According to the American Society for Reproductive Medicine, about one in six women who are trying to get pregnant have trouble doing so. All told, that’s about 7.3 million American women (or couples) struggling with infertility.
Unfortunately, there aren’t generally advance warning signs of fertility trouble—meaning most women don’t know infertility is a problem for them until start trying to have children. And when that time comes, it can be hard not to get anxious about what’s “normal” or not. Is three months too early to start worrying? What about 10 months? Just how long should one wait before calling in a fertility specialist?
“Among healthy couple who are starting to conceive, about 85% will have a pregnancy within 12 months,” says Mylene W. M. Yao, co-founder and CEO of Univfy Inc. and a former Stanford University professor who has done more than 15 years of fertility research.
“It doesn’t mean that, for couples who haven’t conceived in a year, there’s an issue—but that would be a good point to see a doctor about it. Basically we don’t want couples to keep trying on their own if there are specific medical issues that could be addressed.”
Because the fertility window gets smaller as women age, continuing to try the natural way could do more harm than good by delaying medical treatments that are more effective when carried out earlier, Yao notes.
The ASRM recommends that if you are over 35 years old and have tried for six months, you should see a fertility specialist.
Your first fertility appointment
Nervous about making a first fertility appointment? Don’t be. The first visit will mostly be to find out if there’s anything in you or your partner’s health history that may make conception difficult or indicate further medical testing. The doctor will ask about any previous or current health problems, the regularity of your menstrual cycles, contraceptive methods you’ve used, whether you’ve been pregnant before, and whether or not you’ve had any sexually transmitted infections (which can, in some cases, damage your fallopian tubes, making conception difficult).
Even matters that seem relatively normal, like cramping or pelvic pain during or around the time of your regular periods, may be symptoms of potential concerns, like endometriosis.
“Endometriosis is pretty common,” says Yao, “and can cause difficulty to conceive. Not everybody with endometriosis would have problems with fertility, but definitely some women with endometriosis may have problems conceiving.”
Other things that the doctor may be looking for are conditions that may affect your hormonal systems. For example, if your thyroid gland is not working properly, that could affect your reproductive function. So someone could be having fertility problems when their reproductive organs are all fine, but it’s just a matter of addressing the thyroid.