Trying For A Baby: What To Do Before You Conceive

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Most of what gets written about trying for a baby is either a fertility-tracking app advert or a list of things to be frightened of. The list you need is short, and one item on it counts far more than the rest.

Start folic acid now, before you conceive.

400 micrograms a day, ideally from at least a month before you start trying and continuing through the first twelve weeks. It reduces the risk of neural tube defects, conditions affecting the baby’s brain and spine, by around 75%.

It has to be before, not after, because the neural tube closes in the first four weeks, often before you know you’re pregnant at all. By the time you get a positive test, that window has largely passed.

If you’ve previously had a baby with a neural tube defect, the dose is much higher: 4mg, from three months before. That’s a conversation with your doctor, not something to self-prescribe.

The pre-pregnancy check-up

Worth doing, and rarely mentioned. A few things are far easier to sort out before you’re pregnant than during:

Rubella immunity. A simple blood test. Rubella in pregnancy can cause serious harm to a baby, and the vaccine is a live one, so it can’t be given while pregnant. You need it at least a month before trying. If you aren’t immune, this alone justifies the appointment.
Chickenpox immunity, on the same logic.
Existing conditions and medication. Thyroid problems, diabetes, epilepsy, high blood pressure, mental health medication. Several common drugs need reviewing or switching before conception, not after.
Thalassaemia screening. Particularly relevant here: the trait is common across Southeast Asia, and if both partners carry it there are implications worth understanding early.
Dental check. Unglamorous, but gum disease is associated with preterm birth and dental work is simpler now than later.

Finding your fertile window

The fertile window is roughly the five days before ovulation plus the day itself, because sperm survive several days and an egg only about a day.

The clearest free sign is cervical mucus. It changes predictably across the cycle:


What you see	What it means
Dry, or very little	Not fertile
Sticky, thick, cloudy	Approaching, but not yet
Clear, slippery and stretchy, like raw egg white	Peak fertility. Ovulation typically occurs on the last day of this or within about 24 hours after.
Thickening again, drying up	Window closed

Ovulation predictor kits work too and are more concrete if you’d rather not track mucus. Both beat counting to day fourteen, which only works if your cycle happens to be twenty-eight days.

Timing doesn’t need to be perfect. Regular sex every two to three days across the month covers the window without turning it into a scheduling exercise, which is better for most couples than aiming at a single day.

It isn’t only about her

Roughly a third of difficulty conceiving relates to male factors, and sperm take about three months to develop, so changes made now show up in about three months’ time. Both of you should know:

Stop smoking. It affects fertility in both partners and outcomes in pregnancy.
Cut back alcohol.
Weight counts at both ends. Being significantly under or over affects ovulation and sperm quality.
Heat affects sperm. Regular saunas, hot tubs and a laptop on the lap are all worth reconsidering.

Age and fertility

Fertility does decline with age, and the decline steepens after the mid-thirties. Pregnancy at 35 and over comes with somewhat higher chances of chromosomal conditions, gestational diabetes, high blood pressure in pregnancy and preterm birth. Those are real, and you should know about them.

What also needs saying: the great majority of pregnancies after 35 are healthy and straightforward. “Advanced maternal age” is a clinical category that triggers some extra monitoring. It isn’t a warning, and plenty of people read it as one.

If you’re over 35 and have been trying for six months without success, that’s the point to see a doctor, not the twelve months usually suggested for younger couples. Not because something is wrong, but because there’s less value in waiting.

How long is normal

Most couples conceive within a year. Roughly eight in ten are pregnant within twelve months of trying, and a good share within six.

See a doctor if: you’re under 35 and have been trying for a year, you’re over 35 and have been trying for six months, your periods are very irregular or absent, you’ve known conditions like endometriosis or PCOS, or either of you has had treatment that might affect fertility.

If the process is taking a toll, our guide to stress and infertility covers what the evidence says, including the widely repeated claim that stress causes infertility, which has the relationship backwards.

Frequently asked questions

When should I start taking folic acid?

At least one month before you start trying, and continue through the first twelve weeks. 400 micrograms daily is the standard dose, and it reduces the risk of neural tube defects by around 75%. Starting after a positive test is late, because the neural tube closes in the first four weeks. A much higher dose applies if you’ve previously had a baby with a neural tube defect. Discuss that with your doctor.

What should I check before trying to conceive?

Rubella and chickenpox immunity, since both vaccines are live and can’t be given during pregnancy. A review of any existing conditions and regular medication, as several common drugs need changing before conception rather than after. Thalassaemia screening is particularly relevant in Singapore. A dental check is a good idea too.

How do I know when I’m ovulating?

The clearest free sign is cervical mucus: clear, slippery and stretchy like raw egg white indicates peak fertility, with ovulation usually on the last day of that or within about 24 hours. Ovulation predictor kits are a more concrete alternative. Both are more reliable than assuming day fourteen, which only holds for a 28-day cycle.

How often should we’ve sex when trying to conceive?

Every two to three days across the month covers the fertile window without needing to pinpoint ovulation. The window is roughly the five days before ovulation plus the day itself, since sperm survive several days while an egg lasts about one.

Does age really matter that much?

Fertility declines with age, more noticeably after the mid-thirties, and pregnancy at 35 and over brings a somewhat higher chance of chromosomal conditions, gestational diabetes, raised blood pressure and preterm birth. But the great majority of pregnancies after 35 are healthy. Advanced maternal age is a category that prompts extra monitoring, not a warning.

How long should we try before seeing a doctor?

Twelve months if you’re under 35, six months if you’re over 35. Go sooner if periods are very irregular or absent, if there’s a known condition such as endometriosis or PCOS, or if either partner has had treatment that could affect fertility.

Does the man need to do anything?

Yes. Around a third of difficulty conceiving involves male factors. Sperm take roughly three months to develop, so stopping smoking, cutting back alcohol, addressing weight and avoiding regular heat exposure all show their effect about three months later. Worth starting at the same time as the folic acid.

What to do

Folic acid now, 400mcg a day, before you start trying. That’s the one with the largest and best-evidenced payoff.

Book a pre-pregnancy check for rubella immunity and a medication review. Learn to spot egg-white cervical mucus instead of counting to fourteen. Have both partners make the lifestyle changes, since sperm take three months to catch up. And if you’re over 35 and six months in, see someone. Earlier is simply better.