When Is The Right Time To See A Fertility Specialist?

Written by Dr. Hal Danzer

Studies show that less than 50% of patients who are referred to a fertility specialist by their OB/GYN actually end up making the appointment. Why is this?

Reasons vary, but in my experience as a fertility specialist, I've observed that it can feel intimidating for a woman or a couple to have to go to a fertility doctor. Many women feel that as long as they are trying to get pregnant, even if they are experiencing difficulties, there is still always a chance that things will work out. The last thing they want is a specialist telling them that they are unable to get pregnant. And so they avoid the possibility of having to confront that scary truth by avoiding the fertility specialist. Of course, there is also the ever-present deterrent of cost.

Regardless, many women and couples have to overcome fear of bad news in order to take charge of their fertility and reproductive health. Information from a fertility specialist can empower women to go forward with treatments if necessary. The time is now to open up to that information. That's why I'm here to talk about particular situations when it's a good idea to see a fertility specialist:

1. If you are a woman under 35 who has not conceived within 9-12 months.

A woman's fertility is closely connected with her age. A woman is born with approximately one million eggs, but by the time she is a teenager and her period starts, the number of eggs remaining in the ovary has already dropped to about 50,000. Over the next 40 years until menopause, which on average is age 52, the woman uses up or releases approximately 1,000 eggs per year.

At age 35, the egg reserve beings to diminish. We know that the percent of eggs that is genetically balanced or normal begins to decrease.

That's why the largest group of women who should go see the fertility specialist are those that are under 35 years of age. These women need to make sure everything is gynecologically normal as well as to make sure they are having regular cycles.

2. If you are a woman over 35 years old who has not conceived within 6 months.

This group of women should absolutely see a fertility specialist to develop a plan for diagnosis and treatment of identified issues. This could include gynecological problems, pelvic infection, ovarian cysts or fibroids.

3. If you are a woman in her mid-to-late 30s who is attempting to get pregnant for the first time.

These women have the best chance at eventually having a second or third child (if desired) when they visit a fertility specialist. A woman who gets pregnant at 38 and is ready again to get pregnant at 40 or 41 may have difficulty conceiving at that time. Visiting a fertility specialist can help a woman understand her egg reserve and whether things such as in vitro fertilization would be a good fit.

4. If you are a woman over 40 years of age.

Women of this age should really see a fertility specialist before they attempt to get pregnant. Blood tests can determine their follicle reserve, and with their doctor, they can develop a plan to identify ovulation times. Couples should also make sure the male partner's sperm count is normal. These tests help the doctor and couple develop a plan together, so that six or 12 months are not lost at attempting pregnancy. We know that women over 40 release a genetically balanced egg one in four cycles. It is crucial that every attempt is made to successfully fertilize the egg at each ovulation time.

Overall, it is important view a consultation as a way of developing a plan to maximize your chance of fertility. Just because you miss these steps does not mean you have to embark on any special therapy or invest a lot financially. It just means you now will have the tools to develop a plan for the future.

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