Ready to have a baby? Most couples will get pregnant on their own within six months of stopping birth control. However, if it has not happened for you yet, and you are beginning to worry about your fertility, the most important question you need to ask yourself on a regular basis is whether to seek professional help now or to continue to try on your own.

Your answers to these questions will help guide you in making the right decision.

How old are you (wife’s age)?

29 or under:

Good news! Your age group has the best predicted outcome of all! This means that you are the least likely to end up without ever having a baby. You are the least likely to have a miscarriage and the least likely to have a child with genetic disease. The average time it will take you to get a baby is predicted to be shorter than for people in the other age groups.

Most of you in this age group will not be seeking infertility help yet. In fact, many times, when couples in your age group actually do come to me for advice, after finishing the evaluation, I may offer them a few tips on how to make some simple changes to improve their chances of conceiving and then I would advise them to postpone starting medical treatment and to continue trying on their own with a set deadline of when to come back for treatment. Furthermore, after an initial infertility consultation, most couples in this age group who test normal can end up getting pregnant on their own within a few years without any further treatment at all.

Depending on your answers to the other screening questions, you are probably not recommended to seek expert help in conceiving at this time.

Continue to next question.

30 to 34:

You are in a group that still has good expected outcome. Your overall fertility is only slightly diminished (25% lower) in comparison to the fertility of women in the 25 to 29 age group.

While this is slightly significant, it is still not a source of great worry yet.

While there is no tremendous urgency at this age, depending on how you answer the next questions, it may be wise to at least have a one-time consultation to discuss your overall fertility options and to help plan your decision-making.

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35 to 39:

Age 35 is what obstetricians officially set as the beginning of Advanced Maternal Age. Women in this age range are well advised to give serious thought to their fertility plans immediately. Bearing in mind that all women are different, it’s sometimes tricky to understand that at this age range, there are still many women who end up getting pregnant on their own very easily. However, there will also be many who have significant problems. It is estimated that out of all women who first BEGIN their attempts at childbearing after age 35, approximately one third of them will eventually need medical help. Babies born to mothers in this age range demonstrate an increased risk of congenital abnormalities in comparison to babies born to women in their 20’s. The miscarriage rate is also higher.

Regardless of what your answers to the other questions are, it would be wise to be proactive with regards to your fertility, meaning that six months after you stop using birth control methods, if you still are not pregnant, you should protect your future fertility options by seeking professional advice and professional help promptly.

Still unsure? Continue to next question for further clarification.

Ready to get help now? Click here for help in choosing a doctor.

40 to 44:

Each year in the US, only about 1 out of 150 women in this age group give birth. The explanation for this low number is partly due to voluntary reasons, in that fewer women are trying to have babies at this age as compared to when younger. However, there are major biological reasons as well, in that very few healthy eggs remain at this age range.

Now, if you are in this age group, and you are in the upper percentile of fertility for women your age, you can still have a healthy baby. However, if you are only of average fertility for a woman your age, it is far more likely that not that you won’t ever be able to get pregnant on your own. Standard infertility treatment using your own eggs can boost your odds slightly and the use of donor eggs can boost your odds tremendously.

If you are in this age range and you are serious about having a baby, unless you are in that lucky 1 out of 150, you are advised to seek help immediately even if it has only been a few months of infertility.

Still unsure? Continue to next question for further clarification.

Ready to get help now? Click here for help in choosing a doctor.

45 and over:

It is the most difficult to conceive by far when you are in this age group. Each year, about 1 out of every 2000 women in this age group will give birth and many of these births will involve the help of donor eggs.

Usually, when women over 45 come ask my advice, I will go over the statistics with them with regards to odds of pregnancy, odds of miscarriage and odds of birth defects. There is still great hope, if you are open to the idea of donor eggs. The chance of having a healthy baby with the help of donor eggs can be 60% or higher. Some women wish to try some low-tech treatment options with their own eggs for the purpose of achieving closure and being able to tell themselves that they have given it a good try. As long as their health is not jeopardized and as long as they do not make extreme financial commitments, I can empathize with the value of this for certain individuals. However, in all honesty, without donor eggs, it is extremely unlikely (much less than 1% chance) that a woman in this age group will get pregnant and give birth to a healthy baby.

My advice is for women in this age range to come in right away if they are interested in having a baby with the help of donor eggs. If using donor eggs is not an option for them, then they should be prepared that there is not a tremendous amount of hope.

Of note, it is a tricky situation when high-profile celebrities age 45 and over get pregnant with the help of donor eggs, but for privacy reasons, choose to publicly deny that donor eggs were ever involved. On one hand, these women certainly have a right to their privacy, but on the other hand, they must realize that they are misleading the public in a way which could be partly responsible for many women making bad decisions about their own fertility plans with the overconfidence that they can wait until 45 to start trying.

Continue to next question.

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Duration of Infertility

Besides age, the next most important predictor of future pregnancy success is the duration of infertility. Some couples make a distinction between “trying”

How long have you and your partner been together without using any contraception?

Less than six months:

With such a short duration, it’s still very possible that you have normal fertility and can get pregnant on your own before one year. Remember that over 80% of normally fertile couples will get pregnant before one year. Since it has not even been six months for you, as long as you are under 40 and have no specific reasons to suspect fertility problems, you are fine just waiting. For tips on how to make the best of your natural conception attempts, click here.

