What should I do before trying to conceive?

Start with two things: a good prenatal vitamin and a preconception visit. After that there's a short list of habits with strong evidence behind them, and a longer list worth optimizing if you want to — we've marked how strong the evidence is for each.

A prenatal vitamin

ACOG recommends starting a prenatal vitamin before pregnancy, not after a positive test. Here's what to look for on the label.

Strong evidence Folate. The CDC recommends 400 micrograms of folate daily for anyone who could become pregnant, ideally starting at least a month before trying, because it lowers the risk of neural tube defects that form very early — usually before you know you're pregnant. Folic acid and methylfolate both count, so either kind of prenatal is fine. What matters is taking it every day, starting before you try.

Moderate evidence Iodine, 150 micrograms. Iodine supports the baby's thyroid and brain development, and it's recommended for anyone planning a pregnancy — yet a surprising number of prenatals leave it out. Check the label.

Moderate evidence Choline. Important for the baby's brain and spinal cord development, and most prenatals contain little or none, so many people fall short. More on the choline gap.

Limited or mixed Vitamin D. Most prenatals include it. Its link to fertility itself is mixed in the research, but correcting a low level is standard care — if you've been low before, ask to have it checked before you conceive.

Been told about MTHFR, or that you need "methylated" folate? That comes up a lot, and it's a bigger topic than most people starting out need. Here's what the variant means and what the research actually supports.

A preconception visit

No rating here — this describes what an appointment covers, rather than claiming a treatment works.

A normal appointment with your OB-GYN or primary care doctor. It usually covers medications (some need to be changed before pregnancy), vaccination status, chronic conditions like thyroid disease or diabetes, and family history. It's the single most useful step at this stage.

Cycle basics

Strong evidence Regular cycles of roughly 21 to 35 days usually mean you're ovulating. The fertile window is the several days before ovulation; intercourse every one to two days across that window is enough. Apps and tests can help if cycles are irregular, but tracking perfectly isn't required and can add stress.

Things that genuinely matter

Strong evidence No smoking for either partner, and no alcohol for you while you're trying. You could be pregnant before you know it, and there's no known safe amount. Smoking reduces fertility in women and men, and heavy drinking affects sperm, so your partner should cut back too.

Moderate evidence Keeping caffeine under about 200 mg a day — about two 8-ounce cups of home-brewed coffee. That's ACOG's limit for pregnancy, and a sensible one while trying. Cutting further has not been shown to help.

Moderate evidence Weight at either extreme can affect ovulation, and moving toward the healthy range is associated with better outcomes.

Emerging evidence For your partner: heat exposure, some medications and anabolic steroids affect sperm. The steroid effect is well established; the rest is mostly observational.

Want to optimize further?

You don't have to stop at the basics. There's real research on eating pattern, omega-3s, vitamin D levels, sleep, stress, and specific supplements like myo-inositol and CoQ10, with evidence ranging from solid to early. Sperm take about three months to develop, so this is a good window for both of you. We've sorted all of it by strength of evidence in What actually helps fertility beyond the basics? — so you can choose what's worth your effort and bring the rest to your doctor as questions.