There are many reasons why a couple may seek the help of a fertility specialist. As defined by the World Health Organization, infertility is a disease of the reproductive system resulting in the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. What does that mean? As a general rule, women who are under the age of 35 and have been trying to conceive for a year or are over the age of 35 and have been trying for 6 months, should see a fertility specialist.
But when does that rule not apply? There are many factors, both male and female, that can impact a couple from conceiving. So if you’ve been wondering “should I see a fertility specialist?” here are five reasons you shouldn’t wait.
Should I See a Fertility Specialist? 5 Signs You Shouldn’t Wait
1. You Have Been Diagnosed or Suspect Polycystic Ovary Syndrome (PCOS)
PCOS is one of the most common ovulatory disorders. A few of the key indicators for PCOS are irregular or absent periods, and/or signs of high androgens (male hormones like testosterone) such as acne, facial hair, and trouble losing weight. While these are indicators—no one size fits all for women with PCOS. If you think you have PCOS, it’s important to discuss it with your OB/GYN. Both OB/GYNs and fertility specialists can help many women with PCOS to conceive by stimulating ovulation, often through the aid of medications such as clomiphene citrate (Clomid, Serophene). However, if you have had 3 to 4 rounds of Clomid with your OB/GYN without achieving pregnancy, it is time to see a specialist, who will be able to develop a personalized treatment protocol for you.
2. You’ve Had Two or More Miscarriages
Couples who experience miscarriage are in a difficult position because they have had success conceiving and may not feel as if they are infertile. However recurrent pregnancy loss (two or more miscarriages) is often the result of an underlying issue. A fertility specialist will work with you to determine the cause of miscarriage and develop a plan to help you carry your pregnancy to term.
3. You Had Your First Child (or Children) Without Trouble, But Now You’re Having Problems
If you are having trouble getting pregnant again despite having a child or children without the assistance of fertility treatment or medication, you may have secondary infertility. Often couples wait a few years between children, and in some cases they experience decreased fertility due to age. As a woman ages, the quantity and quality of her eggs decrease making it harder to conceive. Other times, new conditions have developed preventing conception. If you have been trying for 6 months and are over the age of 35, we recommend seeing a specialist, even if you already have a child or children.
4. Your Periods are Irregular, Frequent, or Absent
If your menstrual cycle is less than 21 days or longer than 35 days, or consistently irregular, you may have an ovulatory disorder. Ovulatory disorders are one of the leading factors of female infertility but can often be easily treated through medication.
5. It’s Been Over a Year (or Less in Some Cases) and You Haven’t Been Able to Get Pregnant
Whether or not you have been actively trying to conceive, if you have been having regular intercourse without contraception for a year or longer (or even sooner based on age), it is time to speak with a fertility specialist, as that is classified as infertility. And this doesn’t just apply to the female partner—nearly half of infertility is at least in part male factor—so it is important for both partners to be evaluated.
According to Stephen Greenhouse, M.D., of our Fair Oaks, VA office, a women in her early 30s has a 15 to 20 percent chance of pregnancy per month when she initially starts to try. About 60 percent of couples will get pregnant within the first 4 to 5 months of trying; thereafter, the pregnancy rate begins to decrease each month. After trying for 1 year, the chances of pregnancy declines to 1 to 2 percent per month (Zinaman, 1996). This is the reason that we recommend beginning an evaluation after trying for 1 year if under 35 and after 6 months if 35 or older.
Here are the recommended guidelines. Infertility is present based on the following definition. When a woman is:
- Under 35 with regular cycles and no pregnancy after 1 year
- 35 to 39 with regular cycles and no pregnancy after 6 months
- 40 or over with regular cycles and no pregnancy after 3 months
Other conditions that may warrant an early evaluation include:
- History of pelvic surgery (such as the removal of an ovarian cyst, ablation of endometriosis, ectopic pregnancy, tubal surgery, or ruptured appendix)
- Severely painful periods
- Other female infertility diagnosis
Medical Contribution by: Stephen Greenhouse, M.D.
Shady Grove Fertility reminds you, there are now treatments available to help nearly everyone take home a baby. If you’ve been wondering “should I see a fertility specialist” or if you’d like to learn more please speak with one of our New Patient Liaisons at 877-971-7755.