Most couples who will conceive naturally do so within 6-12 months of trying. But when should you move from patience to action? Here's what fertility specialists recommend.
The Time-Based Guidelines
At this age, you have more time and higher per-cycle odds. Giving it a full year is reasonable before seeking evaluation. However, see a doctor sooner if you have known risk factors (listed below).
Fertility declines more rapidly after 35. Six months is enough time for most fertile couples to conceive, and earlier evaluation preserves time for treatment if needed.
Time is critical after 40. Consider seeing a specialist before you start trying, or after just a few months of unsuccessful attempts. Quick evaluation and potential treatment maximize your chances.
Red Flags: Don't Wait for the Timeline
Certain situations warrant earlier evaluation, regardless of how long you've been trying:
🚩 Irregular or Absent Periods
Cycles shorter than 21 days, longer than 35 days, or absent periods suggest ovulation problems that can be diagnosed and treated.
🚩 Known PCOS or Endometriosis
These conditions affect fertility. See a specialist early to discuss your specific situation and potential treatments.
🚩 History of Pelvic Surgery
Prior abdominal or pelvic surgery can cause scarring that affects fertility. Get evaluated to check for tubal issues.
🚩 Two or More Miscarriages
Recurrent miscarriage warrants investigation for underlying causes that may be treatable.
🚩 History of STIs
Chlamydia or gonorrhea, even if treated, can cause tubal damage. A fertility evaluation can check for blockages.
🚩 Male Factor Concerns
History of testicular issues, undescended testicles, hernia repair, or known low sperm count—get evaluated early.
🚩 Cancer Treatment History
Chemotherapy or radiation can affect fertility. See a reproductive endocrinologist for assessment before trying.
🚩 Family History of Early Menopause
If your mother or sisters had menopause before 45, you may be at risk for diminished ovarian reserve. Get tested.
"The biggest regret we hear from patients is waiting too long. Don't let months slip by if something feels off. Early evaluation rarely hurts and often helps."
Types of Fertility Doctors
OB-GYN (Obstetrician-Gynecologist)
Your regular gynecologist can do basic fertility testing (bloodwork, ultrasound) and prescribe medications like Clomid for ovulation induction. A good starting point for initial evaluation.
RE (Reproductive Endocrinologist)
A specialist in fertility treatment. Completed OB-GYN training plus a 3-year fellowship in reproductive medicine. This is who you see for IUI, IVF, and complex cases.
Reproductive Urologist
A urologist specializing in male fertility. Evaluates and treats male factor infertility, including varicocele, hormonal issues, and sperm retrieval for IVF.
If you're under 35 with no known issues, starting with your OB-GYN for basic testing is reasonable. If you're 35+, have known risk factors, or want comprehensive evaluation from the start, going directly to a reproductive endocrinologist may save time.
What to Expect at Your First Appointment
A fertility evaluation typically includes:
For Her:
- Medical history review: Menstrual patterns, pregnancy history, surgeries, medical conditions
- Bloodwork: Hormone levels (FSH, LH, estradiol, AMH, thyroid, prolactin) to assess ovarian reserve and ovulation
- Ultrasound: Antral follicle count (AFC), ovarian cysts, uterine abnormalities
- HSG (Hysterosalpingogram): X-ray with dye to check if fallopian tubes are open
For Him:
- Semen analysis: Sperm count, motility, morphology
- Medical history: Past health issues, surgeries, medications
- Further testing if needed: Hormone levels, genetic testing, ultrasound
📋 Prepare for Your First Appointment
How to Find the Right Doctor
Look for board certification: For REs, look for board certification in Reproductive Endocrinology & Infertility (REI).
Check SART data: The Society for Assisted Reproductive Technology (SART.org) publishes IVF success rates by clinic. Compare clinics, but understand rates depend on patient population.
Consider logistics: Fertility treatment often requires frequent appointments, sometimes on short notice. A conveniently located clinic matters.
Trust your gut: You should feel heard, respected, and informed. If a doctor is dismissive or you don't feel comfortable, it's okay to seek a second opinion.
Ask about their approach: Some clinics are more aggressive; others prefer conservative approaches. Neither is inherently better—find one that aligns with your values and timeline.
Cost and Insurance Considerations
Fertility treatment can be expensive, and coverage varies widely:
- Basic evaluation (bloodwork, ultrasound, SA) is often covered by insurance
- HSG may be covered as diagnostic testing
- Fertility medications (Clomid, Letrozole) are often covered; injectables may not be
- IUI may or may not be covered depending on your plan and state
- IVF is frequently not covered, though some states mandate coverage
Before starting treatment, get a clear cost estimate and verify insurance coverage. Many clinics have financial coordinators who can help you understand costs and payment options.
Not Sure Where You Are in Your Journey?
Our quiz can help you understand your situation and suggest next steps.
Take the Fertility Quiz →The Bottom Line
Don't let embarrassment, fear, or uncertainty keep you from seeking help. Fertility specialists see patients at all stages—from just starting to try to those who've been struggling for years. There's no "wrong" time to ask questions and get information.
Key takeaways:
- Under 35: See a doctor after 12 months of trying
- 35-39: See a doctor after 6 months of trying
- 40+: See a doctor right away or after 3-6 months
- Any age: See a doctor sooner if you have red flag symptoms
- Both partners: Should be evaluated—male factor is involved in 40-50% of cases
Early evaluation rarely hurts and often provides peace of mind, actionable information, or treatments that can help. When in doubt, schedule the appointment.