Many couples wait until they're pregnant to see a doctor. This is understandable, but not ideal. The period before conception is a precious window of opportunity to identify and correct factors that could affect fertility, the course of pregnancy or the baby's health. A well-done preconception check-up, carried out a few months before trying to conceive, can make a real difference.
In Quebec, this assessment is not systematically offered by the public system, but is available in private medical clinics or through an IPS.
Why consult before conceiving
Certain unknown or untreated medical conditions can complicate pregnancy or affect fetal development. Hypothyroidism, diabetes, hypertension, coagulation disorders and certain autoimmune diseases are among the conditions that benefit from management before conception rather than during pregnancy. Identifying and stabilizing these conditions in advance reduces the risk of obstetrical complications.
The preconception check-up also makes it possible to verify immunization status, optimize micronutrient intake essential for embryonic development, and identify genetic risk factors if family history warrants.
Key balance sheet items
Preconception blood tests usually include a complete blood count (CBC) to screen for anemia, blood group and Rh factor, TSH to assess thyroid function, fasting blood glucose, rubella and varicella immune status, and serologies for infections such as toxoplasmosis and syphilis. Screening for STIs, notably chlamydia and HIV, is also part of the basic check-up.
Folic acid deserves special attention. Its supplementation, at a minimum of 0.4 mg per day for women with no risk factors, should ideally begin three months before conception to significantly reduce the risk of neural tube defects in the baby. For women with certain risk factors, the recommended dose is higher, and the doctor adjusts the prescription accordingly.
Check vaccination status
Rubella and chickenpox are two infections that are particularly dangerous for the fetus if they occur during pregnancy. If serology shows no immunity, the corresponding vaccines can be administered before conception, but not during pregnancy, as they are live attenuated vaccines. A delay of one month after vaccination is recommended before attempting to conceive. Pertussis is also checked as part of the preconception vaccination status.
Lifestyle habits to optimize
The preconception period is the ideal time to discuss diet, physical activity, alcohol, tobacco and caffeine consumption, and exposure to potentially teratogenic substances in the workplace or home. These factors influence fertility in both partners and embryonic development in the early weeks, often even before pregnancy is confirmed.
In men, too, preconceptional health counts. Sperm quality is influenced by smoking, alcohol, excessive heat, certain medications and nutritional deficiencies. A male check-up is often relevant in the event of difficulty conceiving, but some men choose to optimize their lifestyle as a preventive measure.
Frequently asked questions about the preconception check-up
How long before I conceive should I have a check-up?
Ideally, three to six months before stopping contraception. This allows time for necessary vaccinations, correction of deficiencies and stabilization of any identified medical conditions.
Is the preconception check-up covered by RAMQ?
Some items may be covered if prescribed in a medically justified context. Others are part of preventive medicine and may have to be paid for by the patient in the absence of a family doctor. In private medical clinics, a complete preconception check-up is available without a waiting list.
Should I have a preconception check-up even if I'm in good health?
Yes, even in the absence of known health problems, the check-up ensures that immunization status is up to date, folic acid intake is optimal and that there are no silent conditions that could complicate the pregnancy.
When to consult a healthcare professional
If you're planning a pregnancy in the next few months, have a relevant personal or family medical history, or have had difficulty conceiving in the past, a preconception consultation is essential.
A doctor or specialized nurse practitioner can carry out the check-up, prescribe the appropriate tests and vaccinations and help you prepare for pregnancy. A face-to-face or online consultation teleconsultation at one of our Omicron Clinic in Quebec gives you immediate access.
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