Couples trying to conceive usually start testing for infertility if pregnancy does not occur within 12 months of regular, unprotected sexual activity [1]. However, some circumstances merit a check-up after six months of trying to get pregnant with no success. Here’s what you need to know.
Why do you have to wait a whole year?
Because even in healthy young couples, the probability of getting pregnant on the first attempt is 20 to 25%. The likelihood of conception within the first six months is around 60%. About 84% of couples become pregnant within a year (with regular sexual activity, of course), and about 95 percent of couples conceive after two years. However, it's better to play it safe and find out if there’s a reason why you haven’t conceived after one year [2].
Who should have infertility checks before 12 months?
In couples where the woman is over 35 years old, the probability of pregnancy decreases. Therefore, it’s a good idea to consult a doctor after trying for six months. If a man or a woman has a condition that is known to interfere with conception, then they can seek medical support earlier.
In women, the following conditions may warrant a fertility screening:
irregular menstruation or complete absence of menstruation
negative ovulation tests
sexually transmitted infections, presently or in the past
previous surgeries of the pelvis or abdominal organs.
In men, watch for conditions such as:
injuries and diseases of the testicles, hypospadias (when the urethral opening is not at the tip of the penis)
sexually transmitted infections
issues with ejaculation
If a man or woman has had infertility issues in the past, then there is no reason to delay consulting a doctor [3].
Where should I start to avoid wasting time and money on unnecessary tests?
It depends on what you already know about yourself. If both partners had regular medical examinations, risk factors (such as excess weight, diabetes, and smoking) can be determined by their medical records. Based on those, their doctor will plan further screenings or treatment.
To save time both partners can undergo screening at around the same time. For women, the process may have multiple stages, eliminating one factor after another until the cause of infertility is determined. It may be an endocrine disorder, ovarian dysfunction, fallopian tube blockage, or abnormalities in the structure of the uterus and endometrium, among others [4]. However, men only need to undergo a semen analysis. If the results are normal, then male factor infertility is automatically excluded. If abnormalities are found and confirmed by repeat analysis, the couple may be asked to consider IVF treatment.
