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When it comes to fertility treatment, why is timing everything?

“In retrospect, I wish I wouldn’t have waited,” says Sarah, a current Shady Grove Fertility patient of Joseph Doyle, M.D. of our Rockville, MD office.

Sarah is not alone.

In a recent survey, 65 percent of 1,000+ patients surveyed said they wish they hadn’t waited as long as they did to seek fertility treatment.

From the age at which you start trying to conceive to the days on which you have sex with your partner, timing is one of the most crucial factors when it comes to how easily you will become pregnant.

Because timing is so critical, Dr. Doyle advises individuals who suspect they may be experiencing infertility against waiting to seek treatment. Sarah, who is in the process of conceiving her first child, received this advice.

Together, Dr. Doyle and Sarah have tackled the answers to some common questions about seeking fertility treatment. From timelines to costs, doctor and patient openly discuss why some patients wait and, more importantly, why they shouldn’t wait to start fertility treatment. After all, timing is everything …

Q: What’s so special about trying for 1 year?

Dr. Doyle: The general guidelines are, if you’re under 35 and have been having unprotected intercourse for a year, but haven’t gotten pregnant, you should seek a fertility evaluation. However, if you’re over 35, a 6 month-period of trying is sufficient before seeking help. These terms are based on analysis of statistics that span decades.

Statistically, women in their early 30s have a 15 percent chance of getting pregnant during each of the first 3 months of having unprotected intercourse—or a 45 percent chance of getting pregnant total during the 3 months combined. The most fertile women become pregnant during these first 3 months, and rates of pregnancy start to decrease in month 4, moving from 15 to 13 percent, and then exponentially thereafter.

Once a year has passed, approximately 15 percent of women will not have successfully conceived. These women are the ones who likely will benefit from help.

For women over 35, natural conception rates drop to 10 percent—or less—each of the first 3 months and then decline more precipitously from there. For these women, time is even more essential, so they are only encouraged to have unprotected sex for 6 months before seeking fertility support.

Q: Why do people wait to seek fertility treatment?

Dr. Doyle: Many are reluctant to seek fertility support because reproduction is such a personal process. Struggling couples aren’t inclined to invite someone else into such a private experience—even a doctor.

Others may be worried about what their tests will show. For couples eager to have a baby, the possibility of discovering a serious issue can be too formidable to face.

Another major factor stopping would-be patients from seeking help is their lack of fertility-related knowledge. Patients delay because they aren’t clear on what the treatment will involve. Often, they don’t fully understand the science behind reproduction, let alone infertility.

Current SGF Patient, Sarah: Before beginning fertility treatments, I didn’t have a strong base of reproductive knowledge—even though my mother worked in the field.

And then there was my fear of needles. I was scared that I would end up needing lots of injections—and that’s definitely not something I wanted.

Q: What causes people to wait once they receive a diagnosis?

Sarah: I began exploring fertility treatment in Michigan with a different doctor. Once I received my diagnosis of polycystic ovary syndrome (PCOS), my Michigan doctor provided me with a  potential treatment plan.

But I didn’t proceed.

I decided to wait because I thought that I would still be able to get pregnant without intervention. Even though I had issues with irregular periods my whole life, I assumed pregnancy would just happen, and I wouldn’t end up needing treatment.

I was wrong.

Dr. Doyle: Some patients elect to wait because they want to continue to try on their own. If the patient is young, and the tests come back within normal ranges, waiting a few months won’t hurt her chances of becoming pregnant. We always discuss the risks and benefits of waiting early on in the process.

Others, like Sarah, are worried that treatments will be invasive. In truth, 50 percent of fertility treatments are low-tech. Treatment is always customized to a patient’s needs. After diagnosis, patients are presented with an array of options and given the probability of success with each.

Q: Are couples experiencing secondary infertility more likely to delay treatment?

Dr. Doyle: Yes. For parents experiencing secondary infertility, intervention can feel unnecessary. Parents with one or more kiddos already commonly think that if they’ve been pregnant before, they will be able to get pregnant again.

Delay for these parents can be just as damaging as for first-time parents. In fact, delaying treatment may be even more problematic for these couples because second-time parents are older than when they conceived their first child.

Q: Is timing still important once you start treatment?

Sarah: Because fertility is all about timing, you can’t necessarily dive right into the treatment process. The course of treatment is based on your menstrual cycle, so you might have to wait a bit, even if you’re ready to go after your first appointment.

Once you do start the fertility treatment process, it’s important that you stick to the timeline your fertility specialist suggests.

I keep close track of my appointments. And, surprisingly, I look forward to each and every one— even those that involve a needle—as each one lets me know how the process is going and keeps my pursuit of having a baby moving forward.

Q: How much will delaying fertility treatment affect someone’s likelihood to conceive?

Dr. Doyle: Honestly, it depends. Your age and your test results will determine how significantly a delay will impact your likelihood of a successful pregnancy.

Delaying treatment may also mean that you may have to use more advanced techniques to achieve a pregnancy, which will increase your costs.

“There can be options in patients who are older, as long as we move more aggressively in terms of their treatment,” reminds Arthur W. Sagoskin, M.D., Co-founder of Shady Grove Fertility.

Testing is easy and will give you the information you and your doctor need to make an informed decision.

Start the conversation with your physician about the testing process. A series of simple tests (three for the female and one for the male) will pinpoint your fertility challenges and help determine the course of treatment.

Delaying an appointment means allowing doors to close that may have otherwise been open to you. Because age plays such a critical role in fertility, you will never be more fertile than you are today. Seize the day and get on the road to parenthood.


fertility treatment
Joseph Doyle, M.D.
fertility treatment
Arthur Sagoskin, M.D.


Medical Contribution by Joseph Doyle, M.D., and Arthur Sagoskin, M.D., of Shady Grove Fertility’s Rockville, MD location

Shady Grove Fertility is ready to help you learn how to put time on your side. Call 1-877-971-7755 or click here to schedule an appointment with Dr. Doyle, Dr. Sagoskin, or one of our other 37 fertility specialists.

At Shady Grove Fertility, we’re here to give you the caring support you deserve as you start or grow your family. As a leading fertility and IVF center of excellence, we offer patients individualized careinnovative financial optionsover 30 accepted insurance plans, and pregnancy rates among the highest of all national centers. We offer patients the convenience of 19 full-service and 6 satellite locations across Maryland, Pennsylvania, Virginia, and Washington, D.C. More than 1,700 physicians choose Shady Grove Fertility to refer their patients, and more than 96 percent of our patients say they would recommend Shady Grove Fertility’s 35+ physicians to a friend. With 10 Shady Grove Fertility babies born each day, your dream of starting or growing your family is within reach.


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