Trying for a Year? Here's How to Ask Your GP for a Fertility Referral
Getting a fertility referral from your family doctor is the gateway to fertility care in most of Canada.
The 12-Month Rule
The standard guidance is to seek a fertility referral after 12 months of unsuccessful trying if you are under 35, or 6 months if you are 35 or older. If you are over 40, most clinicians recommend an immediate referral.
The Script for Your GP
A direct script works better than hinting: "We have been trying to conceive for [X months]. I would like a fertility referral and the standard diagnostic workup. Could you order cycle day 3 bloodwork (FSH, LH, estradiol, AMH), TSH, prolactin, a hysterosalpingogram (HSG), and a semen analysis for my partner? And please send the referral to [Clinic A, Clinic B, Clinic C]."
What the Diagnostic Workup Looks Like
The standard fertility workup includes: cycle day 3 bloodwork (FSH, LH, estradiol, AMH); TSH and prolactin; a hysterosalpingogram (HSG); a transvaginal ultrasound; and a semen analysis for any male partner.
The Ontario 2-Year Fast-Track Tip
Documenting two full years of trying can put you on a faster track at some clinics. If you have actually been trying for closer to two years, make sure your referral letter reflects that accurately.
Multiple-Clinic Referrals
One of the most effective tactics is the multiple-clinic referral. There is no rule preventing your GP from referring you to more than one clinic simultaneously. Ask your GP to send the referral to three or four clinics.
What to Bring to Your First Clinic Appointment
Bring all diagnostic test results. Bring a list of medications and supplements. Bring a brief written timeline.
What Happens After the First Appointment
The fertility specialist will review your workup, may order additional testing, and will recommend a treatment plan.
Practical Plan
Talk to your GP with the specific script. Get a thorough diagnostic workup quickly. Request multiple-clinic referrals. Prepare for your first clinic appointment with all records.
Frequently Asked Questions
How long should I try before seeking a fertility referral?
12 months under age 35, 6 months if 35 or older, and immediately if over 40.
What tests should be in the initial workup?
Cycle day 3 bloodwork, AMH, TSH, prolactin, hysterosalpingogram, transvaginal ultrasound, and semen analysis.
Can my GP refer me to more than one clinic?
Yes. Multiple simultaneous referrals are permitted in Canada.
What if my GP refuses to make a fertility referral?
You can ask for the reason in writing, seek a second opinion from another GP, or contact your provincial College of Physicians. Most GPs will refer when asked directly. If yours will not, finding another family doctor is reasonable.
Should I get baseline fertility tests before seeing my GP?
Some patients order their own AMH test through private labs before the GP visit, which can speed the referral conversation. Ideally your GP orders the full diagnostic workup (AMH, FSH, LH, estradiol, TSH, prolactin, HSG, semen analysis) at once.
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Information only. Not medical advice. Discuss treatment decisions with your healthcare provider.