7 Things to Consider Before You Start Fertility Treatment

Infertility affects at least one in every eight adults in the United States. That means that at least 12% of the population will have a hard time getting pregnant without some type of fertility assistance. That does not mean you have to jump to the fertility treatment conclusion if you’re not getting pregnant as fast as you’d hoped.

Before You Visit a Fertility Specialist…

There are several things to consider before starting any fertility treatments to ensure you don’t jump the gun and have an accurate diagnosis and personalized treatment plan.

1. Don’t Act Too Quickly

The media can make it seem like you get pregnant as soon as you’re ready. In fact, a healthy woman between the ages of 25 and 35 typically takes six months to a year to get pregnant. As OB/GYNs and midwives, we don’t even think about questioning the process unless:

• You’re less than 37 years old and have tried to get pregnant without success for 12 consecutive months.

• You’re 37 years old or more and have tried unsuccessfully for six consecutive months.

• You’re 40 or older and have tried for three consecutive months.

The key is understanding your menstrual cycle, identifying the most fertile window, and having sex every day during that window (which begins in the days leading up to ovulation).

2. You have a clear understanding of when you ovulate.

Here’s another place the media and pop culture have done a disservice to cultural understandings around conception. Most people think you have to wait until you ovulate to get pregnant. That’s false, and that method can hinder your ability to conceive.

We recommend having intercourse during the five days before ovulation and the day of. Healthy male sperm can live for a week or even longer in the female reproductive system. Once you ovulate, the egg only lives for about 12 to 24 hours. So, the more sperm you have waiting, the better.

3. Have you scheduled a preconception appointment with your OB/GYN or midwife?

You may not want family or friends to know you’re trying to conceive, but you should absolutely tell your OB/GYN. You can schedule a preconception appointment dedicated explicitly to optimizing your chances of getting pregnant.

During that appointment, we’ll review diet and lifestyle choices, your current and historical medical history, and identify whether you know when you ovulate. If you’re unsure about your fertile window or aren’t one to track your periods, we recommend using a fertility app, which is a spectacular tool. After three to four months of following your symptoms and periods, touch base with us, and we’ll go from there.

4. Do you ever skip periods?

If you’ve skipped periods your whole life, it may feel “normal” to you. But the truth is that irregular periods are never normal. Healthy women ovulate every month – with the average menstrual cycle ranging from 24 to 38 days.

Skipped periods are a sure sign of factors preventing ovulation, which hurt your chances of getting pregnant as soon as you would otherwise. Some of the most common reasons for missed periods (beyond pregnancy or birth control) include:

• Being underweight or obese.
• Polycystic ovarian syndrome (PCOS), is a leading cause of female infertility in the U.S.
• Chronic stress
• Approaching menopause (if you’re <44, you may be experiencing early menopause).
• Extreme athleticism (many marathon runners, triathletes, climbers, and other extreme athletes skip periods and need to alter their exercise routine before and during pregnancy).

Please let us know if you skip periods because we need to find out why to optimize your fertility chances.

5. Are there any underlying reasons for infertility?

There are other underlying reasons you may experience difficulty conceiving. They include:

• Having endometriosis.
• Fibroid tumors (non-cancerous tumors that can alter the shape of the uterus).
• Certain medications.
• Tubal scars or blockages (often the result of a previous STD or pelvic infection).
• Uterine abnormalities.
• Lifestyle factors (smoking, excessive drinking, recreational drug use, and poor diet/exercise habits) impact fertility in men and women.

These are all of the things we’ll review with you when you schedule a preconception appointment. We’ll order imaging and screening to learn more about your reproductive organs if necessary.

6. Has your partner’s sperm been tested yet?

As the introduction mentions, 12% of adult couples struggle to get pregnant. However, the cause of infertility is shared 50/50 between men and women. So often, the focus goes on the female. It’s just as likely that your partner’s sperm is the culprit.

If you’ve tried to get pregnant for 12 consecutive months without fail (less time if you’re 36 years old or more), have your partner’s semen analyzed by a fertility specialist. General lab technicians do a decent job of sperm analysis but are not as experienced as lab techs in a fertility clinic. We’ve had patients whose partners got the all-clear – only to find out it was, indeed, a sperm issue when a fertility clinic tested the semen sample.

7. Fertility treatments can be as simple as a single pill.

Don’t panic and assume the worst. Just because you struggle to get pregnant doesn’t mean you need IVF. First, we’ll work to establish – and treat – the underlying cause. We may also prescribe Clomid, which has success rates of up to 80% when prescribed correctly and for the right reasons.

It’s only after three failed Clomid cycles that we’ll talk about referring you to a fertility specialist.

Schedule a Preconception Appointment with Northwest Women’s Clinic