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Q&A: When to start worrying about fertility issues?

How long should I wait before getting worried? And how do I know if it's me or my partner that has the problem?

Re: How long should I wait before getting worried? And how do I know if it's me or my partner that has the problem?

The Bump Expert

It’s pretty common to start obsessing after just a month or two of trying to conceive without success. You’ve spent so many years terrified of getting pregnant -- of course you'd assume it would happen within seconds of throwing out that last pill package. (Right?) And as you come to find out that's not quite the case, it's only natural to start jumping to conclusions. But, although it is actually harder to get knocked up than those high school sex ed classes would have you believe, you probably don't have much to worry about.

Most docs say you shouldn't worry until after an entire year of trying to conceive with no success. But, if it’s been nine months or so and you’re worried something’s wrong, don't hesitate to ask your OB to refer you to a reproductive endocrinologist (R.E.)for some tests. If there’s a physiological reason you’re not conceiving you can start exploring your options, and if the tests come back normal you can relax and keep at it. The one exception: If you’re over 35, you might want to visit a specialist after just six months of TTC. Fertility starts to decline at this point, and by discovering any problems early you can avoid wasting time.

Warning signs and red flags

Wondering if the reason things are taking so long have to do more with you or your partner? It's super common for women to blame themselves for fertility issues, but the truth is, about 35 to 40% of cases with infertility issues can be traced back to the man, another 35 to 40% can be traced to the woman, and the rest fall into a grey area mostly due to a combo of factors. The only way to know for sure is to meet with a Reproductive Endocronologist and both get tested. Still, there are some warning signs that could point you in the right direction, even before you see the doc.

Common causes of male infertility

If the problem lies with your guy, the most common culprit will be a sperm disorder -- such as low sperm count, slow sperm motility, or a deficiency in forward progression (the sperm's quality of movement). And any of these problems could be caused by a variety of factors. Here are some biggies to keep in mind, though:

- Age (His sperm count may not decrease, but it starts to lose motility around 40.)
- Immune problems (This can also impact motility and the sperm's ability to implant itself in your egg.)
- Weight issues (If your guy is underweight or overweight, it may be taking a toll on his sperm function.)
- STDs (Untreated STDs could impact sperm transportation, but this can be improved dramatically if he seeks treatment.)

Common causes of female infertility

In your case, there are (unfortunately) many more factors than can cause some bumps in the road on the way to having baby. Here are a few major ones that may be what's behind your fertility issues:

- Age (Even though this may not directly stand in your way of having a baby later in life, your egg count starts to significantly decline around 30 and may become a factor.)
Uterine Fibroids (About 80 percent of women in the U.S. have fibroid growths on their uterus, though in many cases they will not effect fertility at all. When they become problematic, however, you may need a surgery called a myomectomy.)
- Pelvic Inflammatory Disease (PID) (PID is an infection which causes about 20 percent of its carriers to be infertile, but this can often be solved with treatment.)
- Scar Tissue/Adhesions (Scar tissue bands of fibrous material can cause blockages in the fallopian tubes, leading to fertility problems. This can be rectified with surgery, and in less-serious cases, abdominal massage.)
- Ovarian Cysts (These fluid-filled sacs can sometimes grow on the ovaries and prevent eggs from developing or being released. They can sometimes go away on their own, but when they don't, laproscopic surgery may be necessary.)
- Polycystic Ovarian Syndrome (PCOS) (About 1 in 10 women have PCOS, and it's the most common cause of infertility. Signs of PCOS include irregular periods, excess facial hair, acne, and obesity. But many of it's fertility-blocking symptoms can be eased with regular exercise, weight loss, and medication.)
-Irregular Periods (Irregular periods -- and therefore irregular ovulation -- account for about 30 percent of infertility cases. Some patients may see their periods return to normal with a diet and exercise regime, while others may need to turn to meds like Clomid to help out.)

If you've been struggling with fertility for some time, and either you or your partner have one or more of the above symptoms, speak with your OB about scheduling an appointment with an R.E. as soon as possible, to see if something more may be at play.

