Oh, Baby, This Is Harder Than I Thought! Need a Fertility Specialist?

Most couples think that getting pregnant when they're "ready" will be easy. The fact is, however, that an estimated one in six couples will experience infertility. If you're one of those couples, you may be asking, how long should we keep trying to get pregnant on our own, and when is it time to see a fertility specialist? The general rule is this:

If you're younger than 35 and haven't become pregnant after one year of unprotected sex, it's time to talk to a fertility doctor. However, if you have other concerns, such as irregular periods, family history of early menopause or infertility, persistent pelvic pain, then you might also benefit from talking to your OB-GYN about seeing a fertility specialist.

If you're 35 or older, you shouldn't wait as long because getting pregnant can get more difficult as you get older. In this case, you should see a specialist after six months of trying to conceive.

If you don’t have a partner yet and are interested in freezing eggs to preserve your fertility, we are here to help. 

Additional Ways A Fertility Specialist Can Help You

Advancements in reproductive medicine have expanded the range of fertility preservation and treatment options available to those facing medical, genetic or personal challenges, such as: 

• Fertility preservation for male and female cancer patients prior to treatments that could impair fertility
• Fertility preservation prior to gender-affirming therapies
• Fertility options for same sex couples or single women
• Fertility treatments for couples with prior histories of tubal sterilization or vasectomy
• Congenital uterine malformations
• Recurrent miscarriages
• Preimplantation genetic testing to select embryos for couples who carry certain genetic mutations, to prevent having offspring affected by these diseases.

Common Reasons for Not Being Able to Get Pregnant

There is a wide range of reasons women can't conceive:

• The largest group we see, 25 to 30% of patients, are women who don't ovulate (release an egg) regularly. Examples of conditions leading to ovulation problems include polycystic ovary syndrome, hypothalamic amenorrhea, etc.
• Blockages can affect the fallopian tubes, the pair of tubes along which eggs travel from the ovaries to the uterus. Such blockages can result from infection, chronic inflammation from endometriosis, or previous pelvic surgeries.
• In a fairly large percentage of women who can't conceive, infertility is unexplained. All their tests are normal; they simply can't get pregnant. This tends to happen more often as women become older.
• There is also a small percentage of women who have an abnormally developed uterus that make it difficult to conceive. An example of this is uterine septum, which is a muscular wall that completely or partially separates the uterine cavity into two parts. Fibroid is another condition affecting the uterus that could make conception difficult.
• And in other cases, male infertility is the culprit, usually due to a problem with either sperm production or sperm transport.

Fortunately, we offer a variety of medical and surgical options to manage these conditions and help patients get pregnant.

What Can Couples Do Before Seeing a Fertility Specialist?

There are certain commonsense things couples can do to improve their chances of conceiving before they see a fertility doctor. 

• Regular intercourse every two to three days around the day of ovulation. With this, there will always be sperm waiting for the egg to be released and fertilized. However, if this is not feasible, you can try to time intercourse by an ovulation predictor kit. Always remember to consider age and coexisting problems, such as irregular periods, as we would not recommend to keep trying timed intercourse if there’s otherwise a strong reason to see a fertility specialists.
• It could be a good idea to have preconceptual counseling with your regular gynecologist before you start trying.
• Stop smoking. Smoking causes harm in different organs, can lead to earlier menopause, and may increase the risk of sudden infant death syndrome when you are finally able to have the baby you long waited for.
• Lose weight if you're overweight. Obesity in some cases could make fertility treatments much more challenging and can also increase risks of pregnancy complications.
• Take prenatal vitamins/folic acid to aid conception, and normal vitamin D levels may also help. Vitamin D deficiency is fairly common among adults.
• We recommend having as little alcohol as possible when you are trying to get pregnant.
• If you have been using marijuana, we recommend stopping completely. We don't know how cannabis will affect your children in the long run, so it’s best not to use it altogether.

A healthy lifestyle, a balanced diet, and regular exercise can help you maintain a healthy weight and put you at a good place for pregnancy. Fertility treatments are often not a “one cycle and done” process. Connections with friends and family, and above all, a fertility specialist team who responds to your concerns every stop of the way, will help you sail through the ups and downs in your fertility journey.