Do not wait a year to go see a fertility specialist if you're having trouble conceiving -- go after six months. That's the advice we got from every expert we spoke with for this story. Here's why:
- The rule of thumb you thought you'd heard -- to wait a year before seeing a specialist -- applies women younger than 35, not those older. It's a common mistake -- the doctors we interviewed have seen couples try for as many as three years on their own before seeking help. The earlier appointment means potential issues can be spotted earlier, including polycystic ovarian syndrome (which is the most common cause of female infertility), ovulation problems, blocked fallopian tubes, endometriosis or a matter with your partner -- one-third of infertility cases are due to the man's reproductive issues, after all. You'll also be able to come up with a plan now, instead of later, when the quality of your eggs will have declined further and the odds of getting pregnant are lower.
- The news about the fertility cliff happening later isn't actually as good as you thought. As anyone who read the widely shared Atlantic article from a couple of years ago knows, it's true that the sharp drop-off doesn't seem to happen until the late 30s, and potentially as late as 40. However, as that article noted but you might have glossed over, one of the most optimistic studies on pregnancy in the late 30s looked at women who'd been pregnant before, not those who were trying to conceive for the first time. Plus, any expert will still tell you that fertility declines with age and that the slope gets steeper after 35 -- a 2014 study in Fertility and Sterility reported that a couple's odds of getting pregnant during a single menstrual cycle at age 40 are about half what they were at age 30.
- The six-month appointment can actually be encouraging: Your doctor may find that nothing is wrong and tell you to keep trying the old-fashioned way. Plenty of women get pregnant in their mid-to-late 30s. (That same Fertility and Sterility study found that among women aged 35 to 39 who were having sex during the most fertile times of their menstrual cycle, 78 percent got pregnant within one year.) Either way, the six-month appointment means you'll know your odds sooner and what you need to do to improve you chances of getting pregnant.
Who we talked to:
- Elizabeth Fino, MD, reproductive endocrinologist and infertility specialist at the NYU Langone Fertility Center
- Evelyn Mok-Lin, MD, reproductive endocrinologist at UCSF Medical Center
- Elizabeth Stewart, MD, chair of the division of reproductive endocrinology and professor of obstetrics and gynecology and surgery at the Mayo Clinic
- Mary Sabatini, MD, PhD, obstetrics and gynecology at Massachusetts General Hospital
- Elizabeth Ginsburg, MD, medical director of assisted reproductive technologies at Brigham and Women's Hospital
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