As a reproductive endocrinologist, I spend a lot of time talking to my patients about their fertility struggles and what has led them to seek assisted methods of reproduction in order to start a family. Many couples who are currently trying to conceive may wonder when to take that next step and consult with a fertility specialist about why they have not yet gotten pregnant. Taking this step can be intimidating because it means confronting the fact that something may be preventing you from conceiving naturally. However, it is important to recognize the issue so that the right steps can be taken in your journey towards a family of your own. Below, I’ve listed some indicators that it may be time for you and your partner to make an appointment with a fertility specialist.

You’re Under 35 and Have Been Trying for a Year

In terms of conception, “trying” to get pregnant means having unprotected sex, whether or not you’ve had a baby in mind the entire time. With that being said, couples who are under 35 and are not pregnant after a year of unprotected sex should make an appointment with a fertility specialist. This guideline is suggested for women with regular cycles – I’ll discuss those with irregular cycles a little later on.

You’re Over 35 and Have Been Trying for Six Months

Fertility is at its peak between the ages of 20 and 30; it begins to slowly decline after age 30, and once a woman hits age 35, it starts declining more rapidly. Your eggs age with you, and this process often results in fertility issues after age 35. Aging brings an increased risk of miscarriage as well. Seeing a fertility specialist is advisable if you are over 35 and have not gotten pregnant after six months of unprotected sex.

You Have Had Two or More Miscarriages

Miscarriages are devastating, and experiencing a miscarriage more than once is reason to see a fertility specialist. This is because multiple miscarriages can occur for a number of reasons, and indicate a specific type of fertility problem. Miscarriages are often attributed to genetic abnormalities in the embryo, hormonal problems, or structural issues in the uterus, among other causes. The occurrence of two or more miscarriages means that something is going on that is preventing your body from sustaining a pregnancy, and a fertility specialist can work with you to determine the cause.

You Have a History of Pelvic or Abdominal Surgery

Pelvic and abdominal surgeries are not uncommon for young women – these types of surgeries include procedures to remove ovarian cysts, uterine fibroids, or the appendix. In some cases, surgeries in this area can lead to the development of pelvic scar tissue, which can block the fallopian tubes. Ovarian damage can also occur, and both of these surgical after effects have an impact on fertility.

Your Periods are Abnormal

“Abnormal” periods exist on a spectrum, but regarding fertility, having an absent, irregular, or extraordinarily difficult period is an indicator that you may need to see a fertility specialist when you decide to try for a baby. Irregular periods are directly related to ovulation and if you are not ovulating on a regular schedule, infertility is more likely. Irregular periods are often a symptom of Polycystic Ovarian Syndrome (PCOS), while periods that are unusually painful and long may point to endometriosis. Both of these conditions can negatively impact fertility, so if you notice any abnormalities in your cycle, a fertility specialist can help you determine what exactly is going on.

Since there are so many factors that impact a woman’s fertility, talking to a fertility specialist at the right time can take some of the stress and uncertainty out of your mind. If you’re wondering if it’s time for you to see a fertility specialist, I encourage you to reach out and contact me or a fertility specialist in your area.  Resolve.org can help you find an excellent reproductive endocrinologist. Even if you are not ready to consider treatment, a consultation can get a lot of your questions answered, and considering some testing and evaluation may put your mind at ease. I place a high priority on ensuring that my patients understand everything that is going on with their bodies and how it impacts their fertility. I would love to spend some time talking to you about your individual situation, and help move you along your journey towards starting a family.

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