When Should I Worry About Infertility?

April 14, 2015

Trying to get pregnant is one of the most exciting times in a couple’s life…until the ‘’ sign on the pregnancy test stick repeats month, after month, after month. Then, the excitement can quickly morph into worry, concern, frustration and even depression. These feelings are compounded when family and friends know you are trying and continuously ask about your pregnancy status. Gah! 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 all those baby bumps you see walking around the block, conception typically takes about six months to a year for most healthy couples.

Woman Worrying

Image Courtesy of David Castillo Dominici at FreeDigitalPhotos.net

Please Note: If you suspect you or your partner may be infertile, don’t automatically jump to the IVF conclusion. There are plenty of other, more affordable options that are very successful in most cases. IVF is not the first step, so do yourself a favor and put that out of your mind for the time being.

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. The body is very wise and any genetic mutations in the egg and/or sperm will prevent conception from occurring or will eliminate the joined egg and sperm, often before you ever knew 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 months. Age definitely 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 to no avail. Timing your intercourse to coincide with ovulation will typically result in a successful pregnancy within 12 months. In order to do this, you need to understand your menstrual cycle and start tracking it. There are even apps for that! 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. While an egg is only available for fertilization for about 24-hours, sperm can live for several days. Hence, we advise clients to have sex every other day for the days leading up to your estimated ovulation day (8, 10, 12, 14). The more sperm that are waiting for the egg, the better your odds that one will make it to the target. Also, avoid using lubricants or saliva as both of these have been shown to compromise fertility. 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 up. Talk to your doctor. It may be that you have a much shorter or longer cycle than most. Your doctor can help you determine your cycle and your optimal ovulation dates. 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 approaches can be used to see if the potential cause lies with you. 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 his 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 physiologic conditions linked to infertility, your doctor may want to follow your path to conception more closely. She 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? Your doctor will want to know. If you miscarried before and are having difficulties conceiving now, your doctor may recommend fertility testing sooner rather than later. 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 she is 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 meds, like 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.

Worried you may be dealing with infertility issues? Schedule a consultation with Women’s Health Associates. We are an all-female OB/GYN office and we will work closely with you along your fertility journey.