How to talk to your doctor about fertility: A guide to confident conversations

Whether you're just beginning to think about starting a family or you've been trying for some time, booking a preconception or fertility health check with your doctor is an important first step. Navigating fertility conversations with your doctor can feel overwhelming, but with preparation, you can approach these discussions with confidence. This guide will help you feel empowered when talking to your healthcare team about your fertility, so you leave with the clarity and information you need.

Be prepared

When you’re prepared with the questions you want to ask, clear about any concerns you may have, and know what you want to achieve from the appointment, your doctor can better support you in your fertility journey. Keep reading for examples of questions you may want to ask.

Know your medical history

Make sure you’re familiar with your own and your family’s medical history. If possible, gather information on your menstrual cycle, past illnesses, and any chronic conditions. This can provide important context for your doctor.

Track your cycle

If you haven’t already started tracking your menstrual cycle, now is a good time to begin. Your doctor will likely ask about the regularity of your periods, any associated symptoms, and whether you've noticed any changes. Apps can help you track ovulation patterns, cycle lengths, period flow, and any symptoms you may be experiencing throughout your menstrual cycle. You can use a calendar or a period tracking app such as Clue, Flo, Fertility Friend or Apple Health.

It is also a good idea to track when you have had unprotected sex. For deeper insights into your menstrual cycle and reproductive health, you may consider learning Fertility Awareness-Based Methods (FABM). FABM helps you know where in your cycle your fertile window is and confirms when ovulation occurred by tracking your basal body temperature (BBT) and cervical mucus patterns. 

List medications and supplements

Keep an updated list of any medications or supplements (including vitamins and minerals) you are taking. Include the dosage and frequency, and let your doctor know how long you've been taking them. It’s important to check with your doctor that anything you are taking is safe for pregnancy.

Consider nutrition and lifestyle

There are several health services that can also offer further support for preconception and fertility care. Nutritionists, dietitians, naturopaths, acupuncturists, for example, can help with key factors that play a role in fertility, such as diet, exercise, sleep, stress levels, and exposure to environmental toxins. They may also be able to recommend personalised and evidence-based supplementation for both preconception care and pregnancy. You may like to ask your doctor for recommendations or referrals to other practitioners so you have a healthcare team to support you on this journey.

Discuss any concerns and questions

Fertility concerns can stem from many factors, including underlying medical conditions, hormonal imbalances, nutrition, lifestyle, and age. Write down your top concerns and goals for the appointment, such as whether you need fertility testing or are looking for ways to optimise your chances of conception naturally. If you’re unsure where to start with questions, you can also use the list below and consider what your priorities are to discuss with your healthcare professional.

Fertility questions to ask your doctor

The more prepared you are for your appointment, the better your doctor may be able to help you here. Asking the right questions during your appointment can help you gain a deeper understanding of your fertility and what steps to take next. 

Below are some suggested questions to get you started, but tailor them to your specific needs and concerns.

1. What factors could be affecting my fertility?
   This is an important question that opens the door to exploring potential causes, whether they’re lifestyle-related, hormonal, or connected to a pre-existing condition.
2. What tests do you recommend for myself and my partner?
   There are a variety of tests your doctor might suggest, such as non-invasive prenatal testing, sexually transmitted infection screening, immunological markers to certain infectious diseases like chickenpox, general blood tests and a pelvic ultrasound. Your doctor may want to run additional tests based on your medical and family history such as blood tests to check thyroid and hormone levels, or refer to fertility clinics for further testing such as sperm analysis. This is also a good time to check you are up to date with your cervical screening test, as well as discuss genetic carrier screening options.
3. How long after transitioning off birth control should I expect a return of a regular menstrual cycle and fertility?
   This is relevant if you have been on birth control such as the oral contraceptive pill, Mirena, or IUD, and is helpful so you know what to expect and when to seek further advice.
4. Are there any lifestyle changes that could improve my fertility?
   Your doctor may recommend adjustments to your diet, lifestyle, stress management, sleeping habits, alcohol and caffeine consumption, to enhance your fertility. 
5. Are there any other healthcare services or practitioners that may help with supporting fertility and conception?
   This may be especially relevant if you have either a pre-existing medical condition that impacts fertility such as Endometriosis or Polycystic Ovarian Syndrome (PCOS), are over 35 years, or have already been trying to conceive without success. 
   • Having a healthcare team supports your fertility with a multi-factorial approach such as nutrition and lifestyle strategies, or acupuncture, may improve your chances of conception.
6. How does age impact fertility?
   If you're concerned about how your age could be influencing your fertility, ask your doctor to explain if there are any specific considerations for your age group.
7. How long should I try to conceive before seeking further help?
   Generally, if you're under 35 years of age, doctors recommend seeking further support if you have not yet fallen pregnant when having unprotected sex for 12 months, while women over 35 are suggested to seek help after 6 months. However, you can request a referral to a fertility specialist sooner, particularly if you have any concerns about your fertility, an existing medical condition, or you have irregular cycles.
8. What treatment options are available if I have fertility challenges?
   If you’ve been trying to conceive for a while without success, inquire about what the next steps should be and what treatment options are available such as medications, assisted reproductive technologies like IVF, or natural therapies. Ask about the success rate of each treatment option, all costs involved, whether it is covered by Medicare or private health, and whether it is a potential suitable option for you.

After the appointment

Once you’ve had the discussion with your doctor, you may feel a mixture of emotions like relief, hope, or even a bit of anxiety or overwhelm. It’s important to process the information at your own pace and give yourself time to digest what you’ve learned. 

Here are a few things to keep in mind after your appointment:

1. Take time to reflect: It’s common to feel overwhelmed after receiving a lot of new information about your health and fertility. Give yourself time to process the conversation and revisit any notes you may have taken. If you feel uncertain about anything, don’t hesitate to follow up with your doctor or seek a second opinion if necessary.
2. Stay organised: Keep a folder with your medical records, test results, and any recommendations from your doctor. This will make it easier to track your progress and be more prepared for future appointments.
3. Set realistic expectations: Fertility is a complex area of health, and it may take time to get the answers or results you're hoping for. Be patient with yourself and your body as you explore different options and treatments.
4. Seek support: Fertility journeys can be emotional and challenging, and it’s important to have a support system in place. Whether it's your partner, family, friends, a fertility support group, or counsellor, surround yourself with people who understand and can provide support.

The bottom line 

Talking to your doctor about fertility may feel overwhelming, but with a little preparation and open communication, you can feel empowered in the process. Remember to take your time to reflect after the appointment, stay organised, and lean on your support network as needed. Fertility journeys are deeply personal, but with the right resources and guidance, you can navigate them with confidence and resilience.

Related articles:

• Ovulation tracking: Get cycle savvy  and enhance fertility
• Foods for fertility: How your diet can support ovulation
• Epigenetics explained: How lifestyle choices impact your future family

Reviewed by Healthylife health experts December 2024.