Most people will visit their doctor if there is no pregnancy after 12 months of trying. For anybody who is concerned about fertility, especially if they are older (women over 35), it might be a good idea to see a doctor earlier. As fertility testing can sometimes take a long time, and female fertility starts to drop when a woman is in her thirties, seeing the doctor earlier on if you are over 35 makes sense.
The doctor will give the patient advice and carry out some preliminary assessments. As it takes two to make a baby it is better for both the male and female to see the doctor together. Before undergoing testing for fertility it is important that the couple be committed. Fertility testing and investigation can be a lengthy process, and female fertility decreases with age, so it is best to make an appointment early on. It is always best for both partners to visit their doctor because fertility problems can affect a man or a woman and sometimes both partners.
A complete medical history and a physical exam are the first steps in diagnosing a fertility problem. Both partners need to be evaluated. The couple may also need blood tests, semen specimens from the man, and ultrasound exams or exploratory surgery for the woman.
Other factors to consider include:
AGE: your doctor will discuss your age, as fertility in women declines with age.
CHILDREN: If you are a woman, your doctor will want to discuss with you any previous births and any related complications with your pregnancy. They will also ask about any miscarriages you may have had. If you are a man, you will be asked whether you have had any children from previous relationships.
LENGTH OF TIME TRYING TO CONCEIVE: Your doctor will ask how long you have been trying to conceive. Around 95% of couples are able to conceive naturally after two years of having unprotected sex. If you are young and healthy, and you have not been trying for a baby for very long, you may be advised to keep trying for a little longer.
SEX: You will be asked how often you have sex, and whether you have any difficulties during sex. You may feel uncomfortable or embarrassed about discussing your sex life with your doctor. However, it is very important to be open and honest. If the fertility problem is to do with sex, it might be overcome easily.
LENGTH OF TIME SINCE STOPPING CONTRACEPTION: You will be asked about the type of contraception you previously used, and when you stopped using it. It can sometimes take a while for certain types of contraception to stop working, and this may be affecting your fertility.
MEDICAL HISTORY AND SYMPTOMS: Your doctor will want to discuss any medical conditions you have, or have had in the past, including sexually transmitted infections (STIs). If you are a woman, your doctor may ask how regular your periods are and whether you experience any bleeding between periods or after sex.
MEDICATION: The side effects of some medication can affect your fertility. So your doctor will look at any medication you are taking, and might discuss alternative treatments with you. You should mention any non-prescription medication you are taking, including herbal medicines.
LIFESTYLE: Several lifestyle factors can affect your fertility. Your doctor will want to know: if you smoke, how much you weigh, how much alcohol you drink, whether you take any illegal drugs, if you are stressed. They may recommend changes to your lifestyle to increase your chances of conceiving.
After taking a medical, sexual and social history, your doctor may carry out a physical examination, or refer you for tests.