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Reproductive Health and Fertility When It Comes to Starting a Family

Thank you to Northern Nevada Health System for sponsoring this post on fertility by Dr. Amanda Magrini, MD – Family Medicine. Read our disclosure.

As a family medicine physician, I get to see such a wide range of health concerns across all ages and spectrums. It is truly remarkable to be able to go from caring for a newborn to seeing a patient who is 104 and still spry and active. When it comes to families trying to conceive, I am often the first person they talk to about expectations and fertility.


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Trying to conceive begins with a healthy mom

Many of my patients have asked how they can be in top health to support fertility. Although there are lots of options to get started, one of the most important things for women to do before conceiving is make sure they are taking a good prenatal vitamin.

Begin taking at least 400 mcg of folic acid at least one month before you try to conceive. This supplement helps protect against conditions like spina bifida and other neural tube defects.

I encourage patients to speak with their physician about their overall health, medications and over the counter supplements they are taking.

All of these factors into fertility and may affect your ability to conceive. Your doctor will know how to safely continue taking prescribed medications, whether supplements are right for your pregnancy and more.

Additionally, if you smoke, use illicit drugs, or drink heavily, it is important to work on quitting these habits for the healthiest possible pregnancy and to reduce your risks for miscarriage.

The American College of Gynecology has many helpful resources to start your journey.

For women over 35, talk with your provider as soon as possible to determine if early screening for birth defects is right for you. This is an individual decision and the pros and cons should be discussed before making the choice to move forward with these types of screening.

When conception does not come easy, seek support

At times, you may hear from a friend, family member or another woman that they struggled to conceive. I want to be sure women who have experienced difficulty conceiving know there is a network of women around them to provide support and comfort during this time.

So let’s dig into the data. The average rate of pregnancy depends on your age. Assuming you are a healthy 25-35 year old, you have about a 20-percent chance each menstrual cycle of conceiving with regular, unprotected sex.

There are a TON of factors that can influence your fertility, which I will address here.

Generally speaking, 85-percent or so of couples that are able to conceive, will within one year. After one year, if you still have not been able to get pregnant, it is worth seeing a fertility specialist. Some risk factors for infertility that impact both men and women include:

  • Age: For women over age 37 and men over 40, you will see a decline in fertility rates
  • Alcohol, tobacco and marijuana use are proven to affect fertility
  • Weight: being underweight or overweight can impact your ability to conceive
  • Lack of exercise can lead to being overweight and excessive exercise can lead to your ovaries not releasing an egg, which is an integral part of the ability to conceive

Because there are so many factors that can affect fertility, it is important to stay connected to your family medicine provider. They can refer you to a fertility specialist for additional screenings and support with family conception.

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How stress plays a role when trying to conceive

Even though there has been tremendous research in this area, it is still not clear what the impact of stress is on fertility. While infertility causes significant psychiatric symptoms and stress, it can be somewhat a chicken-egg phenomenon.

Maintaining regular physical exercise and social outlets can be therapeutic for women and couples struggling through infertility, as they often feel very isolated and alone.

Consulting a fertility specialist – when and how it works

As I mentioned above, if you are between the ages of 25-35 and it has been more than 12 months since trying to conceive, it is worth reaching out to a fertility specialist for beginning evaluations. If you are over the age of 35, six months of attempting to conceive is considered long enough to undergo a fertility evaluation.

The specialist will typically begin with a sperm count/sperm analysis for men and ovulation tracking and assessment of your uterus and ovaries for women. These are the most important, yet basic pieces of fertility.

When it comes to treatments, they vary depending on what underlying causes are identified, although in some cases there is not a cause found. The more common treatments include:

  • Hormonal support
  • Medications to increase egg or sperm production
  • Intrauterine insemination: this is where your partner’s sperm is actually injected directly into your uterus when you are ovulating
  • In-vitro fertilization: This can be done using your egg and your partner’s sperm, a donor egg or donor sperm or any combination of these

No matter where you are in the process of starting or growing a family, it is important to know that you are not alone.

Ask your provider, friends, family or colleague for support including groups and resources online that will keep you connected to women and families going through similar experiences.

Web Resources:

Northern Nevada Health System is a regional network of care that has elevated and improved access to healthcare for 40 years. The System operates two acute care hospitals located in Sparks and Reno, 24/7 freestanding emergency departments, a Medical Group which offers family and internal medicine, urgent care and specialty care, and Quail Surgical and Pain Management. NNHS is committed to maintaining and improving the well-being of the community and is known for top-rated patient satisfaction, in addition to providing quality care and a safe environment for patients to heal. To learn more, visit northernnevadahealth.com.