What blood tests are recommended when trying to get pregnant?

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Recommended Blood Tests When Trying to Get Pregnant

When trying to get pregnant, a comprehensive panel of blood tests should be performed including complete blood count, blood type and Rh status, rubella immunity, hepatitis B surface antigen, HIV, syphilis, and thyroid-stimulating hormone levels. 1, 2

Essential Blood Tests Before Conception

Basic Laboratory Tests

  • Complete blood count (CBC) to assess for anemia 1, 2
  • Blood type and Rh status 1, 2
  • Urinalysis 1, 2

Infectious Disease Screening

  • Rubella immunity (IgG antibody) 1, 2, 3
  • Hepatitis B surface antigen 1, 2, 3
  • HIV antibody test 1, 2, 3
  • Syphilis serology 1, 2, 3
  • Chlamydia and gonorrhea screening 1, 2

Metabolic and Endocrine Tests

  • Thyroid-stimulating hormone (TSH) levels 1
  • Fasting glucose or hemoglobin A1C to screen for diabetes 1, 2

Additional Tests Based on Risk Factors

Genetic Screening

  • Carrier screening for cystic fibrosis 1
  • Carrier screening based on ethnic background (e.g., thalassemia for Southeast Asian populations) 1
  • Family history assessment for genetic disorders 1

Additional Tests for High-Risk Women

  • Hepatitis C antibody for women with risk factors 4
  • Toxoplasmosis serology for women with significant exposure to cats or raw meat 3
  • Mean corpuscular volume (MCV) for parents to screen for thalassemia if <80 fL 1

Importance of Preconception Testing

Early identification of medical conditions before pregnancy allows for:

  1. Optimization of maternal health: Managing conditions like diabetes or thyroid disorders before conception improves pregnancy outcomes 1
  2. Prevention of congenital anomalies: Ensuring rubella immunity and adequate folic acid levels reduces risk of birth defects 1, 2
  3. Prevention of vertical transmission: Early identification and treatment of infections like HIV, hepatitis B, and syphilis significantly reduces transmission to the baby 1, 5

Common Pitfalls to Avoid

  • Delaying screening until pregnancy: Many interventions are most effective when implemented before conception 1
  • Incomplete infectious disease screening: Missing HIV or hepatitis B screening can lead to missed opportunities for preventing vertical transmission 1, 2
  • Overlooking thyroid function: Undiagnosed thyroid disorders can affect fertility and early pregnancy 1
  • Neglecting genetic carrier screening: Certain genetic conditions have high carrier rates in specific populations 1

Timing of Testing

Blood tests should ideally be performed 3-6 months before attempting conception to allow time for any necessary interventions, such as rubella vaccination or optimization of chronic conditions like diabetes or thyroid disorders 1.

For women who are already trying to conceive, testing should be done as soon as possible, as early identification and management of conditions can significantly improve pregnancy outcomes 1, 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Prenatal Care

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

1: Infections in pregnant women.

The Medical journal of Australia, 2002

Research

Hepatitis C in pregnancy: screening, treatment, and management.

American journal of obstetrics and gynecology, 2017

Research

Syphilis in pregnancy.

Sexually transmitted infections, 2000

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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