Trying to have a baby can begin with excitement. Then a few months pass. Another period arrives. You start counting again. At some point, a quiet question may appear:
“Should we see someone, or should we just keep trying?”
There is no single answer for every couple. Age, menstrual patterns, medical history and how long you have been trying all matter. And importantly, fertility concerns should not automatically be investigated in the woman alone.
If you are trying to conceive with a male partner, both of you may need to be evaluated. Sometimes the contributing factor is female, sometimes male, sometimes both, and sometimes no clear cause is found. 1 4
Quick Answer
If the woman trying to conceive is under 35 and pregnancy has not occurred after 12 months of regular, unprotected intercourse, a fertility evaluation is generally recommended. If the woman trying to conceive is 35 or older, evaluation is generally recommended after 6 months. If the woman trying to conceive is 40 or older, it is reasonable to seek fertility advice before trying to conceive or soon after starting to try, as more immediate evaluation may be appropriate. Earlier evaluation may also be appropriate when either partner has a known or suspected condition that could affect fertility. 1 2 3 5
So, when should you make that appointment?
- If you are under 35
- For couples without a known fertility-related concern, evaluation is generally recommended after 12 months of regular unprotected intercourse without pregnancy. 1 2 5
- That does not mean something is necessarily wrong. It simply means there is enough information now to look more carefully at what may be affecting conception.
- If the woman is 35 or older
- If the woman is 40 or older
You may not need to wait
The 12-month or 6-month timelines are not meant to be rigid rules for everyone.
Seek earlier evaluation if either partner has a known or suspected medical condition, treatment history or reproductive concern that could affect fertility. 1
For the woman, this may include:
- Very irregular or absent periods
- Known or suspected ovulation problems
- Endometriosis
- Previous pelvic or reproductive surgery
- Known uterine or tubal problems
- Previous or planned cancer treatment that could affect reproductive function 1 2
For the man, relevant history may include:
- Previous testicular or reproductive problems
- Certain surgeries or infections
- Erectile or ejaculatory difficulties
- Known or suspected sperm problems
- Certain medications, including testosterone or anabolic-steroid use, which can affect sperm production 4
ASRM recommends prompt evaluation when medical history already suggests a possible fertility problem. 1
What actually happens at a Fertility Consultation?
It usually starts with a conversation — not IVF. Your doctor may ask about menstrual cycles, previous pregnancies, medical conditions, surgeries, medications, sexual history and how long you have been trying to conceive.
If a partner is contributing sperm, his medical and reproductive history should be considered too, and semen analysis is commonly part of the initial evaluation. 1 4
Depending on the situation, evaluation may include assessment of ovulation, the uterus and fallopian tubes, ovarian reserve when clinically relevant, and sperm-related factors. 1 2
The goal is not to order every fertility test available. It is to find the most useful information for your particular situation.
What can you do now?
Before your appointment, both partners can note:
- How long you have been trying
- Menstrual cycle patterns
- Previous pregnancies or miscarriages
- Previous surgeries or significant illnesses
- Relevant medications and supplements
- Any sexual or reproductive concerns
- Relevant family history
And please don’t feel that you need to arrive with a folder full of fertility tests.
For example, AMH is not a general fertility screening test for women who have no indication for infertility evaluation. It can be useful in specific clinical situations, but AMH alone cannot predict whether an individual will or will not conceive naturally. 1
When should you seek fertility evaluation?
Consider a fertility consultation if:
- You have been trying to conceive for 12 months without pregnancy and the woman trying to conceive is under 35. 1 5
- You have been trying to conceive for 6 months without pregnancy and the woman trying to conceive is 35 or older. 1 2
- The woman trying to conceive is 40 or older and pregnancy is being planned. 1 3
- Either partner has a known or suspected fertility-related condition. 1 4
- Periods are very irregular or absent. 1
- There is a history of endometriosis, pelvic surgery or other reproductive problems. 1
- There are concerns about sperm, erections or ejaculation. 4
Key Takeaways
- Under 35: consider evaluation after 12 months of trying.
- Age 35 or older: consider evaluation after 6 months.
- At 40 or above, consider seeking fertility advice before trying to conceive or soon after you begin trying.
- Known fertility risks may justify evaluation sooner.
- Fertility evaluation should consider both partners when applicable.
- A fertility consultation does not automatically mean IVF.
- You do not need to diagnose the problem yourself before seeking help.
- Fertility is not a test that a woman has to pass.
References
- American Society for Reproductive Medicine (ASRM). Fertility Evaluation of Infertile Women: A Committee Opinion.ASRM — Fertility Evaluation of Infertile Women
- American College of Obstetricians and Gynecologists (ACOG). Evaluating Infertility.ACOG — Evaluating Infertility
- American College of Obstetricians and Gynecologists (ACOG). Having a Baby After Age 35: How Aging Affects Fertility and Pregnancy.ACOG — Having a Baby After Age 35
- American Society for Reproductive Medicine (ASRM) / American Urological Association (AUA). Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline.AUA/ASRM — Male Infertility Guideline
- American Society for Reproductive Medicine (ASRM). Definition of Infertility: A Committee Opinion.ASRM — Definition of Infertility