Preconception check
The checks doctors recommend before you start trying, in one visit. Ten markers, explained by an Australian doctor.
The preconception check is a ten-marker blood panel covering the things worth knowing before you try to conceive: immunity, blood group, iron and nutrient stores, thyroid function and blood sugar. It costs $299 with your own doctor's signed request, or $379 with a KnowLuna doctor who requests the panel and explains the results in a 20-minute video consult. Collect at an accredited Australian centre or book a nurse home visit at checkout, with no fasting needed (options below).
What it measures
- Rubella immunity: shows whether you are protected. Immunity can be topped up before pregnancy but not during it, which is the whole reason this is a preconception test.
- Varicella immunity: chickenpox protection, checked for the same reason. Many adults are immune without remembering an infection.
- Blood group and antibodies: your ABO group and Rh status, plus a screen for red cell antibodies. Rh negative women need specific care in pregnancy, so it is better known in advance.
- Iron studies: ferritin and iron stores. Pregnancy draws heavily on iron, and starting depleted makes tiredness and anaemia in later pregnancy far more likely.
- Full blood count: haemoglobin and red cell indices, which show anaemia and can hint at an inherited red cell condition worth investigating. If your family background is Mediterranean, Middle Eastern, African, South Asian or South-East Asian, ask about a thalassaemia and haemoglobinopathy screen (haemoglobin studies), which is Medicare-rebated with a GP request; a KnowLuna doctor can request it for you, and a positive screen is confirmed with a DNA test.
- Folate: essential in the earliest weeks, often before you know you are pregnant.
- Vitamin B12: works with folate for red cells and for the developing nervous system, and is worth checking if you eat little or no meat.
- Vitamin D: commonly low in Australian women, particularly through winter.
- TSH: thyroid function affects both conception and early pregnancy, and pregnancy uses trimester-specific ranges set by the laboratory.
- HbA1c: average blood sugar over two to three months, which flags raised glucose before rather than during a pregnancy.
Who it's for
Anyone planning a pregnancy in the next year, including women thinking about a second or third baby, women coming off contraception, women preparing for fertility treatment, and anyone who wants a clear baseline before trying. It is for adults aged 18 and over.
The preconception checklist, and what each result leads to
| Marker | Why it is checked before pregnancy | What a result can lead to |
|---|---|---|
| Rubella and varicella immunity | Both infections can affect a pregnancy, and immunity is best sorted beforehand | If you are not immune, your doctor discusses timing with you before you start trying |
| Blood group and antibodies | Rh status and red cell antibodies shape monitoring later in pregnancy | Rh negative results are noted so your maternity care can plan for it |
| Iron studies and full blood count | Pregnancy increases iron demand substantially | Low stores are addressed with your doctor before conception rather than in the third trimester |
| Folate and vitamin B12 | Both matter most in the first weeks after conception | Your doctor advises on what to do next in the months before you try |
| Vitamin D | Deficiency is common in Australia and easy to check | A low result is followed up with your doctor |
| TSH | Thyroid function influences conception and early pregnancy | An abnormal TSH leads to a fuller thyroid panel and a doctor's review |
| HbA1c | Raised blood sugar is better identified before a pregnancy than during one | A raised result is confirmed and discussed with your doctor |
What you'll learn, and what you won't
You'll learn where you stand on immunity, blood group, iron, folate, B12, vitamin D, thyroid and blood sugar, and which of those is worth acting on in the months before you try. That is the point of doing it early: several of these are easier to fix with time, and immunity gaps cannot be fixed once you are pregnant.
What it cannot do: it is not a fertility test and says nothing about ovarian reserve or ovulation, it does not screen your genes, and it cannot tell you how long conception will take. It also does not include the routine infection screening that forms part of antenatal care in Australia, which your GP or maternity provider arranges, and it does not replace that care once you are pregnant. A blood test is one input to a doctor's assessment, not a diagnosis on its own.
What to add, and what your partner can do
Two things sit naturally alongside this panel. Reproductive carrier screening looks at whether you carry a gene change for cystic fibrosis, spinal muscular atrophy or fragile X, which RANZCOG guidance suggests offering to every couple. The AMH and fertility panel answers a different question, about ovarian reserve and cycle hormones, and suits women who want to understand their timeline as well as their readiness.
For partners, a semen analysis is the single most informative first test, since male factors contribute to around half of the couples who have difficulty conceiving. Doing both at the same time saves months.
