When to see a healthcare provider about fertility

If you and your partner are trying to conceive, but haven’t found success, know that you are not alone. Studies have found that between 12 and 15 percent of couples in the U.S. are unable to conceive after one year of trying.

Although difficulty conceiving is common, it is no less difficult or emotional for couples who are faced with this struggle. It can be depressing and frustrating to see baby announcements from friends, family members, or old classmates. Sex and intimacy can become a tightly scheduled, tense part of the relationship. You and your partner may experience different emotions, and process your emotions in different ways, which can put a strain on your relationship.

However, couples today have access to greater knowledge and treatment options that couples in previous generations did not have. The past decades have seen multiple innovations in assisted reproductive technologies (ART)—therapies and procedures that have helped many couples conceive. ART is sometimes called “fertility treatment” or “treatment for infertility.”

Why couples struggle to get pregnant

Conception is a complicated process. For conception to occur, a couple must produce healthy sperm and eggs, the fallopian tubes must allow the sperm to reach the egg, the sperm must be able to fertilize the egg, and the fertilized egg (embryo), must be able to implant itself in the uterus.

After that point, the embryo must be healthy, and the hormonal environment must be able to adequately provide for its development. If any of these functions are impaired, pregnancy may not occur.

In other words, there are a lot of reasons a couple may have a difficult time getting pregnant.

When to see a healthcare provider

The recommendation about when to see a healthcare provider can vary from person to person, but the Centers for Disease Control and Prevention offers these guidelines:

• For females ages 35 and younger. If you have no apparent or previously diagnosed health conditions or fertility problems, the recommendation is to see a healthcare provider if you have been trying to conceive for one year without success.
• For females ages 35 and older. The CDC recommends seeing a healthcare provider after trying to conceive for 6 months without success. This shortened timeframe is because a female’s chances of successful pregnancy decline every year after the age of 30.
• For females over the age of 40. Consider working with a healthcare provider immediately for evaluation and treatment, as there is a lower risk of getting pregnant and a higher risk of pregnancy complications after age 40.
• Females at higher risk of infertility. This includes females who have an existing health condition or other medical history that increases their risk of infertility. Examples include endometriosis, pelvic inflammatory disease, uterine or tubal diseases, irregular menstruation, previous miscarriage, or having been treated with chemotherapy or radiation therapy.
• Males at higher risk of infertility. This includes males who have an existing health condition or other medical history that increases their risk of infertility. Examples include prior trauma to the testicles, chemotherapy, surgery to repair hernia, or a condition that affects the normal functioning of the reproductive organs.

The CDC also states that it is a good idea for any couple who is thinking of becoming pregnant to see their healthcare providers beforehand, as there are many factors that can affect fertility.

You may start by working with a healthcare provider you are currently seeing or have seen in the past, such as a primary care provider or gynecologist. These providers may be able to recommend strategies that can help you get pregnant, or they may be able to refer you to a reproductive endocrinologist—a healthcare provider that specializes in fertility treatments.

There are also organizations that can help you find specialists and fertility clinics in your area and help you prepare for your first appointment.