May is National Fertility Awareness Month — and at OGS Tulsa, we think it’s one of the most important conversations we have all year.
Fertility isn’t just a topic for women who are actively trying to get pregnant. It’s about understanding your body, knowing what’s normal, recognizing the signs that something might be off, and knowing when it’s time to talk to a doctor. Whether you’re in your 20s thinking ahead, in your 30s ready to start a family, or simply curious about your reproductive health, this information is for you.
Dr. Gena Gray, a board-certified OB/GYN at OGS Tulsa, breaks down what every woman should know this Fertility Awareness Month.
This article is general education. It is not a personal care plan.
What is fertility awareness, really?
Fertility awareness means understanding the biological processes that affect your ability to conceive — including your menstrual cycle, ovulation, hormonal patterns, and the factors that can help or hinder fertility over time.
It also means knowing the difference between a typical variation in your cycle and a potential signal worth discussing with your doctor.
Here’s something we wish more women knew: fertility challenges are common. According to the CDC, about 1 in 5 women in the United States experiences difficulty getting pregnant or staying pregnant. That’s not a failure — it’s a medical issue, and it’s treatable in many cases. The key is catching it early and getting the right care.
Know your cycle
Your menstrual cycle is one of the most informative health signals your body produces. A typical cycle runs 21–35 days, with ovulation occurring roughly 12–16 days before the start of the next period.
Cycle irregularities worth paying attention to include:
- Cycles consistently shorter than 21 days or longer than 35 days
- Periods that are extremely heavy (soaking through a pad or tampon in an hour or less, for multiple hours)
- Periods that have become noticeably lighter, shorter, or less frequent over time
- Significant mid-cycle pain or spotting
- Cycles that have suddenly changed after being regular for years
These are not always signs of infertility, but they can point to conditions — like PCOS, endometriosis, fibroids, or thyroid dysfunction — that benefit from early evaluation.
Common conditions that affect fertility
Several gynecologic conditions can affect fertility if left unaddressed. The good news is that most are identifiable, treatable, and manageable with the right care team.
Polycystic ovary syndrome (PCOS)
PCOS is one of the most common causes of ovulatory infertility. It affects hormone levels and can cause irregular periods, excess androgen activity, and multiple small follicles on the ovaries. Many women with PCOS are able to conceive with appropriate medical support.
Endometriosis
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, which can affect the ovaries, fallopian tubes, and surrounding structures. It’s associated with pelvic pain, painful periods, and in some cases, reduced fertility. Surgical treatment — particularly excision — can significantly improve outcomes for women trying to conceive.
Uterine fibroids
Fibroids are noncancerous growths of the uterine muscle. While many fibroids don’t affect fertility, those located inside the uterine cavity can interfere with implantation. Treatment options depend on size, location, and your family planning goals.
Thyroid disorders
Both hypothyroidism and hyperthyroidism can affect menstrual regularity and fertility. A simple blood test can screen for thyroid dysfunction — ask about this at your annual well-woman exam if you have irregular cycles or are planning to conceive.
When should you talk to a doctor?
This is the most important question — and the answer depends on your age and how long you’ve been trying.
General guidelines suggest:
- Under 35: See your OB/GYN if you’ve been trying to conceive for 12 months without success
- 35 and older: See your OB/GYN after 6 months of trying
- Any age: See your doctor sooner if you have known conditions like PCOS, endometriosis, irregular periods, or a history of pelvic infections
And here’s something we want to say clearly: you don’t have to wait until you’re trying to conceive to have this conversation. If something about your cycle concerns you — pain, irregularity, heavy bleeding — that’s worth a conversation with your doctor now, not later.
Fertility after 35 — realistic, not scary
A lot of women come to us worried that it’s “too late” once they’re in their mid-30s. We want to be honest with you: egg quantity and quality do decline with age, and this is a real biological reality. But many women conceive naturally or with support well into their late 30s and beyond.
If you’re 35 or older and thinking about starting or expanding your family, the best thing you can do is have an honest conversation with your OB/GYN. There are options — from cycle monitoring to referral to a reproductive endocrinologist — and having that conversation early gives you the most options.
What OGS Tulsa can do for you
Dr. Gena Gray and the OGS Tulsa team provide comprehensive gynecologic and obstetric care, including evaluation and management of conditions that affect fertility. Our services include:
- Annual well-woman exams with full cycle and hormone review
- Diagnosis and treatment of PCOS, endometriosis, fibroids, and hormonal imbalances
- Minimally invasive and robotic surgical options for conditions affecting reproductive health
- Preconception counseling for women planning to grow their families
- Referral to trusted reproductive endocrinology specialists when indicated
We’re not a fertility clinic — but we are often the first step in getting answers and getting on the right path.
One last thing
Fertility Awareness Month is a good reminder that reproductive health isn’t a sidebar — it’s central to your overall wellbeing. Whether or not children are part of your plan, understanding your cycle, knowing your body, and having a doctor you trust makes a real difference.
If it’s been a while since your last well-woman exam, or if something’s been on your mind, this is a good month to make that call.
Frequently Asked Questions
What is fertility awareness? Fertility awareness means understanding your menstrual cycle, ovulation, and the factors that can affect your ability to conceive. It includes recognizing what’s normal for your body and knowing which symptoms or changes are worth discussing with your OB/GYN — whether or not you’re currently trying to get pregnant.
What are the signs that something may be affecting my fertility? Signs that may be worth discussing with your doctor include cycles consistently shorter than 21 or longer than 35 days, very heavy periods, periods that have become significantly lighter or less frequent over time, significant mid-cycle pain, and cycles that have changed noticeably after being regular for years. These aren’t always signs of infertility, but they can point to conditions that benefit from early evaluation.
What conditions most commonly affect fertility? Some of the most common conditions that can affect fertility include polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and thyroid disorders. Many of these conditions are identifiable and treatable. If you have been diagnosed with any of these or have symptoms that suggest one of them, talking with your OB/GYN is an important first step.
When should I see a doctor about fertility? If you are under 35 and have been trying to conceive for 12 months without success, it’s time to talk to your OB/GYN. If you are 35 or older, that timeframe shortens to 6 months. If you have a known condition like PCOS, endometriosis, irregular periods, or a history of pelvic infection, speak with your doctor sooner. If something about your cycle concerns you, you don’t have to be trying to conceive to make an appointment.
Does fertility really decline after 35? Yes, egg quantity and quality do decline with age — this is a biological reality, and it’s important to have an honest conversation about it with your doctor. That said, many women conceive naturally or with medical support well into their late 30s and beyond. If you’re 35 or older and thinking about starting or expanding your family, talking with your OB/GYN now gives you the most options.
Does OGS Tulsa offer fertility services? OGS Tulsa is a comprehensive OB/GYN practice, not a fertility clinic. The team — including Dr. Gena Gray — evaluates and treats many conditions that affect fertility, including PCOS, endometriosis, fibroids, and hormonal imbalances. We also provide preconception counseling and refer to trusted reproductive endocrinology specialists when indicated.
Dr. Sarah Shepherd, Dr. Gena Gray, Dr. Cate Hildebrand and Dr. Danni Hardin are accepting new OB patients at OB/GYN Specialists of Tulsa. Request an appointment online or call the office.
