Trying to get pregnant can be one of the most exciting times in a couple’s life. But when the ‘–’ sign on the pregnancy test repeats month, after month, after month the excitement can quickly morph into worry, concern, frustration and even depression. But, before you go labeling yourself “infertile”, there are a few things you need to know.

Conceiving is a complex process and – usually – it all revolves around timing and egg/sperm viability. Contrary to what pop culture and the media tells you, conception typically takes about six months to a year for most healthy couples.

The Facts About Fertility: When Do You Know You Have a Problem?

Most doctors will not begin looking into fertility issues unless a couple has tried to get pregnant for 12-months or more without success. Even timing intercourse with ovulation is not an automatic recipe for success. You and your partners bodies are very aware of any genetic mutations in the egg and/or sperm, and will either prevent conception from occurring, or will eliminate the joined egg and sperm. This often occurs before you would ever know you were pregnant. If you are 35 years or older, you will want to speak with your doctor if you have tried to conceive for six or more months. Age matters and, in this case, the sooner any potential infertility issues are addressed, the better.

Here are some of the signs that you may have a fertility problem:

1. You’ve been timing intercourse without results.

Timing your intercourse to coincide with ovulation will typically result in a successful pregnancy within 12 months. To do this, you need to understand your menstrual cycle and start tracking it. This is something that has been made easy by tracking apps. The average menstrual cycle is about 28-days, but they can range from 21 to 35 days. Ovulation typically occurs between days 11 and 16. Because everyone is different, tracking your cycle helps you find the right window for your body. While an egg is only available for fertilization for about 24-hours, sperm can live for several days. Because of this, we advise clients to have sex every other day for the days leading up to your estimated ovulation day (Days 8, 10, 12, 14).  If you’ve been timing intercourse for more than a year without any success (6 months if you’re 35 or older), it’s time to have a chat with your OB/GYN for a more thorough fertility workup and to discuss potential solutions.

2. You have irregular periods.

Since ovulation is directly related to your menstrual cycle, irregular periods are a sign that something might be abnormal. If you notice abnormal cycles, talk to your doctor. It may simply be that you have a much shorter or longer cycle than most, but knowing that can help you plan for ovulation. However, you may also have endometriosis or polycystic ovarian syndrome (PCOS), both of which are common causes of infertility. A more thorough pelvic exam and diagnostic approach can be used to see the potential cause. Infertility is spread pretty evenly between men and women (30% men, 30% women and the rest of the cases are shared or remain a mystery) so your partner may want to consider having their sperm analyzed as well.

3. You’ve already been diagnosed with PCOS, Endometriosis, Pelvic Inflammatory Disease, etc.

If you’ve been diagnosed with PCOS, endometriosis or other anatomical or physiological conditions linked to infertility, your doctor may want to follow your path to conception more closely. They may want to introduce fertility options earlier than normal to give you additional assistance.

4. You have a history of miscarriages.

Have you miscarried in the past, or had more than one miscarriage? This information is important to disclose to your doctor. If you’ve miscarried before and are having difficulties conceiving now, your doctor may recommend fertility testing sooner than “normal”. Recurrent miscarriages (three or more in a row) are typically a red flag that something else is amiss and your doctor will refer you to a fertility specialist if they are unable to diagnose the problem via traditional diagnostic procedures.

5. Your job places you in contact with toxins or contaminants.

If you work with radiation or with substances known to have an effect on female or male infertility, you may need to speak with your doctor about more serious protective measures. Research continues to illuminate and expose the regular, everyday chemicals and toxins linked to infertility, so minimizing your exposure to these substances is important.

In most cases, the first step in the fertility journey is oral fertility medications, such as Clomid, which stimulate ovulation. Depending on your situation, Women’s Health Associates may recommend trying Clomid with timed intercourse. In others, we may recommend Clomid in partnership with intrauterine insemination (also called artificial insemination) to increase your odds. If oral fertility medications are ineffective, we are happy to refer you to one of several reputable fertility specialists here in the Kansas City area.

Above all, remember that you are not alone. Talking to your doctors openly and honestly is especially important. We are an all-female OB/GYN office and we will work closely with you along your fertility journey. Contact us if you need a referral or have any questions.