Pre–Pregnancy

This detailed guide is designed to be your primary source of information when planning a pregnancy. It covers fertility, preparing your body, recognising pregnancy, and LGBTQ+ family-building pathways.

How long does it usually take to get pregnant?

If you are having regular vaginal sex (every 2–3 days) without contraception:

  • Around 1 in 4 couples conceive in the first month.
  • Around 7 in 10 conceive within 6 months.
  • Around 8 in 10 conceive within 1 year.

Fertility declines gradually with age, particularly after 35. Both egg quality and sperm quality change over time.

If you are under 36 and have been trying for 12 months, or 36 and over and trying for 6 months, speak to your GP.

Further reading: How long it takes to get pregnant

Understanding ovulation and fertile windows

Ovulation usually occurs around 12–16 days before your next period. An egg survives for approximately 24 hours. Sperm can survive up to 7 days.

Having sex every 2–3 days ensures sperm are present when ovulation happens without creating unnecessary pressure.

Lifestyle factors affecting fertility

Both partners’ health plays a role in conception.

  • Smoking affects egg and sperm quality and increases miscarriage risk.
  • Alcohol can reduce fertility in both partners.
  • Being overweight or underweight can affect ovulation.
  • Recreational drugs may impair fertility.
  • Excessive heat exposure may affect sperm production.

If you have PCOS, endometriosis, diabetes, thyroid disorders, or previous pelvic infections, early medical advice is recommended.

Planning your pregnancy

Preparing your body before pregnancy can reduce risks and improve outcomes.

Before conception you should:

  • Take 400 micrograms of folic acid daily (5mg if advised).
  • Ensure adequate vitamin D intake.
  • Review medications for pregnancy safety.
  • Optimise management of long-term conditions.
  • Check vaccination status (e.g. rubella).
  • Attend cervical screening if due.

Further reading: Planning your pregnancy

Doing a pregnancy test

Most home pregnancy tests are reliable from the first day of a missed period. Testing too early can result in a false negative.

If your test is positive, refer yourself to maternity services promptly.

Further reading: Doing a pregnancy test

Signs and symptoms of pregnancy

Common early symptoms include:

  • Missed period
  • Nausea or vomiting
  • Breast tenderness
  • Tiredness
  • Increased urination
  • Implantation bleeding

Seek urgent advice if you experience severe abdominal pain, shoulder pain, dizziness or heavy bleeding.

Further reading: Signs and symptoms of pregnancy

Planning another pregnancy

Preparation remains important for subsequent pregnancies.

  • Take folic acid before conception.
  • Discuss spacing between pregnancies.
  • Review previous complications.

Further reading: Planning another pregnancy

Having a baby if you’re LGBT+

Family-building options depend on fertility, relationship status and personal preference.

Routes to parenthood

  • Donor insemination (clinic or home).
  • IUI (intrauterine insemination).
  • IVF (in vitro fertilisation).
  • Reciprocal IVF.
  • Surrogacy.
  • Adoption or fostering.
  •  Co-parenting arrangements.

Access to NHS-funded treatment depends on local integrated care board eligibility criteria.

Legal parenthood considerations

If treatment takes place at a licensed UK fertility clinic, both partners in a same-sex couple can usually be recognised as legal parents.

Private donor arrangements may have different legal implications. Independent legal advice is recommended.

Testosterone and pregnancy

Testosterone is not contraception. Pregnancy is possible while taking it, but it is not recommended to conceive while using testosterone as it may affect fetal development.

Further reading: Testosterone and pregnancy

Chestfeeding considerations

Milk production depends on glandular tissue, previous surgery and hormone exposure. Binding may increase the risk of blocked ducts and mastitis.

Further reading: Chestfeeding guidance