When to See a Fertility Specialist: Signs It’s Time to Get Support

 

Navigating fertility and trying to conceive can bring a mix of hope, anticipation, and sometimes worry. If you find yourself wondering whether it is time to bring in extra support, here is a detailed guide to help you recognise when it might be the right time to consult a fertility specialist. A fertility specialist can offer tailored insights and expert care that might be just what you need.

Author: Dr Mei Cheah

Understanding the Journey to Conception

Many people underestimate how long conception can take. Even in optimal conditions, getting pregnant often requires patience. Here are some key points to keep in mind:

  1. Conception is Not Instant

    For healthy individuals under the age of 35, about 85% conceive within one year when trying regularly. That leaves 15% still trying after 12 months.

  2. Timing and Frequency Matter

    Regular intercourse every two to three days during the fertile window increases the chances of catching ovulation correctly. Ovulation typically occurs mid-cycle but can vary, particularly in people with irregular periods

  3. Influencing Factors

    Several factors impact fertility including age, egg quality, sperm health, lifestyle, stress levels, hormonal balance and overall reproductive anatomy.
    Taking all these into account, if pregnancy hasn't occurred after a certain period of trying, consulting a fertility specialist may be advised sooner rather than later.

When to Seek Specialist Advice: Key Indications

  1.  After 12 Months of Unprotected Sex (Under 35)

    If conception hasn't occurred after 12 months of trying without contraception, and you're under 35, it is generally recommended to see a fertility specialist. That time frame allows for the chance that conception may occur naturally, but also ensures early identification of potential issues.

  2. After 6 Months (Age 35 or Older)

    Fertility naturally declines with age, and it can decline more steeply after age 35. If you are 35 or older and have not conceived after six months of regular, unprotected sex, it is wise to consult a fertility specialist. Early evaluation can accelerate access to appropriate interventions.

  3. Irregular or Absent Periods

    Irregular cycles or a lack of menstruation might indicate underlying issues such as polycystic ovary syndrome (PCOS), thyroid dysfunction, high stress levels or hormonal imbalances. A fertility specialist can guide you through investigations and treatments, such as lifestyle changes, adequate balance of caloric intake and output, or medications to help induce ovulation.

  4. Known Reproductive Health Conditions

    If you have a history of conditions such as endometriosis, PCOS, sexually transmitted infections, uterine fibroids or pelvic inflammatory disease, you may want to consult a fertility specialist earlier, even before the six or 12-month mark.

    Those conditions can interfere with fertility in a variety of ways, including scarring, hormone disruption, ovulation issues and inflammation.

    If you suffer from other medical conditions like diabetes, high blood pressure, thyroid disorders, autoimmune conditions, or any genetic conditions, it is also important to seek advice from a fertility specialist to help optimise your health and medications prior to conception.

  5. Previous Surgery or Pregnancy Complications
    Significant surgery, particularly involving your abdominal and pelvic organs, can impact fertility. Likewise, repeated miscarriages, ectopic pregnancies or other complications could signal underlying issues best addressed by a specialist.

  6. Male Factor Infertility

    Infertility is not solely a female issue. One in three cases may be due to male factor infertility. Consider seeing a fertility specialist if your male partner has a history of low sperm count, poor motility, varicocele, previous surgeries affecting the reproductive system, or other factors affecting sperm health. Most of the time, there are no obvious symptoms. Therefore, it is important for both partners to be present when seeing a fertility specialist as “it takes two to tango”.

  7. Genetic Concerns or Family History

    If either partner has known genetic disorders or a strong family history of hereditary conditions, it is prudent to consult with a fertility specialist. Genetic screening or counselling can offer peace of mind and guide your options for conceiving safely. We can also go through potential options to minimise passing on the specific gene to future offsprings, if known. 

  8. Same-Sex Couples or Solo Parents by Choice

    LGBTQ+ individuals or single people using assisted reproductive technologies, such as donor sperm, donor eggs or surrogacy arrangements, can benefit from consulting fertility specialists earlier in the journey to align legal, emotional and medical pathways.

