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)
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.