When to seek medical care when trying to conceive

Once a couple has decided to have a baby, each month brings with it anticipation and potential frustration. For those couples who have practiced six to 12 months of preconception planning further waiting even longer can be more frustrating. In these instances trying to conceive can turn from excitement to anxiety and even stress.

Reproductive specialists believe that on average a woman younger than 30 years old should only seek the advice of her physician if she is not been able to become pregnant in 12 months. Because of the variety of different issues that can occur in the life and health of both men and women, it can sometimes take up to 12 months for normally healthy individuals to conceive a child.

It is also reasonable for a woman who is older than 30 years to check with her reproductive specialists after six months of trying to conceive unsuccessfully. Women over the age of 40 may want to speak with their physicians immediately – especially if they have a history of irregular or painful periods or pelvic inflammatory disease.

When going in to see the practitioner most will want to have a menstrual cycle and body change calendar in order to do an initial evaluation of where the problem may lie. For this reason women younger than 35 may want to start a calendar after nine months of being unable to conceive and women older than 35 after four months. In this way they will be able to bring in several months of data to the physician at their initial visit without having to go home and wait three to four more months.

Reproductive specialists will want to see the changes to body basal temperature and have a record of vaginal mucus. Using a regular calendar women can plot the dates they have their period, changes in vaginal mucus, basal body temperature each day and any pain or discomfort throughout the month.

In a study published with the American Society for Reproductive Medicine in 2008 clinical researchers attempted to estimate the probability that infertile couples will seek medical consultation. They designed a retrospective study in both the UK and France using 901 women between the ages of 18 and 60 years who all successfully achieved a live birth between 1985 and 2000. (1)

The results of this study show that 45% of women who had not yet become pregnant and were infertile after 12 months sought medical consultation and 75% thought advice after 24 months. Interestingly, the probability of seeking a doctor’s advice was half that for women who had already had children and only 45% who sought medical advice actually received infertility treatment.

Women under the age of 35 may want to start their infertility journey with their obstetrician but those women over 35 should most likely start their investigation with a reproductive specialist who is likely an endocrinologist. These specialists are well educated in the hormonal changes and problems that can lead to infertility for women.

While the recommendations for when a woman would seek the advice of her reproductive specialist is fairly laid out the types of testing or how they will discover whether there is a problem or not. Infertility testing is an art form and not a science so women should choose their physicians carefully.
(1) Fertility and Sterility: When do involuntarily infertile couples choose to seek medical help?
http://www.ncbi.nlm.nih.gov/pubmed/19022434
Resources

Centers for Disease Control and Prevention: A public health focus on infertility prevention, detection, and management
http://www.cdc.gov/reproductivehealth/Infertility/PDF/WhitePaper.pdf

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