For most of us, getting pregnant is something we assume will be easy. When it’s not, it can be extremely frustrating and disappointing for most of us. The good news is that for nearly all couples, this doesn’t mean conception is impossible, but that some factor is making it more challenging. So how do you know when it’s time to take the plunge and seek an infertility evaluation?
The general rule of thumb is if you and your partner have been having regular unprotected intercourse for one year with no conception, it’s time for a thorough evaluation (see prior blog for what this entails). If the female partner is over the age of 35, however, it is recommended to seek a workup after art-whentoseeinfertjust 6 months of trying. Women are born with a set number of eggs as opposed to men who produce new sperm every day, so the issue of ‘aging eggs’ is why women over the age of 35 should be evaluated earlier.
Another common scenario that warrants an earlier workup is ovulatory dysfunction. Irregular menstrual cycles can be a sign that you are not ovulating every month. No matter how many eggs you may have inside your ovaries, without an egg ovulating and migrating into the fallopian tube where fertilization occurs, there is no chance of conception that cycle; thus, the time to conceive will be much longer. Testing should be done to look for underlying hormone disorders that can affect ovulation, some of which if treated can improve ovulation and bypass the need for ‘infertility treatment’.
If there is other history you think may put you at risk for infertility, it is never wrong to have testing done before the one year mark. Examples of this include but are not limited to: in women – a history of pelvic infection that can induce scarring of the fallopian tubes, ectopic pregnancy, uterine fibroids, two or more first trimester pregnancy losses, or exposure to chemotherapy or radiation; in men – a history of testicular or inguinal surgery, testicular trauma, or exposure to chemotherapy or radiation.
Once you’ve decided it’s time for testing, who should you see? If you already have a women’s health provider, most can complete the infertility evaluation (see prior blog to be sure you are being screened appropriately), and refer you to an infertility specialist if needed. If you don’t, it is also perfectly reasonable to go straight to an infertility specialist. Remember that doing the investigation does not necessarily commit you to treatment if you choose to continue to try on your own. On the other hand, if the testing does uncover an abnormality, treating the underlying problem will expedite your ultimate goal of conceiving a healthy baby.