Reference ranges and what they mean
| Marker | Typical adult range | What it usually means |
|---|---|---|
| Rubella and varicella immunity | Reported qualitatively as immune or not immune, based on antibody levels | Not immune means your doctor discusses timing with you before you start trying. |
| Blood group and antibodies | Reported qualitatively, with your ABO group and Rh status named and any red cell antibodies listed | These are status results rather than numbers on a scale. |
| Ferritin | Below about 30 ug/L is widely used in Australia to indicate low iron stores, and some laboratories use 15; many doctors prefer stores above about 50 ug/L before pregnancy | Low stores before pregnancy usually mean low stores during it, so this is worth acting on early. |
| Folate and vitamin B12 | Laboratory-specific. Serum folate is generally reported as low below about 10 nmol/L, and serum B12 as low below about 150 pmol/L, with roughly 150 to 220 pmol/L borderline | Low or borderline results are followed up with your doctor. |
| Vitamin D (25-OH) | 50 nmol/L or above is generally considered sufficient | Below 50 nmol/L is deficiency: mild 30 to 49, moderate 12.5 to 29, severe below 12.5. |
| TSH | About 0.4 to 4.0 mIU/L outside pregnancy. In pregnancy laboratories use trimester-specific ranges, with a first-trimester upper limit commonly around 4.0 mIU/L; women already on thyroid medication are usually asked to be below 2.5 mIU/L before conceiving | An abnormal result leads to free T4, thyroid antibodies and a doctor's review. |
| HbA1c | Below 6.0 percent (42 mmol/mol) is typical; 6.0 to 6.4 percent (42 to 47 mmol/mol) is the higher-risk band that is followed up; 6.5 percent (48 mmol/mol) or above on repeat is in the diabetes range | A raised result is confirmed on repeat and discussed with your doctor before you try. |
Ranges vary by laboratory; your report shows the range your lab uses. Typical ranges on this page are drawn from Pathology Tests Explained (RCPA) and the sources listed below.
When to do this test
Ideally about three months before you start trying, on any day, with no fasting. Three months gives you time to act on anything the panel finds, since immunity, iron stores and vitamin D all take weeks to shift. Any cycle day is fine and there is no need to stop the pill first, but tell us if you use hormonal contraception: combined hormonal contraception can lower measured B12 and folate and can change iron readings, and your doctor takes that into account. If you are already pregnant, most of these checks form part of standard antenatal care, so speak to your maternity provider rather than repeating them here. Tell us about any supplements you take, because recent doses can lift iron, folate, B12 and vitamin D readings.
Medicare, and why people order this privately
Your own GP can arrange most of these checks, and some attract a Medicare rebate when there is a clinical reason. Ordering through KnowLuna is self-pay and is not Medicare-rebated. What you are paying for is a single visit, a doctor who requests the panel without a referral, and results explained in plain English rather than left on a portal. If cost is your main concern, start with your GP. Read our factual comparison at KnowLuna and your GP.
How it works
- Order online. Either upload the request your own doctor has signed, or a KnowLuna women's health doctor reviews your short questionnaire and requests the panel.
- Collect at an accredited centre near you, or book a nurse home visit (options below). One visit, any day, no fasting.
- Results are usually ready within a few business days, explained in plain English in your account, with a 20-minute doctor consult if you chose that option. Abnormal results are always followed up by a doctor.
Choose how you collect
Every option is the same accredited test and the same report. Pick what suits you at checkout; the fee, if any, is added to either pathway price.
A quick draw at an accredited pathology collection centre near you. Usually under ten minutes. Included.
A registered nurse comes to your home or workplace for a standard blood draw. Metro areas of capital cities; other locations on request.
Common questions
What blood tests should I have before trying to get pregnant?
Australian preconception care usually covers rubella and varicella immunity, blood group and antibodies, iron studies and a full blood count, folate, B12 and vitamin D, thyroid function and blood sugar, plus routine infection screening that your GP arranges. This panel includes the ten blood markers; the infection screening is done through your GP. Reproductive carrier screening is recommended alongside it as a separate test.
How long before trying should I do a preconception check?
About three months is the usual advice. That leaves time to act on anything found, because immunity, iron stores and vitamin D all take weeks to change. If you are trying already, it is still worth doing now rather than waiting, since several results affect how your pregnancy is monitored.
Is a preconception blood test covered by Medicare?
Your own GP can arrange many of these markers, and some attract a Medicare rebate where there is a clinical reason for them. Ordering the panel through KnowLuna is self-pay, so it is not Medicare-rebated. The trade-off is time and explanation rather than the test itself, which is run at an accredited Australian laboratory either way.
Do I need to fast?
No. None of the ten markers needs an overnight fast, including HbA1c, which reflects average blood sugar over two to three months rather than what you ate this morning. Any day of your cycle works, and you do not need to stop hormonal contraception before collecting, though it is worth telling us you use it, because combined hormonal contraception can shift measured B12, folate and iron readings.
Should my partner be tested too?
It is worth considering. A semen analysis is the most informative first test for a male partner, and male factors contribute to roughly half of the couples who have difficulty conceiving. Partners are also tested for carrier screening if you are found to be a carrier of cystic fibrosis or spinal muscular atrophy.
Is this the same as carrier screening?
No. This panel checks your current health and immunity. Reproductive carrier screening looks at three of your genes to see what you could pass on. They answer different questions, and RANZCOG guidance suggests offering carrier screening to every couple, so many people do both before trying.
Sources and further reading
- RANZCOG: Pre-pregnancy counselling (C-Obs 3a)
- RACGP: Guidelines for preventive activities in general practice (the Red Book)
- Pathology Tests Explained (RCPA): reproductive carrier screening
- Pregnancy, Birth and Baby: planning for your pregnancy
- Pregnancy, Birth and Baby: preconception health for females
- Pregnancy, Birth and Baby: blood tests during pregnancy
General information only, not medical advice. A test result is one input to a doctor's assessment, not a diagnosis on its own, and every abnormal result is followed up by a KnowLuna doctor. If your symptoms are severe or sudden, see a doctor promptly. Read our medical disclaimer.
Related
One visit, ten answers.