Important blood tests for preconception & pregnancy

Written By Madeleine Gates

For all my preconception and pregnancy clients, I always recommend regular blood tests to ensure a healthy pregnancy and to help prevent mothers entering postpartum completely depleted and exhausted.

Bloods can also help detect and prevent things like postpartum depression and postpartum thyroiditis (inflammation of the thyroid that often occurs for women after birth).

Preconception:

Before falling pregnant, I recommend getting bloods done 6 months before trying to conceive (minimum 3-4 months before). This is so markers can be worked on, such as with nutritional deficiencies, inflammation, insulin resistance, low thyroid function or hormonal imbalances. Make sure you are off hormonal contraception at this point too (also as it can change blood test results).

  • Baseline bloods - FBC, LFT, U and Es, lipid panel

  • Serum and active vitamin B12

  • Folate

  • Zinc

  • Vitamin D

  • Iron studies (not just ferritin!)

  • Cortisol and DHEAs

  • CRP and ESR (inflammation markers)

  • Insulin and HbA1c

  • Thyroid panel - TSH, T4, T3, thyroid antibodies

  • Homocysteine (methylation marker)

  • Day 2/3 of cycle - FSH, LH, oestrogen

  • Androgens - testosterone, SHBG, FAI

  • 7 days after ovulation - oestrogen and progesterone

  • Other preconception bloods your doctor will most likely order - Blood group and antibodies, Hepatitis B/C, serology for MMR, syphilis, HIV and varicella.

A note on blood tests - it is best to get your bloods done first thing in the morning, make sure you are fasted from food and drinks (but continue normal water intake), that you are not stressed or sick on the day, no alcohol the night before, do not exercise before your bloods are done. Some supplements may need to be stopped a few days before your bloods like vitamin B7/Biotin, iodine, vitamin D and iron. Ensure your bloods are taken in a window representative of your normal baseline health (e.g. not if you are sick, or highly-stressed one day etc.).

Depending on what is going on for my client, I may also order an urinary iodine test, hair tissue mineral analysis, gut or vaginal microbiome testing.

Pregnancy:

I like to check in with my clients in each trimester and I encourage them to get the specific below bloods done in each trimester.

These inlcude:

  • FBC

  • Iron studies

  • Vitamin B12 - active and serum

  • Folate

  • Zinc

  • Vitamin D

  • TSH (thyroid)

Being proactive about your health during your preconception period and during pregnancy and having your doctor on board is important to feel your best during pregnancy and prevent things like postpartum depletion and thyroiditis.

Madeleine Gates
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