đź•’ General Guidelines: When to Seek a Fertility Evaluation
The timing depends largely on your age and how long you’ve been trying to conceive.
👩‍🦰 If You’re Under 35:
- Try for 12 months of regular, unprotected intercourse before seeing a fertility specialist.
👩‍🦳 If You’re 35 or Older:
- Seek evaluation after 6 months of trying to conceive.
👩‍🦳 Over 40:
- Consider a fertility workup immediately upon deciding to try for pregnancy.
Fertility naturally declines with age, and early testing ensures timely treatment if needed.
đźš© Medical Signs That May Indicate a Fertility Issue
Regardless of age, certain symptoms and medical conditions may indicate a higher risk of infertility. If any of the following apply to you, don’t wait—consider scheduling a fertility workup sooner.
1. Irregular or Absent Menstrual Cycles
Your menstrual cycle is a key indicator of reproductive health.
What to watch for:
- Cycles shorter than 21 or longer than 35 days
- Missing periods (amenorrhea)
- Very heavy or very light bleeding
- Infrequent or unpredictable cycles
Why it matters:
Irregular periods often signal ovulation problems, which are a leading cause of infertility.
2. Painful Periods or Chronic Pelvic Pain
Potential causes:
- Endometriosis: A condition where uterine-like tissue grows outside the uterus, potentially causing inflammation and scarring.
- Pelvic Inflammatory Disease (PID): Often resulting from untreated STIs, leading to tubal damage.
- Fibroids or ovarian cysts
Why it matters:
Painful menstruation may point to underlying reproductive disorders that affect fertility.
3. History of Miscarriages
If you’ve experienced:
- Two or more consecutive miscarriages
- A single second-trimester pregnancy loss
…it may indicate a structural, hormonal, autoimmune, or genetic issue that requires evaluation.
Why it matters:
Recurrent pregnancy loss can be treated, but it requires identifying the underlying cause.
4. Diagnosed Medical Conditions
Certain health conditions can negatively impact ovulation, egg quality, or reproductive function.
Conditions to monitor:
- Polycystic Ovary Syndrome (PCOS)
- Thyroid disorders (hypothyroidism or hyperthyroidism)
- Diabetes
- Lupus or other autoimmune disorders
- Celiac disease
- Hyperprolactinemia
Why it matters:
Many of these conditions affect hormonal balance or immune response, interfering with fertility—but many are treatable.
5. History of STIs or Pelvic Infections
Past or chronic infections, particularly chlamydia or gonorrhea, may cause scarring of the fallopian tubes.
Why it matters:
Blocked or damaged fallopian tubes can prevent the egg and sperm from meeting, causing infertility or ectopic pregnancy.
6. Previous Abdominal or Pelvic Surgeries
Surgeries involving the ovaries, uterus, or fallopian tubes can lead to adhesions or scar tissue.
Examples include:
- Removal of fibroids (myomectomy)
- Endometriosis surgery
- Appendectomy
- C-section (in some cases)
Why it matters:
Surgical complications or resulting scar tissue can impact reproductive function.
7. Age-Related Fertility Concerns
Fertility declines naturally with age, especially after age 35, due to reduced egg quality and quantity.
Why it matters:
Even if you are ovulating regularly, age may impact your ability to conceive and carry a pregnancy to term. A fertility workup can assess your ovarian reserve and guide your next steps.
8. Trying to Conceive as a Same-Sex Female Couple or Single Individual
Even if there are no signs of infertility, those using donor sperm or assisted reproductive technology (ART) may benefit from a fertility evaluation to ensure uterine and ovarian health before starting treatment.
9. Lifestyle Risk Factors
If you or your partner have certain risk factors, a fertility workup may be recommended earlier:
- Smoking or vaping
- Excessive alcohol or drug use
- Being significantly underweight or overweight
- High levels of stress or overexercising
- History of cancer treatment (chemotherapy, radiation)
Why it matters:
These factors may interfere with ovulation, hormone levels, or implantation.
🧪 What a Fertility Workup Involves
A basic fertility workup typically includes:
- Detailed medical and menstrual history
- Blood hormone tests (e.g., FSH, LH, AMH, TSH)
- Pelvic ultrasound
- Hysterosalpingogram (to check fallopian tubes)
- Ovulation tracking
- Semen analysis (if applicable)
👩‍⚕️ When in Doubt, Speak to a Specialist
Even if you’re not ready for advanced fertility treatments, early testing can provide peace of mind and important information about your reproductive health. In many cases, the earlier you intervene, the better the outcomes.
đź’¬ Final Thoughts
Infertility can feel isolating, but you are not alone—and it is far more common than people realize. Identifying the signs early and seeking a fertility workup is a powerful step toward understanding your body and moving forward with confidence.
Whether you’re just starting your journey or have been trying for a while, knowing when to ask for help can make all the difference.
