When should I see a Fertility Specialist?
Couples should consult with a fertility specialist to evaluate their infertility after one year of trying to conceive. In the case of women over 35 years of age, 6 months is enough to start the assessment
When pregnancy does not happen we are normally not sure when to seek help. We wonder whether we should do it right away or perhaps better wait and see.
In cases like this, the answer is clear. It is recommended to take a fertility assessment (i.e. to seek medical help) after one year of having sexual intercourse without using any method of contraception (hormonal contraceptive pills, patches or rings, IUDs, condoms, or simply coitus interruptus or the “pull out” method).
We know that the chances of pregnancy during a menstrual cycle are not 100%, not even in the case of couples we presume are very fertile. Consequently, it is highly convenient to give nature enough chances before entertaining a reasonable suspicion and take some diagnostic tests. It is esteemed that the chances of achieving pregnancy for couples with no fertility problems are 25% per cycle and that in normal circumstances 85% of the couples who stop using contraceptives achieve pregnancy during the first year of trying.
Many couples who did not succeed to achieve pregnancy in the first year of trying become pregnant during the second year. However, the chances of succeeding without help are much lower. For this reason, it is reasonable to take a number of tests in order to gain a comprehensive evaluation of your case and design an action plan. “Designing an action plan” does not necessarily mean an assisted reproduction treatment. It means visualizing clearly the steps that need to be taken in accordance with the factors present in the case.
We should not be inflexible, though. Considering that one must not take an infertility assessment until a year has passed need not become a norm in every case. This period can be shortened, particularly the older the patient is. In the case of women older than 35, we generally perform the evaluation after 6 months of unprotected intercourse. Likewise, in the case of couples where the woman is younger and no suspicious conditions are detected in their history, delaying evaluation can be a reasonable choice if and when the couple enjoys a satisfactory emotional state.
In many other cases, a previous medical history may raise reasonable doubts, even certainties, that pregnancy can be achieved naturally. This would apply to males who suffered from testicular problems during infancy, females who were diagnosed with ovarian failure and, certainly, females without a partner and couples where one partner underwent voluntary sterilization (through (tubal ligation o vasectomy).
Sometimes it can be reasonable to perform an evaluation even if the couple has only been trying to conceive for a few months. In some cases, uncertainty will generate an emotional response that may have a serious impact on the couple’s relationship. Performing some diagnostic tests and having a quiet conversation with their gynaecologist may lessen their emotional burden.