About Fertility: When to See a Specialist

Though not often discussed, infertility is quite common – approximately 15% of people desiring children will need help conceiving. 

Achieving a pregnancy requires: 

1) ovulation (the release of an egg), 

2) sperm, 

3) a way for the egg and sperm to meet,  

4) a place for an embryo to implant and develop. 

Infertility is a compromise of the reproductive system that can be caused by one or more of these factors. 

Common causes of infertility include:  

Age

Irregular or absent periods

Low sperm counts

Fallopian tube blockage

Endometriosis. 

Infertility can be attributable to both female and male factors in up to 40% of cases, and is “unexplained” in about 25-30% of cases. 

The age of the female partner attempting conception is one of the biggest factors in determining the likelihood of becoming pregnant and the length of time it may take to conceive. 

For women 35 or younger, the likelihood of becoming pregnant after one month of regular unprotected intercourse is approximately 20%, and about 85% of individuals will achieve pregnancy within one year of trying. 

At 38, the chances of getting pregnant naturally are about 10-15% per month, and after 40 they are 5% per month or less. This means that the older the age of the female partner, the longer it can take to get pregnant and the more likely you are to experience infertility.  

Therefore, women under the age of 35 should undergo a fertility evaluation if conception does not occur within a maximum of 12 months. Those over 35 should pursue a fertility evaluation after attempting for 6 months. 

Not all women should wait these timeframes before asking their doctor about a fertility assessment (for example, women with irregular periods or women 40 or older may warrant sooner evaluation).

When To See a Specialist

Infertility affects up to 1 in 6 people and can have many causes. Because the age of the egg is the single most important factor in determining chances of pregnancy, it is recommended to see a fertility specialist if you are:  

• Under 35 years old and have been trying to conceive for 12 months or more
• 35 to 40 years old and have been trying to conceive for 6 months or more
• Over 40 years old and have been trying to conceive for 3 months or more

 In some cases, an earlier consultation with a fertility specialist is indicated. These can include: 

• People with irregular or absent menstrual periods
• Same sex couples or people pursuing single parenthood
• Couples who have experienced two or more miscarriages
• Individuals or couples with known genetic diseases or with a family history of a particular disease (such as early onset breast cancer or Huntington’s disease)
• People with risk factors for tubal disease, such as a history of a sexually transmitted infection or a diagnosis of endometriosis 
• People with a chronic medical condition such as heart disease or diabetes
• People whose mother went through early menopause (40 years old or younger)