I Want to "Check My Fertility"
“Checking My Fertility”: What Does This Really Mean?
Written by Dr. Fiona Callender, ND
I hear this all the time in my practice: “I just want to check my fertility.”
Sometimes this comes from someone who’s planning ahead and wants to be proactive. Other times, it’s someone who has already started trying to conceive and is looking for more information or support. And often, it’s someone who’s simply fertility-curious—perhaps experiencing hormonal symptoms or managing a diagnosis that raises questions about their future fertility.
But what does it actually mean to “check your fertility”?
Let’s walk through what this process can look like, what we can assess in my office, and when it makes sense to involve other providers.
When Should You Start Looking Into Fertility?
Infertility is defined as the inability to conceive after one year of trying. In Canada, about 1 in 6 couples experience infertility.
Guidelines for when to start investigating depend largely on age:
Under 35: after 12 months of trying
35 and older: after 6 months
Over 40: it’s reasonable to begin right away
Immediate evaluation is also indicated for known infertility risk factors such as irregular cycles, known uterine/tubal disease, autoimmune conditions and endometriosis.
That said, information gathering can still happen at any point. There is power in understanding your body and your cycle. If you’re experiencing hormonal symptoms, have underlying health conditions, or simply want to better understand your fertility, it’s absolutely appropriate to start the conversation earlier.
Step 1: A Thorough Health Assessment
The first step in understanding your fertility is understanding you.
This includes a deep dive into:
Your personal and family medical history
Your menstrual cycle (including pain, regularity, and other symptoms)
Current health concerns or diagnoses
Medications and supplements
Sleep, nutrition, movement, and stress
If you’re planning to conceive with a male partner, their health matters too. Sperm health is a key piece of the fertility puzzle, and assessing both partners gives us a more complete picture. You can read more about this here.
From this foundation, we can decide what further testing or support makes sense for you.
Step 2: Investigations, Lab Work, and Imaging
Your age, symptoms, and medical history will guide which investigations are appropriate, and how urgently they should be done.
From a conventional perspective, fertility assessment focuses on three key areas:
Ovulation
Reproductive anatomy
Sperm health
Lab Testing
Blood work will be personalized to your needs and may be used to better understand ovulation and hormonal health. Some possible tests include:
Thyroid function
Prolactin
FSH & LH
Estradiol
Progesterone
I also usually assess Iron levels and Vitamin D as well. These nutrients play an important role not only in fertility, but also in supporting a healthy pregnancy.
In some cases, we may also look at AMH (Anti-Müllerian Hormone), which gives insight into ovarian reserve. However, it’s important to remember that AMH is just one piece of the puzzle, not a definitive measure of your ability to conceive. You can learn more about that here.
Imaging
Imaging may be recommended to assess the uterus, ovaries, and fallopian tubes via Transvaginal ultrasound and/or Hysterosalpingogram (HSG)
Imaging is often recommended earlier if there is a history of:
Known or suspected endometriosis
Abnormal uterine bleeding (including persistent spotting)
Sexually transmitted infections
Cervical dysplasia
Prior abdominal or pelvic surgery
Previous intra-abdominal infections (e.g., appendicitis, pelvic inflammatory disease)
Step 3: Making Sense of the Information
Testing is only one part of the process. A key role I play is helping you interpret this information in the context of your health, lifestyle, and goals. Some factors affecting fertility are modifiable, while others are not. Even when everything looks “normal,” the process of trying to conceive can still take time.
I am always conscious of building a plan that feels sustainable for you. This may include nutrition and lifestyle strategies, targeted supplementation, and support from a broader care team - such as acupuncture, pelvic floor therapy, or mental health support.
Fertility care is not just about optimizing outcomes, it’s also about supporting you through the experience. “Checking your fertility” isn’t a single test and doesn’t usually provide us with a simple yes or no answer. Fertility support involves a process of gathering information, understanding your body, and making informed decisions about your next steps.
Whether you’re actively trying, planning ahead, or simply curious, having the right guidance can make this process feel clearer and far less overwhelming.
If you would like to learn more, you can book a complimentary meet and greet appointment with me to get a sense if I’m the right person to support you in this moment.