Vanessa Oly founder of Root & Remedy Wellness. She hosts the Root & Remedy Podcast and works with women of all ages to help them balance hormones, heal digestive issues, have PMS-free cycles, and get pregnant naturally.
If you know you want a family someday, one of the best things you can do is to start preparing your body now, but where do you start? How do you know what to do, who to talk to and when to make optimizing fertility a priority?
This is your guide to setting yourself up for success so you can start a family whenever you are ready.
- Blood Work and Fertility Testing
Thankfully, you can get most of your baseline testing done for free in Canada (depending on your provider and insurance). But, most people don’t know what to ask their doctor for when it comes to checking in on their overall health, hormones and fertility.
Keep in mind, the markers you can test will be slightly different if you are on hormonal birth control (HBC). Since HBC works primarily by shutting down ovulation and reducing your reproductive hormonal activity, you cannot test your reproductive hormones because the results will be inaccurate.
At your next doctor’s appointment, have a conversation about testing the following markers. You can mention that you are looking for not only a general health check up, but also a window into your overall fertility and hormonal health. These should be covered by insurance, but sometimes you need to pay a small additional fee for certain markers.
If you’re not on hormonal birth control, get these markers tested on day 3-5 of your period:
- Thyroid panel: TSH, Total and Free T4, Total and Free T3, Reverse T3, Anti-TPO, Anti-thyroglobulin
- Fasting glucose
- Fasting insulin
- Iron panel: TIBC, ferritin, serum iron, transferrin saturation %
- B12
- Vitamin D
- Estrogen (estradiol)
- Free & Total Testosterone
- FSH
- LH
- Blood chemistry & CBC
- Cholesterol & lipid panel
If you are on hormonal birth control, get these markers tested anytime:
- Thyroid panel: TSH, Total and Free T4, Total and Free T3, Reverse T3, Anti-TPO, Anti-thyroglobulin
- Fasting glucose
- Fasting insulin
- Iron panel: TIBC, ferritin, serum iron, transferrin saturation %
- B12
- Vitamin D
- Blood chemistry & CBC
- Cholesterol & lipid panel
For additional fertility testing, this often needs to be paid for and done through a private clinic/provider, unless you have been actively trying to get pregnant for 6-12 months with no success. This will include a combination of blood work and an ultrasound to determine your Anti-Mullerian Hormone (AMH) levels and Antral Follicle Count (AFC), which are two in depth markers of your fertility status.
If you’re not ready to start trying for a family, you can contact a local fertility clinic and ask if they do general testing. For example, Twig Fertility in Toronto offers a “fertility check” for those who are curious about their reproductive health. The cost of this is $250 and they offer both male/sperm and female/egg testing. I am currently going through this process and will share my experience, thoughts and results in part 3 of this article series.
When should you get this testing done? The short answer is, as early as possible. Ideally you’ll get this information in your mid to late twenties, but if you’re past that mark and already in your thirties, there’s no need to stress. The goal here is to arm you with the education, options and support you need to plan for your future.
- Cycle Tracking to Understand Your Hormones
If you are not on hormonal birth control, tracking your cycle is an amazing tool to learn more about your body, hormones, cycle and fertility. It will also be important to have these skills when you’re ready to start trying because you will know exactly when you’re ovulating.
There are two main fertility markers to begin tracking: Basal Body Temperature and Cervical Fluid.
Basal Body Temperature (BBT)
This is your resting body temperature. From the first day of your period, up until ovulation (aka the first “half” of your cycle), your BBT is lower - typical ranging from 36.2 - 36.6 degrees celsius. Once you ovulate, your temperature increases significantly for the remainder of your cycle - typically 36.6 - 37 degrees celsius, and drops when you start your next period (see graphic below).
To track your BBT, all you need is a basal body thermometer and a trusted app (my favourite is Read Your Body). Take your temperature every morning as soon as you wake up – before you kiss your partner, drink water, get out of bed or do anything else, and record it in the app. Over the course of a few cycles, you should see a pattern start to develop that looks similar to the chart below.
Cervical Fluid
This is the “stuff” you find in your underwear. It comes in 2 main categories: fertile and infertile. Fertile cervical fluid’s job is to keep sperm alive in the body until ovulation, and it can do this for up to 5 days! Infertile cervical fluid does not have the same effect, and sperm will die within minutes to hours inside the vaginal canal.
To track your cervical fluid, wipe front to back with two clean fingers or a piece of toilet paper before you pee, ideally at least 3 times per day. Throughout your cycle, cervical fluid changes in amount, colour, texture and consistency because of the fluctuating levels of estrogen and progesterone. This is what each category typically looks like:
- Infertile (Dry): Dry, crusty, glue-like, minimal cervical fluid.
- Fertile (Non-Peak and Peak): lotion-like, white, creamy, stretchy, clear, slippery. Often resembling a thin moisturizer or looking similar to a raw egg white or clear gel. Fertile cervical fluid is often more abundant and noticeable the closer you get to ovulation
If you’re experiencing a yeast infection or bacterial vaginosis, this can impact how your cervical fluid appears. If something seems off, reach out to your trusted healthcare provider.
A Note on Hormonal Birth Control
If you are on hormonal birth control, an important piece of the puzzle is deciding when and how you will transition off. No matter which type of HBC you’re using (the pill, patch, Nuva Ring, IUD, etc.), you will want a targeted protocol to help you prep, transition off, and get your cycle back to normal. Many people experience something called Post-Birth Control Syndrome (PBCS) in the 3-9 months after they have stopped birth control due to lingering hormonal imbalances. Symptoms include, hair loss, heavy, painful periods, acne, mood issues, low energy, missing periods, anxiety, and more. Thankfully, there are a lot of tools we can use to bring your hormones back into balance as quickly as possible.
I typically recommend coming off hormonal birth control at least one year before you want to conceive so that you can solve any underlying issues that arise. If you have a history of difficult cycles, or have a suspected diagnosis of PCOS, Endometriosis or another reproductive health condition, you may want to allow for more time. I dive deeper into this protocol in one of our podcast episodes here.
Conclusion
It’s such a disservice that we are taught to only think about our hormones and fertility when we’re actively trying to get pregnant. Our cycles are a primary marker of health that deserve to be prioritized and considered as early as possible. If you know you want a family someday, your future self will thank you endlessly for learning about and optimizing your fertility now.
You can connect with Vanessa on instagram @rootremedywellness and learn more about working with her at www.rootandremedywellness.com