questions to ask before fertility

Overview

Fertility care is medical support for people who are trying to get pregnant and may need extra help. Before starting any tests or treatments, it’s important to ask your healthcare team questions. This article lists key questions you can bring to your appointment so you feel informed and in control.

Fertility problems are common. Around 1 in 7 couples may find it hard to get pregnant, so you are not alone.

Fertility issues can affect anyone, no matter their age, gender, or background. Both female and male health can play a role.

Symptoms

Common symptoms

• Having sex regularly without birth control for 12 months without getting pregnant (or 6 months if you are over 35)
• Irregular, missed, or painful periods
• Known conditions such as polycystic ovary syndrome (PCOS) or endometriosis
• Multiple miscarriages in the past
• Difficulty with erections or ejaculation (for men)

Symptoms in children

• Fertility care is not for children, but some conditions that affect future fertility can start early. Talk to your pediatrician if you have concerns about development or puberty.

Symptoms in older adults

• Fertility naturally declines with age, especially for women after 35 and men around 40. If you are trying to conceive later in life, discussing your plans with a healthcare provider early offers more options.

Causes

Main causes

• Problems with ovulation (the release of an egg)
• Blocked or damaged fallopian tubes
• Endometriosis (tissue similar to the womb lining growing outside the uterus)
• Problems with sperm count or quality
• Unexplained infertility (no cause is found in either partner)

Risk factors

• Age (especially over 35 for women)
• Smoking tobacco or vaping
• Heavy alcohol use
• Being significantly underweight or overweight
• Having a sexually transmitted infection that was untreated
• Stress and poor sleep

When to see a doctor

See a doctor urgently if:

• If you have symptoms like severe pelvic pain, heavy bleeding, or fever, contact your healthcare provider or local emergency number now.
• If you are over 35 and have been trying to conceive for 6 months, or under 35 for 12 months, it’s time to book a fertility appointment.

Book a routine appointment if:

• If you have been trying to get pregnant for a year (or 6 months if you are over 35) without success, ask your regular doctor for a fertility check-up.
• If you have irregular periods, known risk factors, or concerns about your reproductive health, don't wait — talk to a provider now.

Diagnosis

A fertility workup usually begins with a detailed conversation about your health and history, plus tests for the person who will carry the pregnancy and often their partner. The tests are not painful and are usually spread over a few months.

Tests that may be done

• Blood tests to check hormone levels
• An ultrasound scan of the uterus and ovaries
• A semen analysis for the male partner
• A hysterosalpingogram (an X-ray of the fallopian tubes, if needed)

What to expect at your appointment

You will meet with a specialist or your regular doctor. They will ask about your medical history, previous pregnancies, and lifestyle. They will order appropriate tests and explain the results in plain language. You should ask what each test is for and what the timeline looks like.

Treatment

If a cause is found, there are effective treatments. Some involve medication, others involve procedures like intrauterine insemination (IUI) or in vitro fertilization (IVF). Always ask about the benefits, risks, success rates, and costs of each option before deciding.

Self-care at home

• Track your menstrual cycle to know when you ovulate.
• Maintain a healthy weight through balanced eating and gentle activity.
• If you smoke, ask for support to quit.
• Limit alcohol and caffeine intake.
• Manage stress with relaxation exercises, journaling, or talking with a friend.

Medical treatments

Treatment may include medication to support ovulation, intrauterine insemination (IUI), or in vitro fertilization (IVF). Other procedures can address specific issues like blocked tubes or endometriosis. Your doctor will discuss which approach is best for your situation. Any medication is prescribed specifically for you — never use fertility medicines without a professional assessment.

When is surgery considered?

Surgery may be an option for removing fibroids, repairing fallopian tubes, or treating endometriosis. If surgery is needed, your healthcare team will explain the risks and recovery time.

Living with this condition

Fertility treatment can be emotionally and physically demanding. You don't have to put your life on hold. Continue working, socialising, and resting as much as possible. It is also okay to take breaks from treatment if you need to.

Lifestyle tips

• Aim for 7–9 hours of sleep each night.
• Try gentle exercises like walking, swimming, or yoga.
• Stay connected with people who support you.
• Limit caffeine to about 1–2 cups a day.

Diet and exercise

A balanced diet rich in fruit, vegetables, whole grains, and lean protein supports overall health. Both very low and very high body weight can affect fertility, so work with your provider to find a healthy range. Always check before starting a new exercise programme.

Mental health and emotional wellbeing

Trying to conceive can bring feelings of stress, sadness, anxiety, and grief. These feelings are completely normal. It can help to speak with a counsellor or therapist who understands fertility issues.

Prevention

Most causes of fertility problems cannot be prevented, but you can protect your fertility by not smoking, limiting alcohol, getting treated early for STIs, and seeing a provider as soon as you have concerns.

Vaccines

Make sure you are up to date on routine vaccines, such as measles, mumps, rubella (MMR), before trying to get pregnant. Ask your doctor about the flu and COVID-19 vaccines during pregnancy planning.

Screening programmes

Regular gynecological check-ups and cervical screening (Pap smear) can help detect conditions that might affect fertility. Talk to your provider about what screenings are right for your age and risk factors.

Complications

If left untreated

• Without investigation, you may miss out on treatments that could help you become pregnant.
• Some underlying conditions, such as endometriosis, can cause chronic pain and may get worse if left untreated.

Long-term outlook

Many couples who seek fertility care go on to have children. Even if a specific treatment doesn't work, there are other options, including different treatments, adoption, or living child-free. With support, you can make the path that is right for you.

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