Fertility Check and Planning
Dr Jenny Cook | Sydney Gynaecologist & Advanced Laparoscopic Surgeon
What We Discuss
During your consultation, we will explore your menstrual health, general wellbeing, lifestyle choices and how these factors may affect your fertility and future pregnancy.
Menstrual Cycles
We begin with a discussion about your menstrual cycles:
Pelvic pain, which can be a symptom of endometriosis
Irregular cycles, which may suggest Polycystic Ovarian Syndrome (PCOS)
General Health
Your general health will also be reviewed. We will look at any medications you are taking and whether they need to be adjusted to ensure safety during pregnancy. You will also be introduced to MotherSafe, a free NSW-based service run from the Royal Hospital for Women, Randwick, which provides expert advice on the safety of medications before pregnancy, during pregnancy, and while breastfeeding.
Lifestyle Factors
Lifestyle factors are another important focus. We will talk through:
Smoking, alcohol, caffeine, and recreational drugs
Pre-pregnancy supplements such as folate, which supports the baby’s nervous system and reduces the risk of neural tube defects like spina bifida
Weight, since the ideal BMI for fertility is 20–25 kg/m²; both underweight and overweight can reduce fertility, and we can discuss strategies to optimise this
Exercise, as more than three aerobic sessions per week may have a negative effect on fertility
Diet, with the option of a referral to a dietician if needed
Fertility Investigations
A range of investigations can be organised to give you a clearer picture of your fertility.
pelvic ultrasound
This allows us to check for ovarian cysts, measure the number of follicles (an indicator of egg reserve), and examine the uterine structure for polyps, fibroids, septa, or other abnormalities that could affect fertility.
HyCoSy (Hysterosalpingo-Contrast Sonography)
This ultrasound assesses whether the fallopian tubes are open and provides detailed information about the shape of the uterus. HyCoSy is also known to sometimes improve fertility by flushing out the tubes, with many women conceiving spontaneously within three months of the procedure.
Semen analysis
For partners, to assess sperm count, motility (speed), and morphology (shape).
Blood tests may include:
Anti-Mullerian Hormone (AMH)
Thyroid function
Full Blood Count and Iron studies
Antenatal serology (HIV, Hepatitis B & C, VDRL, CMV)
PCR for Chlamydia & Gonorrhoea
Prolactin
Androgen profile
Varicella Zoster serology
Rubella serology
If results show you are not immune to infections such as rubella or chicken pox, I will recommend vaccination before pregnancy. These infections can be particularly harmful during pregnancy and may cause serious complications.
Genetic Testing
We will discuss whether you would like to proceed with genetic testing. Options include:
Genetic Carrier Screening (GCS):
Tests for more than 400 genetic conditions
Around 1 in 30 couples discover they carry a condition which may be passed on
Test kits can be ordered online from the Monash IVF website
Three Gene Panel Test:
Screens for cystic fibrosis, fragile X syndrome, and spinal muscular atrophy
Around 1 in 200 couples discover a risk through this test
This test is covered by Medicare
Planning Ahead
Finally, we will talk about your future family plans, including your preferred timeframe for starting a family and how many children you hope to have. Fertility is most closely linked to age and begins to decline after 35 years. If you are single but not yet ready to have a baby, we can also explore options for fertility preservation.
Ready to Take the Next Step?
Book an appointment with Dr Jenny Cook today to discuss your fertility, pre-pregnancy planning, and the steps you can take to optimise your health before pregnancy.