  9. Emotional and Mental Health Challenges

    Fertility struggles can take an emotional toll. If anxiety, stress, grief, frustration or other mental health concerns are overwhelming, fertility specialists can connect you with a support network of counselling, peer support groups or referrals. Resilience is deeply personal, and building a team of professionals, including a fertility specialist, can help you stay grounded.

  10. Preparing for Assisted Reproductive Techniques

    If you’re preparing for or considering assisted reproductive techniques such as in vitro fertilisation (IVF), intrauterine insemination (IUI) or fertility preservation (eggs, sperm or embryos), a fertility specialist is essential. They provide evaluation, planning, monitoring and tailored treatment pathways to optimise success.

What Happens During a Fertility Specialist Consultation?

When meeting a fertility specialist, you can expect a comprehensive, thoughtful process that typically includes:

  1. Comprehensive Medical History
    The specialist will ask about menstrual cycles, past pregnancies, medical conditions, surgical history, sexual health, lifestyle, family history, genetics, medications and emotional well-being.

  2. Physical and Diagnostic Assessments

    • For people assigned female at birth: Pelvic ultrasound, hormone blood tests (FSH, LH, TSH, prolactin, AMH), and assessment of tubal patency (e.g. hysterosalpingography or sonohysterography).

    • For people assigned male at birth: Semen analysis to assess sperm count, motility and morphology.

  3. Treatment Options Discussion

    Treatment may range from lifestyle and dietary changes, ovulation induction, IUI or IVF, to surgical interventions or referral to mental health professionals.

  4. Personalised Timeline and Support Plan

    Based on results, specialists help determine the most appropriate timeline and plan for next steps, including at-home strategies, medical interventions or accessing fertility clinics and services.

Taking Charge: What You Can Do Before Visiting a Specialist

Your personal preparation can make appointments more effective and support your fertility journey holistically:

  • Track Cycles and Ovulation
    Keep a record of menstrual patterns, ovulation signs (such as basal body temperature or cervical mucus), and timing of intercourse. It’ll be helpful if you are using an app, and are able to show the summary of your cycle patterns. 

  • Healthy Lifestyle Choices
    Quit smoking, reduce alcohol, maintain a balanced diet, manage stress, get regular exercise and ensure a healthy body weight.

  • Consider Supplements
    Discuss with your doctor whether to supplement with folic acid, prenatal vitamins or other support, especially if there is a known deficiency.

  • Understand Fertility Tests
    Familiarise yourself with what common diagnostic testing involves, and which ones your doctor might suggest.

When to See a Fertility Specialist: Quick Reference Guide

You may wish to see a fertility specialist if:

  • You are under 35 and have not conceived after 12 months of regular unprotected sex

  • You are 35 or older and have not conceived after six months of trying

  • Menstrual cycles are irregular or absent

  • You have known reproductive health conditions (e.g. PCOS, endometriosis, fibroids)

  • You have had previous surgeries or pregnancy complications

  • Male partner has fertility concerns

  • There are genetic risks or a family history of inherited conditions

  • You are using donor gametes, surrogacy options or starting a solo parent journey

  • You feel emotionally overwhelmed by the fertility journey

  • You are considering or preparing for ART, like IUI or IVF

Taking the Next Step Toward Support

Figuring out when to consult a fertility specialist can feel daunting, but it is ultimately a proactive step toward taking control of your reproductive health. Whether it is early due to age, medical history or emotional pressures, or later after months or even years of trying, it is never too soon to reach out for help.

A fertility specialist can help assess your individual situation and guide your path with clarity and care. You do not have to go through this journey alone. Support, options and hope are often closer than you think.

Author Bio

Dr Mei Cheah

Dr Mei Cheah, a Fertility Specialist and advanced laparoscopic surgeon, brings over a decade of experience to the field of reproductive health. As a co-founder and director of Create Health and Create Fertility in Melbourne, Dr Cheah is dedicated to providing personalised, boutique fertility services. She specialises in managing endometriosis and fertility surgery, having completed advanced training in Reproductive Endocrinology, IVF, and endoscopic surgery. Dr Cheah also serves in both public and private sectors, mentoring the next generation of specialists and contributing to women's health advocacy. Recognised for her contributions to STEM and women's reproductive rights, she empowers patients to achieve their career and fertility goals with compassionate, holistic care.

 
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