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What questions should I ask my doctor for fertility?

What questions should I ask my doctor for fertility?

Kindara | April 6, 2021 | trying to conceive
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When trying to conceive goes from an exciting journey to a stressful and frustrating experience, it may be time to visit your OBGYN to get some answers to your questions out of the way. You may have loads of questions  and you should ask them all, no matter how embarrassing they may or may not be. Your doctor has heard them all, we can nearly guarantee it. To help you get the most out of that doctor's visit, we've compiled this list of questions to take with you. 

Could my birth control be stopping me from getting pregnant?

If you're trying to conceive, you presumably already stopped using birth control (BC), but depending on what kind of BC you were on, it can take a minute to get pregnant after you go off of it. There's no evidence that long-term use of oral contraceptives interferes with your fertility, although you may experience a short-term delay in your cycle immediately after discontinuing the pill (1). In the case of the hormonal IUD, 89 out of 100 women in a study became pregnant within one year of removing it (2). If you used the vaginal ring, ovulation should pick back up in the cycle following the removal, which is also the case with the birth control implant (3, 4). The only hormonal birth control that's known to cause a significant delay in the return to fertility is Depo-Provera, or the birth control shot, in which users reported an average of 5.5 months before conceiving (5). Be sure to let your doctor know if you've recently gone off of BC, and what kind. 

When should I see a specialist? 

A reproductive endocrinologist (also called an RE, or a fertility doctor) specializes in diagnosing and treating infertility. According to the Mayo Clinic, you probably don't need to seek help from an RE unless you've been having regular sexual intercourse without using birth control for more than a year without conceiving (6). There are reasons to consult a health care professional earlier, though. If you: 

Should my cis male partner be evaluated for fertility issues? 

Yes. In 1/3 of cases involving infertility, male reproductive issues play a role (7). That means 1/3 of the time, the cause can be attributed to female reproductive issues, and the other 1/3 is a combination of both parties, or the cause is unknown (8). When male reproductive issues are involved,  something is often going on with the sperm that's impeding conception, such as a low sperm count, abnormal shape, or movement (9). 

Your doctor may recommend that your male partner undergo a physical exam, along with a medical history intake and a semen analysis, in which the semen is examined for abnormalities. There are also medical causes for male infertility, including infections, ejaculation issues, and antibodies that attack sperm (10)

Is there anything in my medical history that could be impeding conception? 

Keeping your doctor abreast of your medical history is essential, since there are certain medical conditions that can influence your ability to conceive, like diabetes, polycystic ovary syndrome, thyroid conditions, pituitary gland disorders, and endometriosis (11). Uterine structural issues, such as fibroids, untreated inflammation or a septate uterus (when the uterus is separated by a wall of tissue running vertically down the middle) may also be impacting your ability to conceive (12). 

Is my chart or fertility app showing anything that may help? 

Keeping track of your period and other fertility signs like your cervical mucus and temperature (basal body temperature or continuous core body temperature) can reveal a lot about the health of your cycle, such as whether or not you're actually ovulating. The more information the better, so be sure to show your doctor your cycle charts for a more personalized treatment plan and ask any questions you may have. With the details about your temperature, OPK test results, as well as when you're having timed intercourse, your doctor can suss out what might be impacting your chances of conceiving. 

Watch our video of how Jess learned about her cycle and luteal phase.

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Are my medications affecting my fertility? 

Along with making sure your doctor knows about any medical conditions you have, also be sure they're aware of what medications you're taking to treat them. Some psychiatric medications, immunosuppressants, steroids, and antiepileptics can impact your ovarian reserve (egg supply) and your levels of prolactin, a hormone that helps to regulate your menstrual cycle (13, 14). Also be sure to mention any over-the-counter vitamins, Chinese herbs, or other supplements you’re taking — basically anything you eat that’s not food is worth mentioning to your doctor. 

What kind of fertility tests will we need to find out why I/we are not getting pregnant?

