When should you seek assistance to conceive?

The general rule that most people quote is that women under the age of 35 years should try to conceive for 12 months prior to seeking assistance, and women 35 years or over should try to conceive for 6 months before seeking assistance. The reason that women 35 years or over are advised not to try for a full year prior to seeking assistance is that egg quality and quantity decreases with age, and after around 35 years of age it becomes increasingly difficult to conceive. With delays in conception, the difficulty increases further. Therefore, it is imperative that any obstacles to natural conception are identified early and, if natural conception is unlikely to occur, intervention instituted as soon as possible.

The exception to the ‘try for 6-12 month rule’ prior to seeking assistance is if there is a known or suspected problem. Examples include:

  • Irregular periods – this almost always indicates that a woman is not ovulating regularly, and if a woman isn’t releasing an egg each month, then it is very difficult to conceive without some assistance
  • Very painful periods – suggestive of endometriosis which reduces fertility
  • Very heavy periods – suggestive of uterine pathology such as fibroids
  • History of a sexually transmitted pelvic infection – fallopian tubes may be blocked, making it impossible for the sperm and egg to meet
  • History of miscarriage, especially if recurrent miscarriages
  • History of cancer requiring chemotherapy – chemotherapy can substantially reduce the ovarian reserve (number of eggs remaining in the ovaries)
  • Family history of early menopause – you may also have an early menopause, so there may be a limited amount of time in which conception is possible
  • If you are a known carrier of a genetic condition that predisposes you to develop cancer, eg, the BRCA mutation that predisposes to breast or ovarian cancer – it is possible for us to freeze eggs for you at a relatively young age so that if you develop cancer in the future and require fertility-damaging cancer treatment, we will have already stored eggs for later use
  • Family history of a genetic condition – there is a good chance that if members of your family are affected with a genetic cancer and you are a carrier or are affected, we can use IVF techniques with preimplantation genetic testing of embryos to ensure the genetic problem isn’t passed on to your children
  • Any other fertility-related concerns you may have

There are different times when couples seek assistance:

  • Prior to any attempts to conceive because they would like a full fertility assessment prior to attempts to conceive, or due to concerns that they have a condition that may decrease fertility
  • After trying to conceive for a short amount of time because they want reassurance that everything is ok and that they have a good chance of conceiving naturally
  • After trying to conceive for a significant amount of time and becoming frustrated and upset that conception has not occurred

After having one or more miscarriages

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