Worried About Infertility? Here’s What to Do

If you’re having difficulty conceiving, it may be time to work with a fertility specialist.

Typically, an infertility evaluation includes a medical history, a physical exam and fertility testing.

Medically reviewed in August 2021

From sperm malformation to gynecologic diseases, there is a wide range of factors that can affect fertility. If you’ve been trying to conceive for a year or more without success, or if you’re 35 and older and haven’t had any luck for the past six months, it’s time to talk to a healthcare provider (HCP) about infertility. 
Many HCPs, including OBGYNs and primary care physicians, can perform a basic infertility evaluation, explains OBGYN Gregory Starks, MD, with Midwest Women’s Healthcare Specialists in Kansas City, Missouri. Here’s what you can expect, along with possible next steps.  

Fertility testing and treatment 
Typically, an infertility evaluation includes a medical history, a physical exam and fertility testing. While the process for men is non-invasive and focuses on semen analysis, the process for women may be much more involved.  

"A woman should expect an extensive evaluation of her infertility history, a review of old records, a possible exam, further targeted testing and protocol selection for future management,” says Dr. Starks. More specifically, your HCP may have you chart your body temperature to track your ovulation and/or they may take blood samples. They can also order procedures to examine the causes of infertility, such as a hysterosalpingogram (HSG), which looks for abnormalities in the uterus and fallopian tubes.  

Sometimes, providers can’t find a cause for infertility. Called unexplained infertility, RESOLVE: The National Fertility Association estimates it occurs in about one of every five couples. However, it does not mean you will not be able to get pregnant.  

Once you have been evaluated, treatment can begin. Most of the time, people with infertility are able to conceive with help from medication or surgery. This includes in-vitro fertilization (IVF), during which a woman’s eggs are fertilized in a lab and then implanted into the uterus.  

“IVF is needed when there are unresolved male factors, occluded fallopian tubes, extensive endometriosis, age-related factors and unresolved issues from traditional therapies,” says Starks. “This therapy resolves the vast majority of reproductive issues.” Speak with your HCP about the best fertility options for you. 

Questions to ask a fertility specialist 
Stay informed by bringing up questions throughout the fertility evaluation and treatment processes. Your HCP should be able to provide answers or refer you to someone who can. Be sure to ask:  

  • How will you find the cause of the infertility? What fertility testing is involved for me and my partner? 
  • What fertility treatments are good choices for me? 
  • How many of these treatments has your practice done before? 
  • How successful are fertility treatments? 
  • Should I make any lifestyle changes to help with treatment? 
  • Do fertility treatments have any risks? 
  • Will my insurance cover fertility testing and procedures? How much do they cost? 

As more questions occur to you, write them down and bring the list to appointments. Together, you and your HCP can make the best fertility decisions for you.

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