One of the most powerful tools in my work as a Maternal Medicine specialist is preconception counselling.
It is something I routinely offer to women with complex medical needs
those with autoimmune conditions, high blood pressure, heart disease, or kidney disorders.
But increasingly, I am offering it to a group often overlooked in this space: elite athletes.
And I could not be more pleased that more athletes are asking for it.
The best pregnancies are planned ones. Most people are aware of the basics like taking folic acid, vitamin D, or perhaps aspirin in certain cases
but high-performance athletes need something more tailored.
Their physiology, workload, and long-term goals demand a more nuanced approach.
Elite athletes face the same fertility challenges as other women.
Conditions like PCOS, fibroids, and endometriosis are not uncommon.
But athletes also face unique risks.
One of the most important is Relative Energy Deficiency in Sport (RED-S).
It can silently disrupt the menstrual cycle, shorten the luteal phase, and even stop ovulation altogether.
These disruptions often go unnoticed, but can lead to fertility issues or increase the risk of miscarriage.
That is why I created the Dr Zafrani Elite Preconception Protocol — a bespoke, athlete-specific approach designed to help elite performers:
- Optimise their health and athletic performance
- Understand and protect their fertility
- Make informed decisions around timing, medical risk, and career planning
The protocol includes (but is not limited to):
- Comprehensive hormonal and blood testing
- Egg reserve (AMH) assessment
- Menstrual cycle tracking and mapping for actionable insight
- Nutrition and training reviews with performance and pregnancy in mind
- Injury history analysis and recovery planning
- Partner involvement, including sperm health assessments — because it is not just about the woman
Preconception is a unique window of opportunity. What you do in this phase can shape not only your pregnancy outcomes, but your performance trajectory and long-term health.
If you are an athlete — or support one — and want to explore how this protocol can fit into your goals, I would love to speak with you.
Let’s make sure you are as prepared for pregnancy as you are for competition.