You can talk to your doctor about getting pregnant at any stage of the game. Maybe you're just thinking about getting pregnant and want to have a basic exam and get some trying to conceive tips. Maybe you've been trying for a year and are concerned about your fertility, or you've not been trying too long but you're concerned about possible infertility symptoms. Perhaps you don't intend to get pregnant any time soon, but you have concerns about family planning you're your future fertility. These are all good reasons to talk to your doctor.
Talking to your gynecologist before you conceive is an important first step in having a healthy pregnancy - but it can also be anxiety provoking. Remember that she is there to help you and is ready to discuss any and all reproductive topics - even embarrassing or sensitive ones.
Here are some tips to keep in mind before, during, and after your appointment.
Mention When Making Your Appointment You Want a Fertility Consultation
When you call to make your appointment, let the receptionist know you want to discuss family planning and fertility. You may be tempted to schedule your regular pap smear and sneak in the conception planning question during that appointment, but your doctor's time slots may not be long enough to allow time for discussion.
Another good reason to request extra time to talk about fertility and family planning is it's not easy to talk in a half open gown with no undies on underneath. Politely request to discuss the conception issues in her office, as opposed to up on the table with the stir-ups. You'll feel more comfortable.
Bring Your Partner With You
Ideally, you should meet your doctor together with your partner. There may be questions about his health that your doctor wants to ask, not to mention questions and concerns your partner may want to ask on his own.
Even though you may be speaking to your gynecologist, family planning and conception is an issue that affects you both. If your partner can't be there, just be sure to ask him if he has questions he wants you to ask, and see if he can be reachable via phone for any medical questions you can't answer.
Discuss Stopping Birth Control, If You Haven't Already Done So
If you're taking any kind of birth control, this is the time to discuss stopping it. Ask how to stop taking it, and how much time you need to wait before trying to get pregnant. If you have an IUD or implant, discuss having it removed.
You can also ask when you can expect your fertility to return, and if there are any concerning symptoms to watch out for.
Ask About Supplements and Lifestyle Changes
Vitamins aren't only for pregnant women. Some supplements, like folic acid, should be taken before you even start trying to conceive. How much folic acid to take is a matter of debate and may depend on your past history. Most women can get what they need from a regular multivitamin.
You may also want to discuss with your doctor any lifestyle changes you can make. Is it ok to enjoy a glass of wine with dinner when you're trying to conceive? What about your coffee habit, is that a problem? These are all good topics to bring up.
If You're Not Trying to Conceive Yet, Ask Your Doctor About Family Planning
More and more couples are waiting to start families after age 35. Fertility and age is a hot topic these days, and if you're concerned about your future fertility options, talk to your doctor about them now. Fertility does decline as you get older, but not everyone will have difficulty conceiving.
Are you single or not in a position to start having kids? This is also a good topic to discuss with your doctor. More women are considering egg freezing, but it's pricey - up to $15,000 per cycle. The American Society of Reproductive Medicine doesn't encourage women to use egg freezing as "fertility insurance" because it may not even be necessary (you may conceive naturally anyway), and it's not guaranteed to work. Though generally considered safe, the procedure is not risk free.
That said, in some cases egg freezing is a good option. Talk to your doctor about your particular situation.
Bring a List of All Medications You and Your Partner Are Taking
Some medications are not considered safe to take during pregnancy. In some cases, you may need to stop taking them before you start trying to conceive, while in others you can take them up until you actually get pregnant. You may also be able to switch to a different medication instead that is safer.
There are also medications that can interfere with fertility, in both men and women. This is another reason to tell your gynecologist all the medications you are taking, even your allergy medications (which can sometime interfere with conception in women).
Important note: don't stop taking any medication without discussing it with your doctor first! Some drugs, like antidepressants, need to be slowly weaned off. It's also possible that for you, it's worth the risk in continuing a particular medication even during conception.
Don't Be Shy About Mentioning Embarrassing Symptoms
Unwanted facial hair. Seemingly unusual vaginal discharge. Erectile dysfunction. Some infertility symptoms can be embarrassing to talk about, but you need to mention them anyway. Your doctor can diagnose a potential problem only if they have all the information they need.
