Some say if you just relax, you’ll get pregnant. Others tell you that they got pregnant on the first try. All you know for sure is you’ve been trying to conceive, nothing is happening, and you’re trying to decide if you are just impatient or if it’s time to perhaps see a fertility doctor.
First things first. The American Society of Reproductive Medicine released a revised definition of infertility in 2008. They said it is a disease, defined by the failure to achieve pregnancy if the woman is under 35 years old and has been trying to conceive 12 months or more of regular unprotected intercourse. Earlier evaluation is recommended after 6 months for women over age 35.
Basically, it’s not uncommon for it to take a few months depending on your age. If you have no known issues and you fall within in the age and “trying guidelines,” you do have time.
However, there are some reasons you may want to go sooner, which include:
- Are 38 years old or older
- Have had a history of pelvic infection, such as pelvic inflammatory disease or pelvic pain
- Know they need treatment for tubal damage or endometriosis
- Have had Recurrent Pregnancy Loss (two or more miscarriages)
- Have irregular menstrual cycles, ovulate irregularly, or miss their periods (and aren’t pregnant)
- Have had a poor semen analysis that showed low motility, low count, or poor morphology
- Have frequent urinary infections
Whether your insurance covers fertility treatment or not is one thing, but most insurances will at least cover a consultation and initial testing with a Reproductive Endocrinologist. A consultation will include a physical examination, a review of your and your partner’s health histories (do you have any known illnesses, do you smoke, etc.), and discussion of your family building goals.
For women specifically, blood work will be done to check your FSH (follicle-stimulating hormone), LH (as mentioned earlier), and your AMH (anti-mullerian hormone). These three hormones can provide an overview into your ovulation, egg supply, and egg quality. An ultrasound will also be included to make sure you do not have any cysts, polyps, or any detectable anatomical issues.
For men, if you haven’t already had one done, a semen analysis and infectious disease test will be performed. A semen analysis is used to evaluate sperm count, shape of the sperm (sperm morphology), and how well the sperm swim (sperm motility).
After these tests are run, your doctor will review if there are any concerns and, if there are, how to help address them. It’s important to note that if they do find any issues, it doesn’t always mean you will have to have fertility treatment. Sometimes, the recommendation may be lifestyle changes, medication, or potentially surgery.
If for some reason they are recommending fertility treatment, while no one longs to conceive a family with the help of medical intervention, it is comforting to know it exists to help people expand their families.
Intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI), and various other options can help.
But before getting to considering all the Assisted Reproductive Technology available, consider the above and decide if it’s time to take that first step and see a fertility doctor.