When should I see a fertility specialist?
Whether you’re thinking about trying to conceive or have been trying for some time, here’s when and how to seek healthcare support.
When you first start trying to conceive, you may wonder: do I need to see a healthcare provider? If you have been trying for some time, you also may wonder whether it’s time to see a specialist.
Let’s unpack what you need to know about when and how to get the right healthcare support before trying to conceive, and if things don’t happen on the timeline you thought they would.
First, let’s set the record straight on some common myths about what does and doesn’t actually impact conception.
Common conception myths
Myth: I took hormonal birth control for years. I’ll never be able to conceive.
Fact: Previous hormonal birth control use will not impact your ability to conceive (1).
Myth: I am worried that my body size will make it difficult to conceive.
Fact: There is some evidence that suggests weight and conception are related, but people of every size, and people with health conditions can still become pregnant (2,3). Fertility specialists recommend adding fruits, vegetables, and whole grains to your meals, as well as moving your body regularly to optimize the likelihood of pregnancy (4,5).
Myth: I used to drink and/or smoke and now I can’t conceive.
Fact: Previous use of tobacco and alcohol likely won’t impact your ability to conceive. Fertility specialists agree that it is important to quit smoking and limit alcohol intake in the months before you want to become pregnant (6).
Myth: I can’t conceive and it’s all my fault.
Fact: It can be hard to remember when you are trying to conceive, but your worth is not determined by if or how quickly you conceive. Culturally, the ability or inability to conceive is largely placed on women and people with cycles, but keep in mind that the partner with sperm is equally responsible for conception (7,8). It can be helpful to know that you are not alone. Conception challenges are common, and there are many medical conditions that can affect the ability to conceive that can be addressed (we’ll get into more detail on this below).
How long should I wait before seeing a healthcare provider?
Consider a preconception visit before you even start trying.
Recommendations for more support vary by two things: how long you have been trying and your age. Not sure what counts as “trying”? If you have predictable periods, you can count each cycle that you have been actively timing unprotected sex or home insemination on specific cycle days.
Here are the specific recommendations (5,9):
If you are 34 or younger, talk to your healthcare provider after trying to become pregnant for 12 months.
If you are 35 or older, talk to your healthcare provider after trying to become pregnant for 6 months.
If you are 40 or older, talk to your healthcare provider now about your plans for pregnancy.
What to bring to your appointment
It’s common to feel a little anxious or unsure of what to expect before seeing a healthcare provider about trying to conceive. To help calm your nerves, it might be helpful to gather a folder of personal information to take with you. This information will help your healthcare provider give you more personalized care.
1. Cycle data you tracked while trying to conceive
First, you’ll need to know how long you’ve been trying to get the specific advice and help you might need (10).
It can also be helpful to have other tracked data like your cycle lengths and cycle-related experiences (10).
2. When you have sex
Certain days during your cycle are better for trying than others. Timing sex during these days is also important when trying to conceive (11,12). The days that have the highest likelihood of conception are related to when you ovulate. Ovulation doesn’t happen on a certain day each cycle. It can vary from person to person and can change month to month (13). Tracking when you have sex, as well as other factors such as changes in cervical mucus, can give your healthcare provider important information about your cycle, and help them tailor their advice to you.
3. Your medical history
Make a list of any health conditions, surgeries, accidents, or traumas you have experienced. Be sure to include your mental health history as well, even if you don’t see it as important; it could be helpful information.
You’ll also want to bring a list of medications and supplements you currently take (9).
What happens if I need to see a healthcare provider?
Trying to conceive without quick results can be frustrating and scary. It might help you to know that it’s common. About one in five American women who have sex with men face challenges conceiving before one year (14). The World Health Organization (WHO) estimates that 186 million individuals globally experience conception challenges. This makes up 8-12% of all couples worldwide (15).
These challenges can be difficult,
but know that you are valuable and worthy,
whether or not you become pregnant or a parent.
Choosing a healthcare provider is an individual choice, and might be influenced by your budget, values, and how long you have been trying to conceive.
If you’re ready to see a healthcare provider, you'll likely want to find someone who specializes in fertility and reproductive health. Medical fertility organizations recommend working with a Reproductive Endocrinologist (REI). REIs are doctors who are OB/GYNs who receive additional years of training to focus on issues specifically related to reproduction.
The American Society of Reproductive Medicine (ASRM) is a good source to find an REI or reproductive provider. Some primary care providers like family doctors and nurse practitioners also have expertise that can help people conceive and may be easier to access for some people (16,17).
Complementary and alternative approaches to fertility
There is growing research to support the use of complementary and alternative medicine (CAM) to help people conceive (18). Acupuncture is the most common alternative approach and might help regulate ovulation or reduce stress (19,20).
There is limited research on other types of CAM like homeopathy, herbs, and supplements but mindfulness practices like yoga, and meditation could be helpful while you are trying to conceive (21). More evidence is needed to support using CAM without medical support. Talk to your specialist to get specifics about the potential benefits or harms of these therapies related to your specific situation.
Advice for people who need a sperm donor
If you need sperm from a donor for conception, a healthcare provider can help you navigate options like intrauterine insemination (IUI), home insemination, or assisted reproductive technology (ART) such as in vitro fertilization (IVF). There are lots of considerations when buying sperm – going through a trustworthy healthcare provider is likely your best option for ensuring safety and quality. Obtaining sperm through other methods (like online or through community networks) could have personal health risks (22).
Medical conditions that could impact conceiving
If you have or have had one of these conditions, talk to your healthcare provider about managing it and if they recommend the care of a specialist.
Know that conditions on this list do not make a person unable to conceive or automatically need special care. In some cases, managing the condition as optimally as possible can help you become pregnant. If you do need help conceiving, know that many people are able to conceive using assisted reproductive technology (ART).