When should you see a fertility specialist?
Trying to conceive can come with a lot of questions, particularly when things aren’t happening as quickly as you expected.
One of the most common questions I’m asked is, “How long should we keep trying before we seek help?”
There are some general guidelines, but fertility is never one-size-fits-all. Your age, medical history, menstrual cycle and your partner’s health can all influence when it might be worthwhile seeking advice.
How long should you try before seeking fertility advice?
As a general guide, if you’re under 35 and have been trying to conceive for 12 months without success, it’s worth speaking with your GP or a fertility specialist.
If you’re 35 or older, I generally recommend seeking advice after six months of trying.
But you don’t necessarily need to wait six or 12 months. There are circumstances where it makes sense to seek advice earlier.
When should you see a fertility specialist sooner?
It may be worthwhile making an appointment earlier if you:
have irregular or absent periods
have very painful periods
have been diagnosed with endometriosis or PCOS
have previously had pelvic surgery
have experienced recurrent miscarriage
have a known medical condition that may affect fertility
have concerns about sperm quality or male fertility
have undergone cancer treatment or other treatment that may affect fertility
are considering fertility preservation, including egg freezing
You can also make an appointment simply because you have questions about your fertility or would like a better understanding of where things stand.
You don't have to wait until there's a problem to ask for advice.
Fertility involves both partners
Fertility challenges can affect either partner, or sometimes both.
For this reason, I recommend that both partners attend the initial fertility consultation where possible. This allows us to look at the whole picture from the beginning rather than focusing on one person in isolation.
Both partners will require their own GP referral.
What happens at your first fertility appointment?
Your first appointment is primarily about understanding your individual circumstances.
We'll discuss your medical and reproductive history, how long you've been trying to conceive, your menstrual cycle and any previous pregnancies, investigations or fertility treatment.
For couples, we'll also discuss your partner's health and fertility history.
Depending on your circumstances, I may recommend some initial investigations. These can include blood tests, an ultrasound, assessment of ovulation and semen analysis.
Once we have the information we need, we can talk about what it means and what — if anything — needs to happen next.
Seeing a fertility specialist doesn't mean starting IVF
This is an important one.
Making an appointment with a fertility specialist does not automatically mean you'll need IVF.
For some people, investigations may show that everything looks reassuring and more time is appropriate. For others, we might identify something relatively straightforward that can be addressed.
Depending on your circumstances, treatment options may include ovulation induction, intrauterine insemination (IUI), surgery or assisted reproductive treatment such as IVF or ICSI.
The aim isn't to jump to the most complex treatment. It's to understand what's happening first and recommend an approach that's appropriate for you.
Sometimes, getting answers is the first step
If you've been trying for a while, are concerned about your fertility or simply aren't sure whether it's time to seek help, having a conversation can provide some clarity.
You don't need to arrive at your first appointment knowing what treatment you want. That's what the appointment is for.
We'll look at your individual circumstances, answer your questions and develop a plan for what comes next.
Dr Michael Allen is a Specialist Obstetrician, Gynaecologist and Fertility Specialist consulting in Subiaco, Perth, and Clinical Director of IVF Australia WA.
To make an appointment, contact Dr Allen's rooms on (08) 9381 2400 or fill in the contact form.
