Even if you don’t intend to get pregnant anytime soon, you may have concerns about family planning and your biological clock. These are all good reasons to talk to your health care provider. Talking to your gynecologist or midwife before you conceive is an important first step in having a healthy pregnancy—but this discussion can be anxiety-provoking. Your health care provider wants 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.
Request Fertility Consultation
When you call to make your appointment, let the receptionist know you want to talk about family planning and fertility. You might be tempted to schedule your regular Pap smear and sneak in the conception planning questions at your appointment, but your provider’s time slots might not be long enough to give you adequate time for a productive conversation. Another good reason to request extra time is it’s that it’s not always comfortable to talk while wearing a half-open gown in an examination room. If your provider has an office, ask if you can talk there instead. If you’ll be chatting in an exam room, politely request time to get changed into your clothes before your conversation if being fully dressed would make you feel more at ease.
Bring Your Partner
If possible, it can be helpful for both you and your partner to meet with your health care provider if you’ll be discussing conception plans. Your provider may want to know more about your partner’s health. Your partner might also have questions or concerns that they would like to ask. Family planning affects you as a couple as well as individually. For example, your partner might also need fertility testing if there are suspected fertility problems. If your partner can’t be there, check-in with them beforehand to see if they have any questions that you can ask. If their schedule permits, you might see if they would be available by phone or text to answer any medical questions your provider has.
Discuss Stopping Birth Control
If you’re taking any kind of birth control, you’ll want to talk to your provider about stopping it. This includes finding out how to stop taking it as well as how much time you need to wait before trying to get pregnant. If you have an IUD or implant, you might want to make an appointment to have it removed. Ask your provider when you can expect your fertility to return and find out if there are any signs or symptoms you should be on the lookout for after removal that could indicate a problem. Most birth control methods allow you to try and get pregnant quickly after stopping, but others require more time. For those on Depo-Provera, fertility might not resume for several months—sometimes even a year or longer.
Ask About Supplements and Lifestyle Changes
Vitamins aren’t only for people who are pregnant. Some supplements, like folic acid (or folate), should be taken before you even start trying to conceive. How much folic acid you should take is a matter of debate and may depend on your medical history. Most prenatal vitamins contain sufficient amounts of folic acid for most people who are, or will be trying, to get pregnant. It’s also a good idea to ask your provider if there are any lifestyle changes you could make. Examples of questions you might ask include:
Am I at a healthy weight for pregnancy? Are there any products that I use on my body or in my home that should be replaced? Can I have a glass of wine with dinner when I am trying to conceive? Do I need to kick my coffee habit? Is my diet adequate? Am I meeting the recommended amounts of nutrients? Should I quit smoking or using other substances?
Ask About All Your Options
More couples are waiting to start families after age 35. 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. If you are single or otherwise not in a position to start trying to have a family, this is also an important topic to discuss with your health care provider. You might choose to consider egg freezing—though it is expensive and is not without risk. Ask your doctor if egg freezing would be an option for you, given your specific situation.
Bring a List of Your Meds
Some medications are not considered safe to take during pregnancy. For some medications, you might need to stop taking them before you start trying to conceive, while others might be fine to take up until you actually get pregnant. Your provider might also switch you to a different medication. There are also medications that can interfere with fertility. This is another reason to tell your health care provider about all the medications you are taking—even if it’s “only” an over-the-counter product or supplement. Do not stop taking any medication without discussing it with your provider. Some drugs, like antidepressants, may need to be slowly reduced over time (tapered). Your provider might decide that the risks of stopping your medication are greater for you than those associated with continuing to take it while you are trying to conceive. Make sure that your provider knows about any health conditions you have. There are several chronic medical conditions that can affect pregnancy, and it’s best that they are optimally managed before you get pregnant.
Speak Up About Embarrassing Symptoms
Unwanted facial hair, seemingly unusual vaginal discharge, erectile dysfunction— some symptoms can be embarrassing to talk about, but you need to mention them. Whether they are related to your fertility or your general health, it’s important that you tell your provider about any symptoms you are having. They can’t make a diagnosis or recommend treatment unless they have all the pertinent information.
Write a List of Your Questions
Making a list of your concerns, symptoms, and questions before your appointment can be a big help. Good reasons to write it down include:
Having your questions in front of you as a prompt can be easier than trying to gather your thoughts or come up with your questions off the top of your head.If you are anxious about verbalizing your concerns or questions, it might be easier to hand your provider a list to read instead (just try to keep it brief and to the point).You’re less likely to forget what you (or your partner) wanted to say or ask.
Bring Your Fertility Calendar
If you have irregular periods, bring a least a list of the dates of your last six periods to show your provider. An irregular cycle once in a while is generally not considered unusual, but consistently irregular cycles will often require evaluation and testing. 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.
Ask for Testing or a Referral
According to the American Society for Reproductive Medicine, if you’ve been trying to get pregnant for more than a year, even if you have no other symptoms of infertility, you should talk to your doctor about having fertility testing done. If you’re over 35 and have been trying for at least six months, you are 40 years old or older, or if at any age you have a condition known to cause infertility, you will need to have prompt testing and treatment. Most doctors will take your concerns seriously and either start testing or refer you to a fertility specialist, but not all doctors are willing to take action when they should. You might be told that you are “too young” for infertility and that you need to try to get pregnant for longer than a year. Some people are told that they are overweight and therefore need to lose weight to conceive and to only return to their doctor if weight loss doesn’t help them get pregnant. The problem with putting off testing is that some causes of infertility worsen over time—even when you’re young. You can still decide to lose weight or try a little longer to get pregnant after you have had testing.
Make Sure Your Partner Gets Basic Fertility Testing, Too
Some providers will order fertility testing while others prefer to refer you directly to a fertility specialist. If you have a male partner, ask if they need to have a semen analysis. Male infertility is present in about 40 to 50% of all infertile couples—either as the sole factor or with female infertility. Your provider might refer your partner to a urologist or an andrologist, a doctor that specializes in male fertility. Neglecting to test male fertility can lead to a female partner trying fertility treatments (like Clomid) that won’t succeed.
A Word from Verywell
Your health care provider’s job is to advocate and care for your health. Most likely, they will be pleased that you’ve brought up your family planning questions and concerns and be happy to talk about your options. If your provider does not seem engaged in a conversation about your fertility or family planning goals, or if you are uncomfortable speaking with them, you might want to get a second opinion. Provider bias isn’t unheard of. Patients have been discouraged or turned away from care for a variety of reasons, including socioeconomic status, gender identity and sexuality, and age. Health care providers are only human and not every provider-patient relationship works out. If you don’t feel like your provider is able to support you and your partner on your conception journey, look for someone who will.
