5 Things You Can Do Today to Make the Most Out of Your Fertility Appointments

Affecting approximately 1 in 6 Canadian adults, infertility has become a growing health concern for many people coming into my office. I am often the first point of contact for many couples on their fertility journey but also commonly see patients in-between their numerous fertility appointments, confused and feeling in the dark as per what is going on with their own bodies. They want to understand their situation and their health better.

As with nearly every other medical specialty, many patients are waiting months to see the fertility doctor after the referral to the clinic is made. Perhaps more unique to fertility though is the concept of “maximizing”- use of time, chances, efforts, and funds. It becomes a game of strategy because of our own finite resources.

It is no mystery that our healthcare system is not equipped to manage the changing needs of Canadians. We saw a lot of doctors retire over the pandemic, disproportionately higher than the number of new doctors entering the workforce. As patients we feel the effects of this when we experience long wait times, shorter appointments, and a difficulty in gaining clarity as per what to do with our own health situations.

A lot of this is out of our own hands. But, one of the best things we can do is make the most out of the limited opportunities we have in the doctor’s office. So, here are 5 things I suggest in preparation for your time at the fertility clinic:

1. Be objective when describing your health history. In medicine we call this being an “accurate historian”. This means:

• Keeping an accurate timeline of any surgeries, hospitalizations, and diagnoses

• Bring up your top, recent medical concerns first, vs one-offs or less bothersome symptoms. I often ask patients if they feel their concern happens “more than the average person” or "is enough to interfere with work or daily activity" when considering things like poor digestion, headaches, insomnia, etc. This is probably more relevant information than a broken arm in grade 6 or the occasional heartburn we get after eating tomatoes

2. With menses specifically: Understanding concerning symptoms. What I consider to be the most relevant:

• Heavy flow: if you are changing feminine hygiene products more than once every 2-3 hours because of heavy flow, any clots larger than a dime

• Pain: if it cannot be managed by ibuprofen, causes nausea or vomiting, or interferes with your ability to go to work or school

• Inconsistency in timing: if cycles are longer than 35 days or shorter than 21 days, and this happens more than once or twice a year

3. Track the timing of your menstrual cycle using an app or calendar. This is helpful in both fertility testing and timing intercourse, and can skip a lot of confusion during the first couple of appointments at the fertility clinic. Some things to note:

• Day 1 of your period is day 1 of your cycle

• Your cycle length is Day 1 of one period to day 1 of the next period

• Follicular phase: Day 1 to day 14 of your cycle

• Luteal phase: Day 15 to day 28 of your cycle

Note: this assumes a 28 day cycle. For majority of female patients, it is typically the follicular phase that varies in length, where the luteal phase tends to stay at a consistent 14 days.

4. Maintain your own records of bloodwork, imaging, and medications. Ontario does not have a centralized database that keeps track of all medications, imaging, and labs. When gathering your own records, consider that:

• Majority of your lab work and imaging will be kept with your family doctor, and your family doctor usually receives any records from other doctors- including other specialty referrals and emergency room visits

• Every pharmacy you have ever gone to should have a record of the prescription you have filled at that physical location

• Lifelabs and Dynacare have online portals to download PDF copies of your labs. This is usually a more expedited option to access your labs in comparison to getting your own copies through the family doctor’s office

5. Book a visit with a fertility-focused ND first!

No surprises with this one- NDs can help with developing a health strategy while planning around fertility treatments, and waiting for that initial referral. We know you have a very limited amount of time with the fertility doctor and can answer many of the questions surrounding preconception. Something I commonly hear is the value patients see in understanding lab work, and knowing what is important from a nutrition and supplement standpoint. We are here to provide education for you too!

To book a complimentary discovery call, click here: