The neural tube closes by day 28.
That is four weeks after conception, which for most women is about the time a period goes missing and a test gets bought. By the point you know you are pregnant, the structure that becomes the brain and spinal cord has already formed or failed to. Nothing you start in week six affects it.
This is the whole argument for preconception care, and it is why the phrase exists as a separate thing from prenatal care.
What preconception care actually means
Preconception care is the medical and lifestyle preparation done before conception rather than after it. It covers screening tests, vaccinations, correcting nutritional gaps, reviewing existing medications and conditions, and changing habits that affect egg and sperm quality. The standard recommendation is to begin at least three months before you start trying.
Three months is not arbitrary. It is roughly one cycle of egg maturation and one full cycle of sperm production, so it is the shortest window in which anything you change can actually show up in the biology.
Folic acid, done properly
Most women in India have heard they should take folic acid. Far fewer have been told when to start or how much, and this is the part clinics rush through.
The standard dose is 400 mcg daily, started at least one month before conception and ideally three. Not the week you get a positive test.
A higher dose, usually 4 to 5 mg, is advised if you have had a previous pregnancy affected by a neural tube defect, if you have diabetes, if you are on antiepileptic medication, or if your BMI is above 30. That decision belongs to your doctor and not to a blog or a chemist.
Some formulations use L-methylfolate instead of folic acid, which is the already active form and skips a conversion step in the body. Both work. The methylfolate versions are more relevant for women with known MTHFR variants, though the practical difference for everyone else is smaller than the marketing suggests, and I would rather someone took plain folic acid consistently than took a premium version irregularly.
The pre pregnancy checkup: what to actually get tested
Ask for a preconception panel and you will often get a vague nod and a thyroid test. Here is what a reasonable workup includes:
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Blood group and Rh typing, for both partners
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Complete blood count with ferritin, since iron deficiency is very common in Indian women and starting pregnancy already depleted is a bad opening position
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TSH, because untreated hypothyroidism affects both conception and early development
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Fasting glucose or HbA1c
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Vitamin D and vitamin B12
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Rubella IgG, to check immunity
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HIV, HBsAg and VDRL
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Thalassemia carrier screening with HbA2
That last one deserves emphasis. Beta thalassemia carrier rates in parts of Gujarat and western India sit well above the national average, and two carriers have a one in four chance of an affected child in every pregnancy. It is a cheap test. Both partners need it, and it is worth doing before conception rather than at the twelve week scan when the options narrow considerably.
Add a pelvic ultrasound if your cycles are irregular, and AMH only if there is a specific reason, since it predicts response to stimulation better than it predicts natural conception.
Vaccines, and the timing that catches people out
Rubella infection in early pregnancy can cause serious birth defects. If your rubella IgG comes back negative, you need MMR, and then you must avoid conception for one month afterwards. This is the single most common reason preconception planning has to be pushed back, and finding out in month one is far better than finding out later.
Also worth reviewing: hepatitis B if unvaccinated, Tdap status, and influenza depending on the season. Chickenpox too, if you have never had it and have no record of vaccination.
Medications and conditions to sort out first
Bring every strip and bottle to the appointment. Prescription drugs, over the counter painkillers, Ayurvedic preparations, skincare.
The ones that commonly need changing before conception rather than after: isotretinoin for acne, certain antihypertensives including ACE inhibitors and ARBs, some antiepileptics, methotrexate, and high dose vitamin A. Antidepressants often continue, and stopping them abruptly because of a pregnancy plan tends to cause more harm than the medication does. That is a conversation, not a unilateral decision.
If you have PCOS, thyroid disease, diabetes or hypertension, the goal is stable control before conception, not after. Getting HbA1c into range before pregnancy measurably lowers the risk of congenital anomalies. Getting it into range in month three does not do the same job.
Weight, food and the things to stop
Both extremes of weight affect ovulation, and the middle of the range is where cycles behave. Losing weight in the run up is useful. Attempting it during pregnancy is not.
Diet advice here does not need to be exotic. More iron and protein, more leafy vegetables, dairy or a calcium source, and enough B12, which matters more for vegetarians than most Indian diet articles admit.
Stop smoking and cut alcohol, both partners. Caffeine is worth capping around 200 mg a day, roughly two cups, and the evidence for panic beyond that level is weaker than the internet suggests.
Get a dental checkup. Gum disease is associated with preterm birth, and dental work is simpler done before pregnancy than during it.
The half of this that gets skipped
Preconception care is written almost entirely for women, and the workup in most Indian households follows that pattern. It should not.
A semen analysis is cheap, fast and non invasive, and male factor contributes to roughly half of all cases where couples struggle. Sperm run on the same ninety day clock, so the changes a man makes in this window matter for the same reason hers do. We have written separately about what actually affects sperm health and about how to time your fertile days once the preparation is underway.
Both partners should be taking this seriously in the same quarter, which is why Neujoy's preparation range is built for two.
When to bring this forward
See a doctor sooner rather than starting on your own if you are 35 or older, if your cycles are irregular or absent, if you have had two or more miscarriages, if there is a family history of genetic conditions or thalassemia, or if you have any chronic condition currently on medication.
FAQs
What is preconception care?
Preconception care is the medical and lifestyle preparation done before pregnancy, covering screening tests, vaccinations, folic acid, medication review and habit changes. It is usually recommended to begin three months before trying to conceive.
When should I start folic acid before pregnancy?
At least one month before conception, ideally three. The standard dose is 400 mcg daily, with higher doses only on medical advice.
What tests are done in a pre pregnancy checkup?
Blood group and Rh, CBC with ferritin, TSH, blood sugar, vitamin D and B12, rubella immunity, HIV, HBsAg, VDRL, and thalassemia carrier screening for both partners.
How long before pregnancy should I start preparing?
Three months at minimum, since that is roughly one full cycle of egg and sperm development.
Do men need preconception care too?
Yes. Sperm develop over about ninety days, and male factors contribute to nearly half of conception difficulties.
Book the tests first. The diet and the supplements will still be there next week, but the rubella result decides whether you are starting this month or the month after.
This article is for general information and is not a substitute for medical advice. Neujoy products are wellness supplements, not medicine.