Tests before conception: what both partners should check

In shortBefore conception, a woman checks: TSH, ferritin with a complete blood count, vitamin D, folate, glucose; with an irregular cycle — prolactin, FSH, LH, estradiol, and progesterone on specific days; after 30–35 — AMH. A man provides a semen analysis and a blood count. Both partners get infection screening per the obstetrician's list. hCG enters the picture after a missed period to confirm pregnancy.

Why test before pregnancy

The first weeks of fetal development happen before a woman knows she is pregnant, and that is exactly when the thyroid, iron, and folate are critical. Finding and closing a deficiency in advance is far easier than catching up through first-trimester nausea.

The second reason is time: if tests reveal hypothyroidism, anemia, or a hormonal glitch, you get a couple of months to correct it before conception instead of emergency decisions while already pregnant.

The female minimum: thyroid, iron, folate

TSH is the first test: even subclinical hypothyroidism hinders conception and raises risks for the fetus, so the level is corrected before pregnancy. Alongside — a complete blood count and ferritin: iron stores will halve over a pregnancy, and entering it deficient is not an option.

Folic acid will almost certainly be prescribed — intake starts 1–3 months before conception; testing its level together with vitamin D helps choose doses deliberately. Fasting glucose closes the question of hidden diabetes, which is critical for pregnancy.

Hormones and reserve: by indication

With a regular cycle and an age under 30, a hormone panel is not needed: try to conceive for 6–12 months before looking for a problem. But with an irregular cycle, prolactin, FSH, LH, and estradiol on days 2–5 and progesterone on days 21–23 are drawn right away — this shows whether ovulation happens.

After 30–35 or after unsuccessful attempts, AMH is added to gauge ovarian reserve. It is not a verdict but navigation: with a low reserve, a fertility specialist will suggest not losing time waiting.

The partner sees a doctor too

In half of couples with delayed conception the cause is a male factor, so a semen analysis is a mandatory item — and it is simpler and cheaper than any female workup. Preparation: 2–7 days of abstinence, no overheating or alcohol beforehand.

Both partners get the standard infection screening from the obstetrician. And after a missed period, a quantitative blood hCG confirms pregnancy — it gives an exact number and allows following the trend in early weeks.

A preconception checklist

TSH — the thyroid is corrected before pregnancy
Ferritin and a complete blood count — iron stores
Vitamin D, folate, glucose
Hormones on cycle days — if the cycle is irregular
AMH — after 30–35 or long attempts; the partner — a semen analysis

Markers covered in this article

AMH hCG Follicle-stimulating hormone Luteinizing hormone Prolactin Estradiol Progesterone TSH (thyrotropin)Vitamin D Folic acid Ferritin Blood glucose

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Frequently asked questions

How far ahead of conception should we test?

Three months is optimal: enough to correct the thyroid, raise ferritin, and build up folate. Most results stay current for the whole planning period.

Does everyone need AMH?

No: before 30 with a regular cycle, AMH changes little in the plan. It is informative after 30–35, after ovarian surgery, and before IVF.

The cycle is irregular — where to start?

With TSH and prolactin — these two lines most often explain a broken cycle and are corrected fastest. Then the doctor reads FSH, LH, and estradiol against cycle days.

Sources

Anti-Müllerian Hormone Test: MedlinePlus Medical Test — MedlinePlus, National Library of Medicine. Accessed: August 31, 2026.
HCG blood test - quantitative: MedlinePlus Medical Encyclopedia — MedlinePlus, National Library of Medicine. Accessed: August 31, 2026.
TSH (Thyroid Stimulating Hormone) Test: MedlinePlus Medical Test — MedlinePlus, National Library of Medicine. Accessed: August 29, 2026.
TSH test: MedlinePlus Medical Encyclopedia — MedlinePlus, National Library of Medicine. Accessed: August 29, 2026.