Most healthy couples conceive within 6–12 months, depending on age and cycle regularity.

General guidelines:

• Under 35: Seek support after 12 months of trying

• 35–39: Seek support after 6 months

• 40+: Consider early evaluation

• Irregular cycles, PCOS, thyroid issues, or previous losses: Seek support sooner. You do not need to wait 6 or 12 months. 

If you’re timing intercourse correctly for several months without success, earlier evaluation can help you avoid unnecessary delays.

Ovulation signs include:

• Egg-white cervical mucus

• A sustained rise in basal body temperature

• Mittelschmerz (ovulation cramps)

• A positive OPK (LH surge)

Important:
A positive OPK does not guarantee ovulation, it only indicates LH has risen.
The most reliable confirmation is a mid-luteal progesterone test, about 7 days after suspected ovulation.

Your fertile window is:

• 2 days before ovulation

• The day of ovulation

Because sperm can live 3–5 days, having intercourse before ovulation gives you the highest chance of conception.

Most women benefit from:
Intercourse every other day from cycle days 10–18 (for a typical 28–32 day cycle).

Irregular cycles often mean that ovulation isn’t happening consistently — but it does not mean pregnancy is impossible.

Common causes of irregular cycles include:

• PCOS

• Thyroid disorders (especially Hashimoto’s)

• Post–birth control hormone disruption

• High stress or under-eating

• Elevated prolactin

• Perimenopause

• Insulin resistance

• Inflammation

With proper testing and individualized support, most women can restore regular ovulation and improve their chances of conceiving.

I typically start with:

Hormone Panel

• FSH

• LH

• Estradiol

• Progesterone (7 days after ovulation)

• AMH

• Prolactin

• Testosterone (total + free)

• DHEA-S

Thyroid Panel

• TSH

• Free T3

• Free T4

• TPO antibodies

Metabolic Panel

• A1C

• Fasting insulin

• Fasting glucose

• Lipid panel

• CRP (inflammation)

Partner Testing

• Comprehensive semen analysis

• Sperm DNA fragmentation (if indicated)

These labs help us build your Fertility Blueprint, a personalized plan based on your hormones, thyroid, metabolism, and cycle patterns.

Yes. Hashimoto’s can impact:

• Ovulation

• Progesterone levels

• Cycle regularity

• Implantation

• Miscarriage risk

For women trying to conceive, research supports optimizing:

• TSH between 1.0–2.5

• Free T3 and T4 in optimal ranges

• Thyroid antibodies reduced when possible

Thyroid optimization is one of the most impactful steps you can take for fertility, and it’s something we monitor closely in my practice.

Yes! Many women with PCOS conceive naturally with the right support.

When PCOS affects fertility, the primary issues are:

• Irregular or absent ovulation

• Insulin resistance

• Elevated androgens

• Inflammation

• Hormone imbalance from post–birth control use

In my practice, PCOS fertility care focuses on:

• Restoring consistent ovulation

• Balancing blood sugar and insulin

• Reducing inflammation

• Using evidence-based supplements

• Tracking ovulation correctly (OPKs alone often mislead)

With a targeted plan, many women achieve natural conception without medication or IVF.

A lot.
Male factor infertility contributes to nearly 50% of TTC challenges.

Factors that impact sperm quality include:

• Semen count

• Motility

• Morphology

• DNA fragmentation

• Alcohol intake (especially weekend binge drinking)

• Heat exposure

• Stress and inflammation

• Nutrient deficiencies

Because sperm take 90 days to regenerate, even small lifestyle changes can make a big difference.

You may want to consider a specialist or fertility-focused doctor when:

• TTC > 12 months under age 35

• TTC > 6 months age 35+

• Cycles are irregular or painful

• You are not ovulating

• You have other pre-exisiting conditions like hashimoto's, PCOS, insulin resistance, or obesity. 

• You’ve had recurrent pregnancy loss

• There’s known male factor infertility

• You want guidance before IVF or IUI

You do not need to wait for a fertility clinic before getting answers.
Many couples conceive working with me before needing IVF, and others use this prep work to dramatically improve IVF outcomes.

Preparing 90 days before an IVF cycle is one of the best things you can do to improve outcomes.

In my practice, IVF prep focuses on:

• Optimizing thyroid and hormones

• Enhancing egg quality

• Improving sperm quality

• Balancing blood sugar

• Reducing inflammation

• Correcting nutrient deficiencies

• Supporting gut health

• Using mitochondrial support for egg development

• Reducing oxidative stress

• Preparing the uterine environment

Better prep = Better embryos = Better results.

Birth control doesn’t cause infertility, but it can mask underlying issues like PCOS, thyroid dysfunction, or irregular ovulation.

After stopping birth control, it’s common to experience:

• Irregular cycles

• Temporary anovulation

• Delayed ovulation

• Hormonal acne

• Spotting or long cycles

If your cycles haven’t normalized within 3 months, or if you’re trying to conceive sooner, a fertility evaluation can help.

Simple, evidence-based habits include:

• Aim for 30–40g protein per meal

• Eat balanced meals to support blood sugar

• Prioritize sleep (7–9 hours)

• Take a high-quality prenatal with methylated folate

• Reduce alcohol (especially weekend binge drinking)

• Include omega-3 rich foods

• Track cervical mucus

• Manage stress and exercise appropriately

• Reduce environmental toxins when possible

Small, consistent changes make a meaningful difference over a 3-month cycle.