Let's get you ready
Questions to ask
- Is there anything in my health history or medications that we should address before I start trying?Bring the whole list. Some prescriptions need switching months ahead, and a few that people stop out of caution should be continued.
- Should I be taking anything beyond folate, based on my history? I've read about methylfolate versus folic acid, vitamin D, omega-3s, and CoQ10.Bring the research as questions. It gets you a real answer and keeps what you take on your record.
- Can we check my vitamin D and thyroid levels now, so I can correct anything before trying?
- Given my age and history, how long should I try before coming back for an evaluation?Under 35, guidelines suggest an evaluation after twelve months of trying, or sooner if there's a known reason to (irregular cycles, a history of pelvic infection or surgery, endometriosis, or a partner with a known issue).
- Is there anything my partner should have checked or change now?
- Should I have carrier screening before we try, and am I immune to rubella and chickenpox?Both are far easier to handle before pregnancy than during it, and neither happens unless someone asks.
Things to bring
- A list of current medications and supplements, with doses
- Your vaccination record if you have it
- Rough notes on your cycle length and regularity
- Any family history of clotting disorders, thyroid disease, early menopause, or genetic conditions
Tests to ask about
- A prenatal vitamin. Start one now, ideally at least a month before trying. Look for 400 micrograms of folate (folic acid or methylfolate both count — more if MTHFR has come up for you), 150 micrograms of iodine and vitamin D. Many prenatals skip choline, which is worth checking for.
- Medications and supplements. Bring every prescription, over-the-counter medicine and supplement to your first visit. Some need switching months before you try, and a few of the ones people stop out of caution are ones to stay on: see medications and trying to conceive.
- Vaccinations. Rubella and varicella immunity, plus routine vaccines, are usually checked at a preconception visit.
- Knowing when you ovulate. Regular cycles of roughly 21–35 days usually mean you're ovulating. The fertile window is the five days before ovulation plus the day itself — sperm survive several days, the egg survives about one. Cycle apps mostly do arithmetic on past cycles and predict the actual day less than half the time; LH tests pinpoint it, and cervical mucus warns you earlier. Apps, sticks, mucus and temperature, compared →
- How often, and when. Every one to two days through the window is what ASRM's guidance points to. "Every other day" is inside that range, needs no tracking at all, and is far easier to sustain. Timing, lubricants, and the mistakes that are easy to make →
- The two weeks after. Implantation happens 6–12 days after ovulation and hCG only appears afterwards, which is why early tests and symptom-spotting can't tell you what you want to know. What's actually happening, and when to test →
- Health conditions. Thyroid disease, diabetes, high blood pressure, and a history of pelvic infection, surgery, or endometriosis are worth raising now.
- Your partner's health. Smoking, heat exposure, certain medications, and some health conditions affect sperm. It's half of the equation and rarely mentioned.
- Optimizing beyond the basics. A Mediterranean-style diet, omega-3s, vitamin D, sleep, and (for some) myo-inositol or CoQ10 all have research behind them — mostly early or mixed for fertility, and good for your health regardless. See what actually helps, sorted by evidence, and how to choose a quality brand.
- Calming the body. Caffeine under 200 mg a day, a daily stress practice, sleep, and an anti-inflammatory eating pattern. One randomized trial in IVF found a structured mind/body program helped; the evidence is early. See caffeine, stress, and inflammation.
Nail this down before you leave
- Whether any medication needs to change before you try
- How long your doctor suggests trying before an evaluation, given your age
- Whether anything in your history means you should be evaluated sooner
If they say everything looks normal
- Which of the standard tests have actually been done, and which haven't?
- If everything is normal, what would you look at next, and when?
- Is there anything in my history that would make you consider additional testing?
- What's the plan from here, and at what point would you change it?
What happens next
Start a daily prenatal with folate (folic acid or methylfolate both count) now if you haven't, and make any medication changes your doctor recommends.
Under 35, guidelines suggest an evaluation after twelve months of trying, or sooner if there's a known reason to (irregular cycles, a history of pelvic infection or surgery, endometriosis, or a partner with a known issue). Put that date on your calendar so it isn't a decision you have to make while discouraged.
When you reach it, move to the next Path: We've been trying.
Notes from the appointment
Onward Babe is educational, not medical advice. Everything here is built from published research and professional guidelines so you can have a better conversation with the doctor who actually knows your situation.