For many couples, conversations around fertility often begin only when they decide it is finally time to have a baby. But fertility does not always become a concern overnight. Changes in menstrual cycles, period symptoms, thyroid levels and even a partner's health can sometimes be worth paying attention to much earlier. This is especially relevant for couples who may be planning a pregnancy a few years from now and want to understand their reproductive health before they start trying.

While fertility treatments such as IVF can be expensive, early attention to possible concerns may help couples understand what is going on with their health sooner. 

Nutritionist Rashi Chowdhary has shared an Instagram post on the subject, pointing out five signs women planning a baby should not ignore. She refers to the three to six months before conception as the “zero trimester” and suggests using this time to check in on different aspects of health.

Here are the five red flags she highlighted:

1. Your Period Comes Too Early Or Too Late

According to Chowdhary, a menstrual cycle that is shorter than 21 days or longer than 35 days could be a sign of inconsistent ovulation. “No ovulation means no egg to fertilise,” she says in the video. However, cycle length can vary for several reasons, so an irregular cycle is worth discussing with a gynaecologist rather than assuming it automatically means an ovulation problem.

2. Spotting Before Your Period

Chowdhary also asks women to pay attention to spotting that happens three to five days before their period. She says this is sometimes mistaken for an early period and links it to low progesterone and a shorter luteal phase. The luteal phase follows ovulation and, as she explained, is the stage when embryo implantation can take place.

3. Severe Period Pain

Period pain that does not improve with rest or painkillers is another concern she flagged. Chowdhary says this could sometimes point to endometriosis, a condition that can take time to diagnose. She advises women with persistent or severe pain to seek medical advice and, if needed, get more than one gynaecological opinion.

4. Keep An Eye On Thyroid Levels

The nutritionist also speaks about TSH levels while planning pregnancy. She says many fertility experts prefer TSH to be below 2.5 during fertility planning, adding that a level around 4 or 4.5 may fall within a general lab's normal range but may not be considered “optimal” in this context. Thyroid results should be interpreted by a doctor based on the individual.

5. Fertility Is Not Only A Woman's Responsibility

Chowdhary's final point is about male fertility. She stresses that both partners should be involved in fertility planning, saying, “When it comes to fertility, we now have confirmed studies that it is 50% egg and 50% sperm.” The exact causes of infertility can vary, but male factors are an important part of the fertility picture. She encourages husbands to take equal responsibility for their health and fertility checks instead of leaving the entire process to women.

If you are planning to have a baby in the next few years, paying attention to your health early may be more useful than waiting until you start trying to conceive. And if you notice changes in your periods, pain, thyroid reports or other concerns, speaking to a qualified gynaecologist or fertility specialist is a better first step than self-diagnosing.