Case Study: Preparing for a Healthy Pregnancy – Ruth’s Preconception Journey
The Challenge
Ruth, in her 30s, came to see me as she was preparing for pregnancy and wanted to make sure her body was in the best possible health before conceiving. Her blood tests revealed:
Very low vitamin D levels (37 nmol/L – optimal is 100+)
Low iron stores (ferritin), following influenza A and a recent blood donation
A history of fluctuating moods in winter
Concerns about egg reserves after a low AMH result
While fertility was on her mind, Ruth mainly wanted clarity and professional guidance around her health results. Rather than unnecessary worry, she was seeking practical, evidence-based solutions to feel confident heading into conception.
My Approach
I ran a complete preconception panel and walked Ruth through each marker in detail, explaining how her results related to her overall health and fertility. My focus was on building her nutrient stores well before conception, correcting imbalances, and reassuring her about her reproductive health.
Key steps included:
Boosting Vitamin D: Prescribed an activated vitamin D to quickly lift her levels, followed by a safe maintenance dose in her prenatal multi.
Supporting Iron Stores: Recommended iron supplementation along with food-based strategies (e.g., adding iron-rich foods such as dried apricots), while explaining the impact of recent illness and blood donation.
Hormonal Reassurance: Reviewed her hormones and cycles, highlighting her regular ovulation and balanced progesterone and estrogen. I reassured her that while AMH can reflect egg quantity, her cycle showed strong ovarian function.
Tailored Preconception Nutrition: Prescribed a comprehensive prenatal multi including folate, B12, vitamin D, plus additional nutrients such as DHA and choline for future baby’s brain and nervous system development.
Dietary Guidance: Suggested practical food swaps and adjustments, like modifying her breakfast to better support iron and B-vitamin intake.
I explained to Ruth: “We want your nutrients ready before conception, so your body isn’t trying to both build its stores and support a growing baby at the same time.”
Results
Within just a few months, Ruth experienced noticeable improvements:
Nutrient Replenishment: Vitamin D, folate, and B12 began rising towards optimal ranges.
Clarity & Confidence: “I finally understand what my blood tests mean and feel reassured instead of anxious.”
Fertility Peace of Mind: She no longer felt distressed about her AMH and trusted that her hormones and cycles were healthy.
Emotional Wellbeing: With nutrient levels improving, her mood stability strengthened, especially through winter.
As she shared:
“It’s such a relief to know my nutrients are where they should be and to have a clear plan for pregnancy. Everything was explained so clearly – I finally get it. I feel confident and ready.”
Key Wins
Lifted vitamin D to support immune regulation for conception
Corrected low iron storage without the need for an infusion
Reinforced her understanding of healthy ovulation despite low AMH
Created a clear 3–6 month preconception plan to optimise both her nutritional and emotional readiness
Takeaway
Ruth’s journey highlights the value of thorough preconception care: not only correcting nutrient deficiencies, but also fostering trust in the body’s ability to conceive. For Ruth, the right guidance turned her blood test worries into an empowering plan that built confidence and readiness for the next chapter.
