How is infertility diagnosed?

The Centers for Disease Control and Prevention defines infertility as being unable to get pregnant after at least one year of trying to conceive naturally. It is very common, affecting nearly 1 in 5 females in the United States according to some estimates.

But the fact that infertility is common doesn’t mean that it is any less stressful or difficult for every one of the millions of people who are experiencing infertility.

If this is your experience, know that there are healthcare providers and fertility treatments that help many people get pregnant every year.

Here, we look at one of the first and most important steps in addressing infertility—seeing a healthcare provider and diagnosing what is causing infertility.

Finding a fertility specialist

Your initial appointment may be with a healthcare provider you have worked with in the past, such as a primary care provider or gynecologist.

This healthcare provider may order tests and exams or refer you to a fertility specialist—called a reproductive endocrinologist. There are also numerous organizations that can help connect people experiencing infertility with fertility clinics.

Medical history and lifestyle

A fertility specialist will administer exams for both partners that can help identify what is making it difficult for you to get pregnant. Both you and your partner should be prepared to talk about medical history, as well as your overall health and lifestyle.

In both males and females, existing health conditions and lifestyle factors can cause or contribute to infertility. This list includes being overweight or obese, having diabetes, smoking, excessive alcohol use or other substance use, exposure to certain chemicals, and medical history that includes chemotherapy and/or radiation therapy.

Physical exams and tests

Infertility has many potential causes. You and your partner should also be prepared for a variety of exams that look for a variety of conditions that may be interfering with your ability to conceive.

About one-third of cases can be attributed to male factors, another third can be attributed to female factors, and the remaining third are the result of a combination of male and female factors or may be unexplained.

For male partners, a fertility workup focuses on the number and quality of sperm. This will include a physical exam and semen analysis. It may also involve tests and exams that look for genetic disorders, hormonal disorders, and structural abnormalities in the reproductive organs.

For female partners, a fertility workup focuses on the health of the ovaries, fallopian tubes, eggs, and uterus. Tests and exams may include ovulation testing, imaging exams, and hormone testing at different points in the menstrual cycle.

Based on the findings of exams, your fertility specialist can recommend treatments that can improve your chances of getting pregnant.

Different approaches work for different people. Measuring basal body temperature, at-home ovulation tests, and changes to sexual habits work for some. Others may be prescribed medications to stimulate ovulation or have surgeries to correct structural problems in either partner.

And some couples may choose assisted reproductive technologies (ARTs), such as in utero fertilization (IVF).

When to see a healthcare provider

If you have been trying to get pregnant and have so far been unsuccessful, it is generally a good idea to talk to a healthcare provider, though the recommendation may be different depending on your age.

For females 35 and under, the recommendation is to see a healthcare provider after one year of trying to get pregnant. This timeframe is 6 months for females over the age of 35—and it is recommended that females over the age of 40 see a healthcare provider as soon as they begin trying to conceive. Fertility decreases after age 30, and the risk of complications in pregnancy and birth also increases with age.