Bring a List With Everything You Want to Ask or Mention
Writing down all your concerns, symptoms, and questions before your appointment can be a big help. Three good reasons to write it down include:
- You're less likely to forget what you wanted to say.
- It's sometimes easier to read from a list than just bring the questions up off the top of your head.
- If you chicken out and really can't get past the anxiety to say what your concerns are, you can hand your doctor your list to read instead. (Just make sure your list isn't too long or very wordy. Get straight to the point.)
Bring the Dates of Your Last Six Periods (Plus Your Fertility Calendar If You Have One)
Especially if you're concerned about irregular periods, be sure to bring the dates of your last six cycles. Having an off cycle once in awhile isn't considered unusual, but having consistently irregular cycles can be a sign of trouble.
If you've been fertility charting or keeping a fertility calendar, then bring the information from your last six cycles along too. Fertility charts can show potential problems with ovulation or the luteal phase, something that may not be clear when only looking at the length of each cycle.
Don't Be Afraid to Push for Testing or a Referral if You've Been TTC for Awhile
If you've been trying to get pregnant for more than a year, even if you have no other symptoms of infertility, you should see your doctor and have basic fertility testing done. If you're over 35 and have been trying for at least six months, you should also see your doctor. This is the recommendation of the American Society of Reproductive Medicine.
Most doctors will take your concerns seriously and either start testing or refer you to a fertility clinic, but not all doctors are willing to take action when they should. Some women are told they are "too young" for infertility and to try longer than a year. Some are told they are overweight and therefore they should lose the weight and only then, if they still don't get pregnant, see the doctor again.
The problem with putting off testing is that some causes of infertility worsen with time. (Yes, even when you're young). As for being overweight, it could be your weight problem is connected to the same hormonal imbalance as the infertility. You can always decide after testing to lose weight or try a little longer before seeking treatment, but there's really no good reason to put off testing.
If Your Doctor Orders Basic Fertility Testing, Be Sure Your Partner Is Tested, Too
Some gynecologists will run some basic fertility testing, while others prefer to refer you directly to a fertility specialist. If your gynecologist does decide to run tests, make sure to ask her about your partner having a semen analysis.
Male infertility is an issue in about half of all infertile couples, either as the sole factor or together with female infertility. Neglecting to test male fertility may lead to trying fertility treatments (like Clomid) that are bound to fail. The gynecologist may refer your partner to an andrologist, a doctor that specialized in male fertility problems.
Don't Delay Following-Up on Testing or a Referral
Once you've received an order for fertility testing, follow through with it! Fertility test anxiety is normal, but it's much easier to just go ahead and get the testing done. Don't wait, just do it.
If Your Doctor Doesn't Take You Seriously, Consider Getting a Second Opinion
Remember that your doctor's job is to advocate for you and care for you. If she isn't taking your concerns seriously, then consider seeking a second opinion. For that matter, if you're uncomfortable with your doctor, you may want to consider seeing someone new altogether.
Sometimes we forget that while doctors usually know best, doctors aren't God-like beings. Some are better than others, and not every doctor-patient relationship works out. If you feel your current doctor isn't listening, find a doctor who will.
More on infertility symptoms and getting help:
- Quiz: Do I Have Infertility Symptoms?
- When Should You Seek Help for Getting Pregnant?
- Why Can't I Get Pregnant if I'm Healthy?
- How to Start Improving Health and Increasing Fertility
- Causes of Infertility
- Take a Fertility Quiz
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Frequently Asked Questions About Infertility. American Society of Reproductive Medicine. Accessed October 23, 2012. http://asrm.org/awards/index.aspx?id=3012
Fertility Experts Issue New Report on Egg Freezing; ASRM Lifts Experimental Label from Technique. American Society of Reproductive Medicine. Accessed October 23, 2012. http://www.asrm.org/Fertility_Experts_Issue_New_Report_on_Egg_Freezing_ASRM_Lifts_Experimental_Label_from_Technique/