Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO. Last updated: June 2026.
Information on this page is educational and does not replace a medical consultation. Outcomes depend on individual clinical factors.
Aansh Hospital & IVF Center is a growing chain of fertility and women's health centers across Vidarbha and northern Telangana, with its headquarters and in-house embryology lab in Chandrapur, led by Senior Clinical Embryologist Aayush Agarwal, Ph.D. Preconception counseling at Aansh is led by Dr. Shweta Agarwal (MBBS, DGO) — the same clinician who manages fertility assessment, IVF, and antenatal care, so that your care is continuous from the planning stage through to pregnancy. "Aansh" (अंश) refers to this clinic group; you can verify our government ART registration on the National ART & Surrogacy Registry.
Why does what you do before pregnancy matter as much as what you do during it?
The foundation of a healthy pregnancy is laid in the weeks and months before conception. Fetal neural-tube formation begins at approximately three to four weeks of gestational age — before many women have a confirmed pregnancy — and organ development is largely complete by the end of the first trimester. Conditions such as poorly controlled diabetes, unmanaged thyroid disease, or a nutritional gap like insufficient folic acid during this window carry real consequences that cannot be fully corrected once pregnancy is confirmed. Equally, some medications that are safe and necessary for a mother's chronic condition carry teratogenic risk in early pregnancy, and switching to pregnancy-compatible alternatives takes time to be effective. A preconception consultation addresses every one of these factors while you still have the time to act on them — this is fundamentally different from waiting until a positive pregnancy test. For couples planning IVF or ART, preconception optimisation of both partners is also standard practice before stimulation begins.
Who should book a preconception counseling appointment?
A preconception consultation is appropriate for anyone planning a pregnancy — not only people who have experienced difficulties. It is particularly important if any of the following apply:
- Chronic medical conditions in either partner: diabetes (Type 1 or 2), thyroid disorder, hypertension, epilepsy, autoimmune conditions (lupus, antiphospholipid syndrome, rheumatoid arthritis, inflammatory bowel disease), or cardiac conditions.
- Current medications that may need review for teratogenic risk — including antiepileptics, certain blood-pressure drugs, retinoids, immunosuppressants, and disease-modifying antirheumatic drugs.
- Previous pregnancy loss or complicated pregnancy — recurrent miscarriage, stillbirth, preterm birth, or a baby with a birth defect. (See also recurrent pregnancy loss.)
- Family history of an inherited condition — a close relative with thalassaemia, sickle-cell disease, haemophilia, cystic fibrosis, fragile X, a chromosomal condition, or any recessive disease that runs in the family.
- Planned IVF, ICSI, or other ART — preconception optimisation of both partners before stimulation is standard clinical practice.
- Age and fertility planning — understanding how age-related changes in egg and sperm quality affect fertility is a legitimate reason to consult early, even if you are not yet ready to conceive.
- Lifestyle factors — BMI at either extreme, smoking, alcohol use, occupational exposures.
- Previous abnormal Pap smear or cervical procedure — relevant for interpreting early pregnancy risk.
Even if none of the above apply, a routine preconception consultation gives you personalised guidance on supplements, timing, and what to expect, and opens the conversation with your clinician before pregnancy rather than during it.
What does the preconception consultation actually cover?
A full preconception consultation at Aansh typically covers the following areas — the depth of each depends on your individual history:
Medical history review and chronic disease optimisation. Any pre-existing condition — diabetes, thyroid disorder, hypertension, epilepsy, autoimmune disease — is reviewed for its current control status. The goal is to reach the best achievable control of the condition before conception. For example, HbA1c is reviewed in a woman with diabetes because poorly controlled blood glucose in the periconceptional period is associated with increased risk of congenital anomalies; for thyroid disease, TSH is reviewed against pregnancy-specific targets. Where a condition is not yet optimally controlled, counseling includes the steps needed to achieve that before proceeding.
Medication safety review. Every current medication is reviewed for its pregnancy-safety classification. Medications known to carry teratogenic risk are identified and, wherever clinically safe, switched to pregnancy-compatible alternatives — ideally weeks to months before conception so that the switch is stable and effective by the time pregnancy begins.
Folic acid and supplementation. Folic acid supplementation started before conception and continued through the first trimester reduces the risk of neural-tube defects. The standard recommendation for low-risk women is 400 mcg to 500 mcg (0.4 to 0.5 mg) of folic acid daily starting at least one month before trying to conceive and continuing through the first 12 weeks of pregnancy (per FOGSI). For women at high risk of neural-tube defects (such as those with a history of a prior affected pregnancy or taking anticonvulsant medications), a higher dose of 4 mg to 5 mg daily is recommended starting at least one month before conception (per FOGSI). Additional supplementation (iron, vitamin D, iodine) is reviewed on an individual basis.
Immunisation status. Rubella (German measles) immunity is checked, because rubella infection in early pregnancy carries serious risk of fetal abnormality. Women who are not immune are advised to receive the rubella vaccine before conceiving and to delay conception for at least 1 month (per WHO and CDSCO product labels) or up to 3 months depending on clinical advice. The preconception immunisation review assesses immunity to rubella and varicella (live vaccines requiring a delay of at least 1 month before conceiving), Hepatitis B (for high-risk individuals), and ensures up-to-date status for Tetanus, Diphtheria, and Pertussis (Tdap), and Influenza (per FOGSI).
Lifestyle counseling. Weight, nutrition, physical activity, smoking, alcohol, and caffeine are reviewed. Being at a healthy weight before conception is associated with lower risk of gestational diabetes, pre-eclampsia, and complications in labour.
Screening for anaemia and infections. A blood count and relevant infection screens (hepatitis B, HIV, syphilis, rubella serology, thyroid function) are typically requested before conception, so that any finding can be addressed before pregnancy rather than managed reactively during it.
