Fertility · Egg and sperm health
Why am I not getting pregnant? Six questions to ask
Most of us learned in school that getting pregnant is easy. For many people it turns out to be more complicated than that.
Whether you’ve just started trying, have been trying for months on your own, or are considering IUI or IVF, these six questions are a good place to start.
The six questions
Where to look first
1
Timing
Am I having sex at the right time?
There’s a window of about three to five days each cycle when intercourse can lead to pregnancy. Knowing when yours falls makes a real difference.
2
Ovulation
Am I ovulating?
Counting days on a calendar may not be enough. Ovulation test strips (LH tests), basal body temperature and changes in cervical fluid can show whether, and when, you ovulate.
3
Hormones
Are my hormones where they need to be?
Hormones need to be in a good range to grow a healthy follicle, build the uterine lining, ovulate and support an early pregnancy. That means looking beyond estrogen and progesterone, to thyroid hormones as well.
4
Egg quality
Are my eggs healthy?
Sometimes it’s about quality rather than quantity. Nutrient status, antioxidants and cutting down on harmful exposures are some of the things we look at to support egg health.
5
Uterine lining
Is my lining thick enough?
An embryo needs a healthy lining to implant. An ultrasound can measure it, and a very light period can be an early clue.
6
Sperm health
Has sperm been checked properly?
Donor sperm is usually screened. If you’re trying at home or using a partner’s sperm for IUI or IVF, semen quality isn’t always looked at closely. Count, motility, morphology and DNA fragmentation are all worth checking, and DNA fragmentation is often missed.
Next steps
How we help
At your first fertility visit we go through each of these questions with you, along with your health history and any testing you’ve already had.
From there we may suggest bloodwork, urine hormone testing or a semen analysis, and build a plan that can include nutrition, herbal medicine, supplements and fertility acupuncture. It can stand on its own or sit alongside care from a fertility clinic.
Answering these six questions won’t tell you everything, but it often points to the right next step.
Questions people ask us
When should I see someone about fertility?
Common guidance is to get checked after a year of trying if you’re under 35, or after six months if you’re 35 or older. You can come in sooner, including before you start trying.
Can a naturopathic doctor order fertility testing?
Yes. We can order bloodwork through Dynacare and LifeLabs and specialized hormone testing through a partner lab. Your family doctor or fertility clinic may also order tests that OHIP covers.
Does my partner need to be involved?
If you’re using a partner’s sperm, it helps. Sperm health is half the picture and is often overlooked.
What does a first fertility visit cost?
A first fertility visit is up to 90 minutes and costs $295. Many extended health plans include naturopathic care.
Talk it through with Dr. Jada
Dr. Jada sees fertility patients in person in Ottawa and virtually across Ontario, and offers fertility acupuncture at the clinic.
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This page is general information, not medical advice or a diagnosis. Your care plan depends on your own history and assessment.