If you’ve made the decision to have a baby, the initial excitement of becoming pregnant can begin to wear off if you find yourself struggling to conceive right away. While becoming pregnant can take longer than anticipated, how do you know when it’s taking too long?
Medically reviewed on February 17, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
How do you know when you should see a fertility specialist?
According to the American College of Obstetricians and Gynecologists, if you’ve been off birth control for a year without successfully conceiving, or if you’re over 35 and it’s been six months of trying, you might need to visit a specialist .
There are also other situations in which you may want to see a specialist. Seeking fertility care from a specialist, as well as seeking ovarian reserve testing, can be a crucial step. In this guide, we’ll outline when to see a fertility specialist and what to expect when you do. (To learn more about your fertility-related hormones, consider taking the at-home Women's Fertility Test.)
Even if it’s been less than six months to a year since you have begun trying to conceive, there are other reasons to make a fertility specialist appointment. Existing medical conditions or other problems can interfere with the ability to get pregnant.
A fertility specialist can provide advice and treatment options based on your unique situation. Let’s discuss the 5 most common reasons to see a fertility specialist.
Many people assigned female at birth have trouble getting pregnant because of an existing issue. Some of these potential issues include :
Primary ovarian insufficiency (POI) – When a person’s ovaries stop functioning normally before the natural onset of menopause, it may be due to POI. If you have POI, conceiving without medical assistance is unlikely.
Endometriosis – Endometriosis is a painful condition that occurs when the tissue that should normally grow inside of the uterus grows elsewhere—for instance, in the fallopian tubes, ovaries, or pelvic area. This condition can lead to infertility if the excess tissue blocks the passage of the eggs through the fallopian tubes.
Because the symptoms of these reproductive issues can mirror the symptoms of more serious problems, such as gynecologic cancers, it’s important to see a healthcare provider if you’re experiencing any of them. Not to mention, all these reproductive issues require diagnosis by a healthcare professional.
If you’re diagnosed with a reproductive condition that interferes with the ability to get pregnant, there’s still hope for your dreams of having a baby. Fertility treatments can help in many situations.
Individuals assigned male at birth can also have reproductive issues that can result in infertility. There are typically three main causes of male infertility :
Of these three, the most common causes of fertility problems are sperm related. These include:
If a fertility specialist determines that one of these issues is causing an inability to conceive, you’ll want to consider options such as artificial insemination, medication, or surgery.
If periods are heavy, irregular, or non-existent, you might have trouble conceiving.
This is because many of the same problems that cause heavy periods can also negatively impact fertility—uterine fibroids, hormone imbalances, and/or certain cancers can cause you to have heavy bleeding during periods.
Other menstrual irregularities can also affect the ability to conceive. A study discussed in the “Annals of Epidemiology” looked at the menstrual cycles of over 2000 women between the ages of 21–45 . The study found that women with shorter cycles of between 25–26 days had reduced fertility. This suggests a potential link between short menstrual cycles and infertility.
Finally, people who have infrequent or irregular periods often suffer from infertility because they don’t ovulate normally. There may be problems with the frequency of periods due to :
Miscarriages in early pregnancy are common. In fact, about 10-20% of pregnancies end in a miscarriage during the early stages . However, individuals who have had multiple miscarriages should consult with a fertility specialist.
When a person has had repeated miscarriages, there are usually other causes, such as :
A fertility specialist may help determine the cause of miscarriages and the viability of a full pregnancy.
Women who are 35 and older are at an increased risk of :
So if you’re over 35 and want to start a family, it’s a good idea to see a fertility specialist before trying to conceive.
If you decide that a fertility specialist is the next step, there are a few things you need to know. First, the fertility specialist will conduct an infertility evaluation . During this evaluation period, you and your partner will need to answer questions about medical history and health status. These questions will likely cover:
Then, you’ll undergo several tests, including:
If you have a partner, there are additional tests they may need, such as:
Depending on the results of these tests, you may receive a diagnosis or may need further examination. It’s also important to keep in mind that, in some cases, fertility specialists are unable to find an exact cause for infertility. But whether or not a fertility specialist is able to determine a cause, they may recommend methods and treatments to help support conception.
There are several other methods a fertility specialist might use to help you and your partner conceive . Among the most common are:
Another option for female infertility treatment can include freezing the eggs, which can be stored for later use.
As you can imagine, the cost of fertility treatment is often quite high. For example, medication alone may cost $1,000 or more , and IVF can cost $25,000 and up (depending on the number of attempts needed).
To further complicate matters, most insurance plans won’t help cover these expenses.
If you’re over the age of 35, have menstrual irregularities, or have reproductive concerns, a fertility specialist could help support conception efforts. In addition, consider testing the hormones that influence your ovarian function with the Everlywell Women’s Fertility Test. Our simple, convenient, and affordable at-home test can give you insight into whether your hormones are causing your fertility issues and help guide your decision-making process.
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2. Common Reproductive Health Concerns for Women. Centers for Disease Control and Prevention. URL. Accessed February 17, 2022.
3. How Common is Male Infertility and What Are its Causes? National Institutes of Health. URL. Accessed February 17, 2022.
4. Wesselink AK, Wise LA, Hatch EE, Rothman KJ, Mikkelsen EM, Stanford JB, McKinnon CJ, Mahalingaiah S. Menstrual cycle characteristics and fecundability in a North American preconception cohort. Ann Epidemiol. 2016 Jul;26(7):482-487.e1. Epub 2016 May 31. PMID: 27449569; PMCID: PMC4964792.
5. Amenorrhea: Absence of Periods. American College of Obstetricians and Gynecologists. URL. Accessed February 17, 2022.
6. Early Pregnancy Loss. American College of Obstetricians and Gynecologists. URL. Accessed February 17, 2022.
7. Repeated Miscarriages. American College of Obstetricians and Gynecologists. URL. Accessed February 17, 2022.
8. Having a Baby After Age 35: How Aging Affects Fertility and Pregnancy. American College of Obstetricians and Gynecologists. URL. Accessed February 17, 2022.
9. Treating Infertility. American College of Obstetricians and Gynecologists. URL. Accessed February 17, 2022.
10. Cost of Infertility Treatment. American Society for Reproductive Medicine. URL. Accessed February 17, 2022.