A couple is considered to be having problems with fertility if they have been trying with timed intercourse for more than six months or untimed intercourse for a year or more.   This is a good rule of thumb for patients who are under 38.  If you are more mature in years and especially if you are over 40 it might be a good idea to go ahead and get some basic tests done as time is of the essence.

Women should get blood work done on day 2 or 3 of their cycle to check their FSH or follicle stimulating hormone as well as their estrogen levels.  This will tell us about ovarian reserve and what kind of timeline we may be dealing with.  Men should get their sperm checked as well; the three things looked at are motility, morphology and count.  If everything is a go so to speak the couple can try with timed intercourse for a couple of months and see what happens.  If there is still no sign of pregnancy other tests may need to be performed.  A hysterosalpingogram can make sure your tubes are open and an ultrasound can determine if there are any cysts on the ovaries.  Another test can be done around day 21 of the cycle to see if ovulation has occurred.  Generally I prefer working with Reproductive Endocrinologists as opposed to OBGYNs as REs tend to be more up to date on the most recent fertility developments but most of the above tests can be performed at your OBGYN’s office if that is more convenient.  

To sum up:  if you are >40 and considering trying to conceive it is probably a good idea to get tests done just to make sure everything is ok.  If you are under 38/40 and have only just started trying to conceive give it three months of timed intercourse and then consider heading to the doctor.  At any age if you have been trying for more than 6 months with timed intercourse or a year with untimed intercourse it is time for a reproductive check up.  

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