Continue to next question.

6 months to a year:

One of the biggest fears facing couples in your situation is the worry that they are just wasting time, meaning that there could be something seriously wrong (very low sperm count, completely blocked tubes) that would make it impossible to conceive naturally. One strategy would be to get basic testing. A semen analysis is easy to do for under $100 and would rule out cases where the husband surprisingly has not sperm at all. There is no way to evaluate a man’s sperm by looking at him or by knowing his general health. If you find yourself passing 6 months and coming up on one year, you and in a gray zone where most people would not take advantage of professional help, but some would.

If it is important to relieve your anxiety now, then schedule a discussion with a specialist to help play your strategy. If you are OK with waiting, then set yourself a deadline for how long you’re willing to continue before getting help.

Continue to next question.

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1-2 years

Once you pass one year without contraception and still are not pregnant, you meet the official definition of infertility. It’s still not absolutely required to seek help yet, but you would be strongly advised to at least speak to a doctor and/or get some basic testing.

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Over 2 years

Get help now. Two years is a long time. While, it’s not impossible for you to still get pregnant on your own, it could take several years before it happens or it might not happen at all. You owe it to yourself to get checked out if you are still set on someday having children. Now, there are some small exceptions. For example, if during these two years, you had a pregnancy, but suffered an early miscarriage, it might be acceptable to give it another year as long as you are under 35 and you don’t suspect any other problems. Otherwise, two years of infertility is a clear signal to seek professional assistance.

Continue to next question.

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Specific Causes

Do you have any of the following?

Failure to have a menstrual cycle at least once every 35 days.

If you’re not having regular periods at least once every 35 days, chances are good that you are not having normal ovulation. In fact, even if you are ovulating and having a period every 35 days, you are still at a disadvantage because you will end up having 10 chance per year to get pregnant instead of the average 13 chances per year. This may or not be as significant, depending on your age. Once you suspect that you have an ovulation problem, it is wise to get the problem addressed rather than wasting valuable time.

Get help now.

Preexisting suspicions about sperm problems.

Men who have had unexplained infertility in a previous relationship, who have had chemotherapy or irradiation or who have serious medical problems, such as diabetes should have their sperm checked promptly before wasting too much time. Remember: There is no way to guarantee normal sperm, even if you are a healthy man with no medical problems. Only a semen analysis can accurately evaluate your status. If your sperm test is normal, you may go back to trying on your own with a little more peace of mind.

Get help now.

Extremely painful periods, enough to make you miss school or work.

Painful periods do not automatically mean you have endometriosis or scar tissue. However, it is certainly a risk factor. Women who suffer from infertility and pelvic pain will often seek medical help for the pain before they seek help for the infertility. Often, the solution for both problems overlap, so that things that will help the pain will also help the infertility. This is not always the case however, and sometimes, patients have to make the tough decision of which problem to prioritize, the pain or having a baby. If you have painful periods that are affecting your quality of life, you owe it to yourself to seek treatment now.

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Any other reason to suspect you have fertility problems.

If you have any other reason to be suspicious of your fertility, you are welcome to send your questions to Dr. Lee’s blog www.fertilityfile.com.

Hopefully, by now after answering these three questions, you now have a better idea of the status of your current situation. So, based on your answers to these questions, and your personal sense of urgency, what is your current decision regarding getting help?

- We are in no rush and are content to keep trying on our own for now, but would like some helpful information.

- We are ready to take steps to get pregnant by getting professional help.

Still No Rush

We would like to continue trying on our own. What are some suggestions and some resources that might help us?

  • 1.Make sure you are having sex NEAR the time of ovulation. There is no reliable way to predict the exact HOUR of ovulation. You can’t even 100% predict the exact DAY of ovulation. Fortunately, assuming you are not limited to having sex just once a month, you don’t need to be that exact in your timing, just close to it. For more information on timing of intercourse, read the following article.
  • 2. Optimize your health as much as possible. This means both physical and mental health. Being too thin or too heavy can adversely hurt your chances of conception. Excess caffeine and alcohol consumption and any smoking could hurt your chances as well. Excess stress could adversely affect your chances. Addressing stress consists of a combination of reducing the sources of stress as well as learning how to better handle unavoidable stressors.
  • 3. Do research. Learn what you can about infertility, with the reminder that there is a lot of bad wrong information out there among the good information. Done in a positive way, learning can be enjoyable, reassuring and empowering. Done in a negative way, this can become obsessive and stressful.
  • 4. Set a deadline. Don’t let time pass you by. If you are deciding to try on your own, make a firm deadline one year from now (or sooner) and mark it on your calendar so that if you are still not pregnant by then, you will reconsider the decision to get help at that time.

Judge for yourself

  • 1. Come for a no-cost no-obligation introductory visit.
  • 2. Come for a second opinion on IVF. $500 off IVF fees if you have failed a cycle of IVF elsewhere.

Introductory Visit

Still deciding?

Come visit our facility and find out if you are a good candidate for fertility treatment. Once or twice per month, we invite interested couples to visit and discuss their questions. There is no cost and no obligation to visit. Reservation required as space is limited. If we fill up, you are free to sign up for the following session.

Call now to reserve your chance. (714)256-0777

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