Assessing Females for Infertility

So you booked an appointment with a Naturopath to optimize your fertility, now what? Here are some of the basic questions and investigations to expect during an initial fertility intake.

Factors Related to Fertility

• Age = single most important predictor for fertility

• Menstrual History = specifically late or early onset of your period

• Cycle length = is your period less than 21 or greater than 35?

• PMS symptoms like mood changes, bloating, cramping, back pain, headaches/migraines

• History of dysmenorrhea or pain and cramping with your period

• Signs of androgen excess = hair growth, acne along the chin/jawline, oily hair and skin

Basic Hormonal Blood work

• Day 3 = FSH, LH and Estrogen

• Day 21 (or 7 days post ovulation) = Progesterone

• Not day specific: Testosterone, Prolactin, Thyroid hormone panel (TSH, free T4, free T3, anti-TPO)

Personal History

• History of previous pregnancies, miscarriages, fertility treatments.

• Sleep quality and quantity

• Exercise = do you get adequate movement in? Are you exercising too much or at too high of an intensity?

• Occupational exposures = women who work shift work >20 months are more likely to have cycles <21 days or >40 days

• Dietary choices = are you vegan or vegetarian

• Other health conditions, especially autoimmune diseases (celiac, Hashimoto's thyroiditis, lupus, type 1 diabetes)

Your initial intake is a deep dive into your personal history (yes, even things that may not seem relevant to your fertility), an opportunity to establish report and build a trusting relationship with me that will help you achieve a healthy pregnancy.