When should you see an infertility specialist?

The ASRM (American Society for Reproductive Medicine) says that: "The duration of unprotected intercourse with failure to conceive should be about 12 months before an infertility evaluation is undertaken, unless medical history, age, or physical findings dictate earlier evaluation and treatment." So the major question here is what do they mean by "..medical history, age, or physical findings.."?

You need to see an infertility specialist (reproductive medicine endocrinologist) and possibly undergo fertility testing in the following circumstances:

• You are under 35 and you have been trying unsuccessfully to get pregnant for over a year

• You are 35 and over and you have been trying unsuccessfully to get pregnant for over 6 months

• You have irregular menstrual cycles

• You have medical issues related to infertility

• He has known fertility issues

This handy tool and calculator will help you find out if and when you should see an infertility specialist.

If you've attempted to address the three big questions about your fertility (ovulation, sperm count, tubal patency) with your regular Ob-Gyn and you still need help getting pregnant, it may be time to make an appointment with an infertility specialist (a reproductive endocrinologist, or RE).

You can also use the babyMed interactive fertility specialist tool.

Seeing a reproductive endocrinologist for the first time can be an intimidating experience. You may be nervous, your doctor may not have enough time, and you may forget to ask questions that are important. Here are some tips to help you get the most of the doctor's visit.

Before the visit

1. Make a list of questions you would like to ask the doctor.
2. Take notes during the visit. 
3. Take someone else with you, such as your partner or a friend. Four ears hear more than two. 
4. Make sure you have addressed the three main infertility issues before this point (Am I ovulating normally? Is his sperm count fine? Are my fallopian tubes open?) 

Questions to ask

Which questions you ask depend mainly on what you already know about your fertility, but here is a sample of 10 questions to take to your appointment:

1. What do you think could be the causes of my fertility problems?
2. Is it important to proceed with an infertility evaluation now, or should we wait a while longer, and can we establish a timetable for testing and treatment?
3. What additional tests do you suggest should I have to find out the causes, and what do they cost? Does my insurance cover these tests?
4. What are the treatment options for our suspected diagnosis, and what do they cost?
5. What is the national success rate, in terms of live births, for each of these treatments?
6. Could lifestyle factors such as smoking, alcohol, stress, or job-related issues be affecting my fertility?
7. What else (e.g. nonmedical approaches, such as relaxation or meditation techniques) could improve my chances of becoming pregnant?
8. How many procedures of the type that you are recommending has this fertility clinic performed, and what is its success rate in terms of live births? How does it compare with other clinics?
9. How many doctors work here, what are their credentials, are they certified in infertility (reproductive endocrinology), and are you open seven days a week?
10. Can you give me a list of former patients who have undergone similar treatments?

Your frustration and anxiety about TTC may have reached their highest levels, and you might be saying to yourself, "What ought to be a beautiful, natural process has somehow become a medical condition that needs treatment. It just doesn't seem fair!" Yet now is the time to keep your eyes on your goal of becoming a family. The journey may be longer and harder than you imagined, but getting the assistance you need can help you reach that dream of pregnancy and parenthood.