For these 3 groups, preconception care requires not just ‘caution’ but clear medical assessment.

In clinical consultations, many fertility concerns are not about "whether you can conceive," but whether it is appropriate to conceive under current conditions. Without targeted medical assessment, individuals often repeat attempts under the same risk conditions, prolonging the reproductive timeline.

The following three groups should prioritize a systematic evaluation before trying to conceive, rather than proceeding directly to natural attempts.

1. People on Medication: The key is not whether you take medication, but whether you can tolerate the risk of stopping it.

In outpatient clinics, questions about medication and pregnancy preparation are very common:

• If I have been taking anti-anxiety or mood-stabilizing medication, should I stop it in advance?
• Does using anesthesia for tooth extraction or taking ibuprofen affect conception in the current month?
• I have a thyroid nodule classified as 4A, and my folic acid contains iodine. Should I continue supplementation?

The common thread in these questions is that the medication itself is not the sole source of risk.

Medical judgment typically evaluates three aspects:

1. Whether the drug has clear contraindications during pregnancy or embryo toxicity
2. Whether the underlying disease will significantly relapse or become uncontrollable after stopping the medication
3. Whether there are safer alternatives during pregnancy

For some patients with chronic conditions, maintaining disease stability is a crucial prerequisite for pregnancy safety. Therefore, blindly stopping medication is not necessarily safer and may increase the risk of pregnancy complications.

2. People with Gynecological Conditions: The key is not whether you have a disease, but whether it has already affected reproductive outcomes.

Many individuals preparing for pregnancy discover gynecological issues during check-ups, such as:

• Polycystic ovary syndrome (PCOS) with irregular or persistent anovulation
• Uterine fibroids, especially submucosal fibroids
• High-risk HPV infection or a history of uterine surgery

In clinical judgment, not all gynecological conditions require immediate intervention, but two points must be clarified:

1. Whether the current condition already constitutes a barrier to conception
2. Even if conception is successful, whether it significantly increases the risk of failure or complications

For example, if a PCOS patient has long-term anovulation, directly attempting natural conception has limited success rates. Submucosal fibroids clearly affect embryo implantation and are often recommended for treatment before pregnancy.

Whether to treat first before pregnancy preparation does not have a one-size-fits-all answer, but the prerequisite is to "make a clear assessment before deciding", rather than dragging it out and trying repeatedly.

3. People with a History of Miscarriage: As the number increases, the medical significance changes.

Common clinical consultations include:

• After 2-3 miscarriages, with normal chromosomal tests for both partners, what should we do next?
• Is a high sperm abnormality rate related to miscarriage?
• If we cannot conceive, should we consider assisted reproduction directly?

Medically, a single miscarriage is often a sporadic event. However, when miscarriages recur, it often indicates underlying issues that have not been identified. The evaluation typically focuses on:

1. Embryo chromosomal and genetic factors
2. Uterine structure and endometrial environment
3. Endocrine, immune, and male sperm quality factors

For such individuals, repeated natural attempts do not improve success rates. Identifying the cause and adjusting the strategy is more meaningful.