The guidelines—and when to ignore them
When you’re trying to conceive naturally at home, every passing month can feel like an eternity. Wasn’t this supposed to be easy!? It’s common to feel impatient, but also unsure about what’s considered normal and when it might make sense to bring in the big (medical) guns. To help make that decision a little easier, we asked Bird&Be chief medical advisor Dr. Dan Nayot for his best advice.
When should I see a fertility doctor?
The traditional guidelines are based on how long you’ve been trying and the age of the person with eggs. But those hard-and-fast rules don’t apply to every situation. Here’s a general rundown to consult when you’re wondering if you should book an appointment:
After one year of trying... if your eggs are under 35, your cycles are normal and there are no known risk factors (such as a strong family history of early menopause).
After six months of trying… if your eggs are over 35, your cycles are normal and there are no known risk factors.
There’s no need to wait… if your cycles are irregular, you’ve had recurrent miscarriages or you have a diagnosis such as endometriosis, PCOS or another type of hormonal imbalance. The same goes if you simply want to empower yourself with more information.
As soon as you’re ready… if your family planning doesn’t involve eggs and sperm from you and a partner—a fertility doctor can help you make a game plan.
So, where does sperm age factor in? We know it plays a role, but it’s less predictable. If there are medical risk factors (obesity, uncontrolled diabetes, etc.), functional ones (low libido, ED, low ejaculate volume, etc.) or anatomical ones (testicular lumps, pain with intercourse, etc.), it’s a good idea to get checked early.
How do we start the convo about fertility with our doctors?
Seeing a fertility doctor (a.k.a. a reproductive endocrinologist or REI) doesn’t always mean diving into treatment. “We see patients who want more information or want counselling about future plans,” says Dr. Nayot. Ultimately, there’s no need to wait if you want to empower yourself with more info.
Some family doctors will be comfortable starting a workup on their own; others won’t and can refer you to a fertility clinic. A workup could include these tests:
- An ultrasound to check ovaries
- A sono ultrasound to check the uterus and fallopian tubes
- Bloodwork for general health and ovarian reserve
- Semen analysis
If you don’t have a family doctor or get pushback, many fertility clinics take self-referrals (check their websites) or you can try a tele-medicine clinic to arrange a referral. The key? Advocate for yourself.