Today we are going to talk about when to seek help when you are trying to fall pregnant.
Most couples – so that’s almost 9 out of 10 - will get pregnant over a period of 12 months of unprotected intercourse. And, in fact, that is how we define infertility in most countries. The important point here is that it’s not how long you have been trying for, but more that you have not had any contraception for that period of time. After two years, the chance of conception is less than 2 in 100.
So in general, if you have had unprotected intercourse for more than 12 months you should be seeing a fertility specialist.
But, there are some situations in which you should be seen within six months or even immediately.
We would recommend immediate referral if you are not having any periods, have a known obstruction of your tubes or are unable to have intercourse. The same goes if you have had a test of your ovarian reserve, or an AMH, that is low.
If you have any medical conditions that could complicate pregnancy, like diabetes, heart problems or thyroid abnormalities then you should also be seen immediately because these will need to be optimised before you get pregnant.
From the point of view of your partner, if he has a known sperm problem there is also no point waiting. Of course, that also goes if you don’t have a partner.
Because fertility halves every year after the age of 40, we would also recommend immediate referral in this age group.
In women over the age of 35 we recommend referral after 6 months of unprotected intercourse. The same time frame holds if you have irregular periods, proven endometriosis, known fibroids, a previous ectopic pregnancy, prior pelvic infection, or problems having intercourse.
Now not everyone in these situations would necessarily need immediate treatment, but you should be assessed. Now that’s usually as simple has doing an ultrasound scan, doing a couple of blood tests and may be a sperm sample.