When to see a fertility specialist
The usual thresholds
12 months of trying if you are under 35. 6 months if you are 35 or over.
These are guides, not rules — and there are good reasons to go sooner.
Go straight away, without waiting
- Your periods are irregular or absent
- You have known or suspected endometriosis or PCOS
- Previous pelvic infection or surgery
- Two or more miscarriages — ASRM (2026) defines recurrent pregnancy loss as two or more, and evaluation is offered at that point
- Either partner has a known fertility concern
- You are 40 or over
- Known or suspected male factor
- Previous cancer treatment
Why the threshold shortens with age
Not because conception becomes impossible, but because time itself becomes the scarce resource. Investigation and treatment take months. Waiting a full year at 38 costs more than waiting a year at 28.
Female age is a predictor of live birth — ESHRE grades this a strong recommendation. Ovarian reserve markers like AMH predict how you will respond to stimulation, but explicitly do not predict pregnancy or live birth. So a reassuring AMH at 40 is not a reason to wait longer.
Both partners, from the start
A semen analysis is quick, inexpensive and non-invasive, and should be among the first tests. Male assessment is still frequently delayed while the female partner is investigated — ask for both to be arranged together.
Early assessment is not a commitment to treatment
Often it is reassuring. Where something is found, knowing sooner widens your options rather than narrowing them.
If you are unsure whether it is too early, book anyway. No specialist will consider it a waste of time.
What to expect at a first appointment
History from both partners. Examination. Blood tests — day 2 or 3 FSH and LH, AMH, prolactin and thyroid function for the female partner. Pelvic ultrasound with antral follicle count. Semen analysis for the male partner. A test of tubal patency where there is reason to suspect tubal damage.
Which tests you need depends on your history, so let the specialist direct the sequence rather than requesting a broad panel upfront.
One practical thing
Bring any previous results, including old semen analyses and any carrier screening. ACOG notes carrier screening for a specific condition generally needs doing only once in a lifetime — repeating it is usually unnecessary cost.
Frequently Asked Questions
How long should I try before seeing a fertility specialist?▾
Per ASRM 2023: under 35, try for 12 months. Ages 35–39, try for 6 months. Age 40+, seek evaluation immediately. Try sooner if you have irregular cycles, PCOS, endometriosis, prior STIs, two or more miscarriages, or a partner with known male factor issues.
What tests are done at the first fertility appointment?▾
Typically: transvaginal ultrasound (antral follicle count), blood tests on day 2–3 of cycle (FSH, LH, estradiol, AMH, thyroid, prolactin), day 21 progesterone, and a semen analysis for the male partner. Additional tests like HyCoSy (tubal assessment) may follow.
What is unexplained infertility?▾
Unexplained infertility is diagnosed when standard testing finds no identifiable cause after 12 months of unprotected intercourse (or 6 months if over 35). It affects 15–30% of couples. Treatment typically involves IUI with ovarian stimulation, or IVF which serves both as treatment and as a more detailed diagnostic tool.