Men and partners are important contributors to the health of future generations, yet their own preconception health and wellbeing remain secondary considerations in research, practice, and policy. Siloed research has exacerbated this deficit. Clinical research typically has a narrow focus on proximal behavioural factors related to periconceptional events (eg, paternal dietary influences on the sperm epigenome), with social research focusing largely on postnatal parenting. Here, we update and reappraise the evidence for men's role in preconception health through a transdisciplinary review. Across biological and behavioural research, young men's early life course experiences have been shown to shape their own and their partner's preconception physical, emotional, and behavioural health. Moreover, focusing on men's preconception health offers a corrective for legacies of sexism, which place responsibility for intergenerational health solely on the birthing parent, and of racism and colonialism, which have disproportionately disrupted the familial and societal roles of Black and Brown men. We provide three case studies illustrating these ethical concerns and conclude that greater attention to young men would lead to more equitable and holistic preconception health interventions and policy.

As efforts to support pregnancy planning and improve preconception health are increasing at scale, appropriate systems to monitor progress are required. Despite developments in a few countries, no surveillance systems currently in operation are using a comprehensive set of indicators for monitoring preconception health. This Review describes relevant indicators, reflecting both system-level and individual-level factors, that can be drawn from routine data sources to form the basis for developing new surveillance systems. We present a new framework for national and international surveillance that incorporates, for the first time, community perspectives on the factors that matter most before pregnancy and parenthood. Finally, we describe an international collaboration working towards a core set of indicators that can be compared across low-income, middle-income, and high-income countries, and discuss future directions to enhance and expand international monitoring of pregnancy planning and preconception health.