Alright, 30-somethings, this one’s for you. Your career’s on track, life feels a little more stable, and now the baby talk is starting to pop up.
But where do you even begin? Don’t worry—we’ve got you covered. Whether you’re just starting to think about having kids or already actively trying, it's important to be proactive about your fertility. Let’s dive into the essentials
The answer: as soon as you’re comfortable.
Forget the notion that you have to struggle for a year before seeking answers. Your health is best managed proactively, and fertility is no different. If having children is in your future plans, it’s never too early to check in on your fertility status. And if you know there might already be an issue, or something doesn’t seem quite right, starting early gives you the best chance to address it head-on.
Whether you’re not quite ready for kids but want to plan ahead or you’ve been trying for a while and need help, there are options to explore. Let’s dive in and talk about the steps you can take to ensure you’re setting yourself up for success.
If you're not quite ready to start a family but want to take proactive steps, it’s a great idea to have a conversation with your healthcare provider or connect with a fertility-focused naturopathic doctor (ND). These professionals can help you understand your fertility health and suggest ways to optimize it, even if you're not actively trying for a baby just yet. This would also be a good time to consider proactively freezing your eggs or embryos.
On the other hand, if you've been trying to conceive and feel ready for some guidance, seeking help from a reproductive endocrinologist (REI) is the next logical step. They specialize in fertility and can give you a detailed, science-backed approach to your situation.
No matter which route you take, the goal is the same: take a holistic look at your fertility as a multifaceted puzzle. There are many factors at play, so it’s essential to explore all of them and get a full picture.
Here’s a pro tip: when it comes to fertility help, make sure you’re properly vetting your options. It’s crucial to find a clinic or specialist that you trust. If you’re already part of the myStoria community, be sure to download our free guide Fertility Clinics 101: What to Ask & How to Advocate on how to properly vet a fertility clinic—because we’ve already mapped out the steps to make sure you’re making the right choice. You can download it here.
It all starts with the basics—checking where your body’s at when your cycle kicks off. One of the first tests you’ll likely do is a Day 3 hormonal panel—your go-to test for understanding what’s really happening inside. Done on days two to four of your cycle, this test checks key hormone levels that give you the inside scoop on your fertility. It’s like a preview of how your cycle starts and, honestly, how it’s potentially going to play out. We’re talking everything from whether your last cycle wrapped up properly, to how your body’s gearing up to produce follicles, and—yes—even if there’s a sneaky pregnancy you didn’t see coming.
Another important hormone to check is AMH (Anti-Müllerian Hormone). When it comes to assessing ovarian reserve, AMH is the star of the show. Absolutely, age, FSH, and antral follicle count also play a role, but AMH really gives the lowdown on how many eggs are left in your basket. Here’s the kicker: people born with ovaries are born with all the eggs they’ll ever have—we don’t make any new ones, and once they're gone, they’re gone (hello, menopause!). Knowing your AMH levels isn’t just important for understanding your fertility—it helps your doctor figure out how aggressive to be with treatment.
Another key player in your cycle is progesterone - the ovulation indicator. You usually have a blood test run 7 days after your suspected ovulation, and it is specifically checking your progesterone level. If you successfully ovulated, this level should be nice and elevated. Low levels might indicate a potential issue in your cycle.
First up, it’s time for a Trans-Vaginal Pelvic Ultrasound—your go-to for an early peek at your reproductive system. Usually done at the beginning of your cycle, this ultrasound checks out your uterus, gives a snapshot of your ovaries, and calculates your Antral Follicle Count (basically how many eggs you're working with this cycle). It’s a great starting point for understanding what’s happening inside.
Next, you’ll follow up with a Sonohysterogram or Hysterosalpingogram. Both tests serve a similar purpose: they look inside your uterus for any abnormalities (like polyps, cysts, or lesions) and check if your fallopian tubes are open. Why is this important? The fallopian tubes are where egg and sperm meet, and the uterus is where your embryo needs to settle in for the next 9 months. So making sure everything is in working order here is key!
Now, it’s not just about the mechanics. Just as we focus on the female side of fertility, male hormones are just as important. A hormonal panel can offer valuable insights into potential underlying issues. Abnormal levels of key hormones, such as TSH, testosterone, and others, can highlight factors that may require further attention. Since hormones play a crucial role in male fertility, assessing them properly is key to understanding the full picture.
Swimmers check! Of course, we can’t forget to check the sperm. The base test for analyzing sperm is a Sperm Assessment. This test gives an overview of how many sperm there are, how many are swimming, and a basic morphology check (how they look). If there’s an issue with any of these factors, it’s a good idea to dig deeper with a DNA fragmentation test. This test takes a closer look at the sperm, including the percentage of fragmented sperm.
Coles Notes: A DNA fragmentation test checks the sperm’s genetic material for damage, which can affect fertility and embryo quality. But don’t be fooled—just because your Sperm Assessment comes back normal, it doesn’t mean there’s no fragmentation issue. It’s worth talking to your doctor about the potential benefits of having this test done from the start, rather than waiting.
That pretty much sums up basic fertility testing. But we’re not basic, are we? And neither is your fertility. Let’s talk about a few sneaky areas to explore, as they can play a huge role in our ability to be successful.
Uterine microbiome - bet you haven't considered that one yet. Your uterus is filled with tons of little microorganisms like bacteria, yeast, viruses and more all cohabitating together. It's important to have your microbiome checked because if there is an imbalance (more bad stuff than good) then your uterus becomes a hostile environment for an embryo, and can even inhibit implantation or possibly increase the chance of miscarriage.
Another area that should not be overlooked is your immune system. There are three different ways your immune system could negatively impact your fertility:
All three of these areas can be assessed before conception to ensure steps are taken to calm the immune system down and improve your chances of success.
Your microbiome and immune system are often overlooked but can play a huge role in your fertility journey. Fertilysis is a company that provides tests for both, and more, in the comfort of your own home - no Doctor or appointment required. myStoria community members have access to a special discount on their site, so if you are interested don’t hesitate to reach out and ask us about it.
While fertility testing gives you a clear picture of your reproductive health, there are a few lifestyle factors within your control that can give your fertility a boost—each of which could easily have its own blog post, but they’re worth an honorable mention here. A balanced diet, maintaining a healthy weight, and regular exercise all play a big role in optimizing your fertility. Don’t forget the importance of stress management and quality sleep, both of which can work wonders for your reproductive health.
Limiting alcohol, caffeine, and tobacco use is also key for both men and women. These habits can throw off hormone levels, reduce sperm quality, and impact egg health, all of which make it harder to conceive. While these lifestyle changes aren’t a cure-all, they’re a great complement to the fertility testing process, helping to improve your chances and overall success.
Fertility testing isn’t one-size-fits-all, but being proactive is key. From hormone testing to imaging, sperm analysis, and even looking at the more “quiet” areas like the microbiome and immune system, there’s a lot to consider. Obviously, this isn’t a completely comprehensive list, and there are more specialized tests available depending on your individual needs. So take the reins on your fertility and get informed—because knowledge is power!And remember, the myStoria Concierge Team is always here to guide you through the process, no matter which step you're in. Whether you're just starting out or deep into your fertility journey, we're here to provide support, answer questions, and help you navigate your options every step of the way.
Ready to feel supported? Connect with our Concierge Team today and take the next step in your journey.
Author: Jessie Dunn, Fertility Concierge
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