Your doctor may recommend tests such as blood work or urine tests to see what's going on with your hormone levels, genetic screenings, a sexually transmitted infection screening, an ultrasound to check out your follicles, a sonohysterography, which checks for scarring and other issues in your uterus, a hysterosalpingography, an X-ray that shows the inside of your uterus and can tell whether or not your fallopian tubes are blocked, and a laparoscopy, a procedure in which a camera is inserted into your abdomen in order to show your fallopian tubes, ovaries, and the outside of the uterus (15). 

Is there something genetic going on? 

60% of miscarriages are the result of genetic abnormalities, so your doctor should definitely be made aware of any pregnancy losses you've had (16). They may then evaluate you and your partner for genetic issues, such as balance chromosomal translocation, a common condition in which chromosomes may break off and reattach to other chromosomes, causing a loss or gain of genetic material (17). 

Could stress be stopping me from getting pregnant? 

It's totally normal to feel stressed about trying to get pregnant, but taking care of your mental health during this time is essential. Don't hesitate to be transparent with your doctor about any stress and anxiety you're experiencing and ask how you can manage it. According to a study by Boston University School of Health, higher levels of stress in women (but not men) do impact the odds of conception (18). To be clear, the study doesn't claim that stress doesn't cause infertility. Instead, it supports the importance of mental health care as a part of prenatal and preconception care. 

What lifestyle changes should I make to improve my chances of getting pregnant? 

Some lifestyle factors do have an impact on your ability to conceive, including smoking, diet, alcohol and caffeine consumption, exercise, and mental health. Quitting smoking can double your chances of getting pregnant each month, and limiting your exposure to endocrine-disrupting chemicals (EDC), such as pesticides and parabens, can help in minimizing the negative impact on ovulation and hormones they can have (19, 20). 

Do you have irregular cycles or PCOS? Ready to make lifestyle changes to help naturally regulate your cycle? Download our Healthy You, Healthy Cycle ebook for an in-depth look at the research and tips specifically for you.

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Is my age preventing me from getting pregnant? 

Age does have an impact on fertility, but it's not as straightforward as "it's all over after you turn 35." It's much more complicated than that, although it is important to know that "older" folks (age 35 and up) will likely take longer to get pregnant, and as you age, the odds of miscarriage increases (21, 22). Talking to your doctor frankly about your concerns about age and fertility can help you get a clearer picture of what you might expect moving forward. 

If you have more questions (don't be afraid to get specific), add them to this list before your visit. Addressing your concerns up front will help you and your doctor strategize and get some answers.

Tired of another month gone by without a positive pregnancy test? Priya Fertility System Now Available

 

References +
7

How common is male infertility, and what are its causes? (2016, December 1). Retrieved March 18, 2021 from https://www.nichd.nih.gov/health/topics/menshealth/conditioninfo/infertility#f4

8

 Infertility FAQs. (2009.). Retrieved March 18th, 2021, from https://www.cdc.gov/reproductivehealth/infertility/

9

Why Can't I Get Pregnant? (n.d.).  Retrieved March 10, 2021, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/why-cant-i-get-pregnant

10

Male Infertility. (n.d.). Retrieved March 10, 2021, from https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773

12

Recurrent Pregnancy Loss. (n.d.). Retrieved March 10, 2021 from https://fertility.wustl.edu/getting-started-infertility/multiple-miscarriages/

13

Can certain drugs or medications cause infertility? (n.d.).  Retrieved March 11, 2021 from https://fertileweb.com/faq/can-certain-drugs-medications-cause-infertility/

15

Evaluating Infertility. (2020.). Retrieved March 11, 2021, from https://www.acog.org/womens-health/faqs/evaluating-infertility

16

Repeated Miscarriages. (2016.). Retrieved March 11, 2021, from https://www.acog.org/womens-health/faqs/repeated-miscarriages

18

Stress reduces fertility in women. (2018, October 1). Retrieved March 11, 2021 from https://www.sciencedaily.com/releases/2018/10/181001171207.htm

19 How Stopping Smoking Boosts Your Fertility Naturally. (2019, April 16). Retrieved March 11, 2021 from https://health.clevelandclinic.org/how-stopping-smoking-boosts-your-fertility-naturally/
How Not to Waste Another Month When Trying to Conceive
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