Your Fertility Check-Up: What To Know
Did you know that 1 in 6 individuals or couples are affected by infertility, but often do not know until they are actively trying to conceive? As I have seen many times in clinical practice, folks simply do not know enough about their fertility and reproductive health, often until they are faced with challenges that can feel insurmountable.
For this reason, proactive fertility check-ups are essential to understanding what is happening in your body, even before you may be “ready” to start trying to grow your family. Reproductive health is directly linked to overall health, and knowledge is ALWAYS power, especially concerning our bodies!
So, what is a fertility check-up? In short, it is a proactive assessment of your reproductive health. It is for anyone of reproductive age, and especially for those who may want to have children within five or so years. Fertility check-ups are for everyone, not just people with uteruses. Assessing sperm health is critical to family-building goals.
A fertility check-up may include the following:
Medical History Review → An in-depth review of past and present medical history, including family medical history. Questions about your menstrual cycle, past pregnancy history, STI history, and chronic health conditions are typically included. Being as honest and accurate with your provider as possible is the best way to determine if something needs intervention or if there is something to keep an eye on in the future!
Hormonal Testing → Basic hormonal testing to assess reproductive function often includes testing anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin levels.
Ultrasound and Physical Examination → Your provider may want to do a transvaginal ultrasound to assess your antral follicle count (AFC), a count of how many follicles are present on each ovary, which can give an estimate of how many eggs are present on each ovary at a given time in your cycle. They may also see if you have any polyps or fibroids within your uterine cavity. A physical examination may include a breast exam to assess for any abnormalities in your breast tissue.
Semen analysis → Providing a semen sample for analysis will help to determine any issues with motility, morphology, or sperm count.
Why does a fertility check-up matter? Well, preventive health matters! Early detection of conditions like polycystic ovary syndrome (PCOS), endometriosis, fibroids, and thyroid issues can help determine treatment and a plan for getting pregnant. Endometriosis, for example, takes an average of 7-10 years from the onset of symptoms for a proper diagnosis. Staying on top of your reproductive health early can prevent roadblocks from happening later on and can open the door for interventions and lifestyle adjustments. It can also reduce emotional and financial stress by planning ahead. Simply put, knowing your reproductive health status can give you better chances of family building success in the future.
When and how to schedule a fertility check-up will depend on what stage of your reproductive health journey you are on. For individuals who are not actively trying to conceive, your OBGYN is a good place to start. They often can order hormone testing, and may also be able to do an ultrasound or further examination if you are having abnormal symptoms. The same goes for individuals or couples who are about to start their family building journey. Starting with your OBGYN is usually a more cost-effective way to get the testing you need, as they are typically in-network with your insurance. If you have been trying to conceive for >6 months (and are over 35) or >12 months (and are under 35) you should book an appointment with a reproductive endocrinologist aka fertility specialist.
In summary, here are some key takeaways:
You don’t have to wait until something is “wrong” to check in with your reproductive health. Practicing routine preventive care is the most proactive way to remain in good health overall.
Your reproductive health is directly tied to your overall health. The menstrual cycle is considered by many to be a vital sign, and deserves just as much attention as your blood pressure and heart rate!
Getting a fertility check-up is an empowering way to stay informed about your body, which can then help you make informed decisions about your reproductive trajectory and life.
Are you thinking about your future fertility? Be sure to talk to a provider you trust. Need help or have questions? I’m here for you and would love to help!