Family and genetic history, and carrier screening where indicated. Both partners' family histories are reviewed for inherited conditions. Where the history raises concern — for example, a family background that increases the probability of thalassaemia carrier status, which is relevant in Maharashtra and Vidarbha — carrier screening may be recommended. Beta-thalassemia carrier prevalence in Maharashtra ranges from 1.0% to 6.0%, with specific regional communities in Vidarbha reaching 8.0% to 17.0% (per published Indian data). This type of genetic testing screens for the risk of passing a disease to a child; it is concerned solely with chromosomal and disease health. Genetic testing and carrier screening are never used to determine or select a baby's sex — this is illegal under the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act and is not offered or facilitated by Aansh Hospital & IVF Center in any form. Other carrier screening panels recommended under Indian guidelines (such as ICMR) include sickle-cell disease, spinal muscular atrophy (SMA), cystic fibrosis (CF), and fragile X syndrome.
Fertility awareness and age-related planning. Age and its effect on egg and sperm quality are discussed in a factual, educational way, including when it may be appropriate to proceed to a fertility assessment before a prolonged period of trying.
Special situations. Couples who have experienced recurrent pregnancy loss, a prior complicated pregnancy, or who are planning IVF receive counseling specific to their situation. This page focuses on the preconception stage; ongoing pregnancy monitoring is described on the prenatal care and high-risk pregnancy pages.
When should I book, and what if I have PCOS?
The ideal time to book a preconception consultation is three months before you plan to start trying to conceive. This window allows enough time to act on any findings — complete a medication switch, stabilise a chronic condition, start folic acid, receive a vaccination and observe the required delay, or undergo a carrier screening blood test and receive results — before you are actually trying. Booking earlier than three months is never a problem; booking only after a positive pregnancy test means some of the most impactful steps have already been missed.
For women with PCOS (polycystic ovary syndrome), a preconception consultation is particularly useful: PCOS is associated with irregular ovulation, increased risk of gestational diabetes, and in some women, higher BMI — all of which can be proactively addressed before conception rather than managed reactively in pregnancy.
What happens after the preconception consultation — what are the next steps?
The consultation produces a personalised preconception plan. Depending on what is found, next steps may include:
- Referral to another specialist (endocrinologist, neurologist, cardiologist) for condition optimisation, if not already under care.
- Initiating or switching medications to pregnancy-safe options.
- Starting folic acid and any other indicated supplements immediately.
- Immunisation if indicated, with a conception timeline.
- A follow-up appointment to review blood results or confirm optimisation before proceeding.
- If fertility concerns are identified, a referral for a fertility assessment to understand ovarian reserve, sperm quality, and tubal status before trying.
- Couples planning IVF are guided into the IVF treatment pathway with preconception optimisation incorporated into the protocol.
Once pregnancy is confirmed, care transitions to the prenatal (antenatal) care programme, with the same clinical team continuing to manage your pregnancy.
How is preconception counseling different for couples planning IVF?
For couples planning IVF or another ART procedure, preconception counseling is integrated into the pre-treatment workup rather than being a separate standalone appointment. The medical history review, medication safety check, and chronic-disease optimisation are performed as part of the baseline assessment before stimulation begins. In addition:
- Both partners are assessed — sperm DNA fragmentation, lifestyle factors, and male-partner conditions that affect fertility are addressed before the cycle, not after a failed attempt.
- If genetic carrier screening or preimplantation genetic testing (PGT) is being considered, this is discussed in the preconception stage. PGT screens embryos for chromosomal or genetic disease risk — it is never used for sex selection, which is illegal under the PCPNDT Act.
- Women with conditions such as PCOS, thyroid disorder, or elevated BMI may need a specific period of optimisation before stimulation begins, and this is planned in advance.
Full information on the IVF process itself — stimulation, egg retrieval, embryo transfer — is on the IVF treatment page. Couples with a history of recurrent pregnancy loss who are considering IVF will also find relevant information on the recurrent pregnancy loss page.
What is carrier screening, and why is it recommended before conceiving in some families?
Carrier screening is a blood test that identifies whether one or both partners carry a gene variant associated with a recessive disease — meaning the disease can be passed to a child only when both parents are carriers. In India, and particularly in Maharashtra and Vidarbha, thalassaemia is among the most clinically relevant recessive conditions because carrier prevalence in Maharashtra ranges from 1.0% to 6.0%, with specific communities in Vidarbha reaching 8.0% to 17.0% (per published Indian data). Other conditions screened for depending on family history may include sickle-cell disease, spinal muscular atrophy (SMA), cystic fibrosis (CF), and fragile X syndrome (per ICMR guidelines).
The purpose of carrier screening is to provide a couple with accurate information about disease transmission risk so that they can make informed reproductive decisions with their clinical team. It is concerned solely with the chromosomal and disease health of a potential pregnancy — it has no connection to a baby's sex. Carrier screening and any form of genetic testing at Aansh is never used to determine or select a baby's sex; sex determination and sex selection are illegal under the PCPNDT Act and are strictly prohibited. If you have questions about whether carrier screening is relevant for your family history, please raise them during your preconception consultation.
What does preconception counseling cost, and is EMI available?
The cost of a preconception consultation includes the clinical appointment and any blood investigations recommended at that visit. Further tests — carrier screening panels, specialist referrals — are costed separately and discussed before any investigation is ordered. You receive a clear explanation of what is being recommended and why before any cost is incurred.
Final cost depends on individual clinical evaluation — see Costs & EMI for current pricing.
- 0% EMI options are available for combined fertility-assessment and treatment packages.
- See the costs & 0% EMI page for full detail.