab Work Before Pregnancy

The best time to optimize your health for pregnancy is before you conceive. Preconception testing helps identify and address issues that could affect fertility or pregnancy.

Why Preconception Testing Matters

• Identify nutritional deficiencies
• Optimize thyroid function
• Screen for infections
• Assess metabolic health
• Address hormonal imbalances

The Preconception Lab Panel

Thyroid

• TSH (optimal <2.5 for pregnancy)
• Free T4, Free T3
• Thyroid antibodies

Nutrients

• Vitamin D (aim for 40-60 ng/mL)
• Vitamin B12 (optimal >500 pg/mL)
• Folate (or MTHFR testing)
• Ferritin (optimal >50 ng/mL)
• Iron panel

Metabolic

• Fasting glucose and HbA1c
• Fasting insulin
• Lipid panel

Infections

• Rubella immunity
• Varicella immunity
• Hepatitis B
• HIV (recommended by ACOG)

Reproductive

• Blood type and Rh factor
• Genetic carrier screening (optional)

Optimizing Before Pregnancy

Address any deficiencies or imbalances before trying to conceive:

• Start prenatal vitamins 3 months before
• Optimize thyroid function
• Achieve healthy ferritin levels
• Stabilize blood sugar
• Manage any autoimmune conditions

References

• American College of Obstetricians and Gynecologists. (2019). ACOG Committee Opinion No. 762: Prepregnancy counseling. Obstetrics & Gynecology, 133(1), e78-e89.
• Dean, S. V., et al. (2014). Preconception care: nutritional risks and interventions. PLoS Medicine, 11(3), e1001607.