The Bump Editors | May 01 , 2009 11:02 AM

Q&A: When to start worrying about fertility issues?

I also HIGHLY suggest reading "Taking Charge of Your Fertility." I started it about two months ago and am absolutely amazing at the information that this information isn't given to us. It seems a lot of people have TTC issues just because of timing! I've been charting now for two months and TTC just this month. I can take my first pregnancy test on Monday. With this book, you'll learn about YOUR best time to conceive, the factors that influence ovulation, if your leutal phase is the proper lenght and then, truly, when to see a doctor.

playinghouse | September 18 , 2009 10:45 AM

Q&A: When to start worrying about fertility issues?

We've been off the pill since September and ...... nothing........ I'm 32 and worrying. Any suggestions? I chart and have 28 day clockwork cycles. I had used BC for over 10 years off and on. How can I know if I'm ovluating?

LAURA.CYR | June 23 , 2010 2:43 AM

Q&A: When to start worrying about fertility issues?

I am 30 years old, and we are getting married in 10 weeks time. I love to foreward plan and so I recently went to my specialist fertility clinic to do what's called an Egg Timer Test. It might be called different things in different locations, but the test basically tells you what your Ovarian Reserve is and what your Folicle Stimilate Hormone level is (that's the hormone that triggers ovualtion). The test cost us a coupel of hundred dollars with a government rebate for part of it. They take blood and then do an ultrasound of your ovaries. It's painless and really informative. It won't tell you how "long you have", but it will tell you where you are at right now in terms of your current levels. So if you are worried, it can be a great test, to set your mind at rest, I am so glad that I had it done.

MISSJAYMIEJAY | October 05 , 2010 6:21 PM

Q&A: When to start worrying about fertility issues?

Have you tried ovulation test strips? You can purchase them at a pharmacy or online.

Kamy07122008 | October 05 , 2010 8:05 PM

Q&A: When to start worrying about fertility issues?

We've been ttc since June and nothing yet. I went to my doctor last month and she said I was counting my days wrong. So we have started "over" last month. My cycle varies so I ordered some ovulation kits today and that should be arriving within the next few days. The reviews that I read were great and a few of my co-workers have used the kits and they conceived fairly quickly. I hope they work for us. Goodluck to everyone trying.

KimRhone | October 05 , 2010 10:28 PM

Q&A: When to start worrying about fertility issues?

My Hubby and I have been TTC now for 9 months, since January...nothing so far. :( I have charted with bbt, I have used ovulation tests, still nothing. My Dr won't even begin to talk with me until we've been ttc for a full year, so I am left worrying every month if it's ever really going to happen. I know worrying doesn't help, so I have stopped charting and using ovulation tests last month. We'll see how that goes - the "don't worry about it and it'll happen" theory. The charting and ovulation test were great because I now know more about my cycle than I ever did and I know that I have been ovulating, but I found myself almost obsessing over it. Info is good if you don't let yourself go too overboard. Good luck to all trying!!!!

loestreich | October 08 , 2010 9:20 PM

Q&A: When to start worrying about fertility issues?

My hubby and I have been TTC for 3 months now and no luck :( . I took an ovulation test and it came back that I was positive for LH. I didn't get pregnant. I got my period. Ive even tried the lifting bottom with a pillow,still didn't work. I'm not giving up yet since its only been 3 months. I wish those luck who are TTC as well!!!

are2009 | October 20 , 2010 11:06 PM

Q&A: When to start worrying about fertility issues?

My huband and i have been together for six years. We,ve never used protection. im 25 and have ovarian cysts and an inverted cervix. my doctor said this could cause a small problem but could it be worse than we thought?

beubie123 | December 05 , 2010 4:14 PM

Q&A: When to start worrying about fertility issues?

I agree with the person who said read "Taking Charge of Your Fertility." I have pages earmarked in that book; it's fantastic! I read it before going to my new OBGYN (my husband is military and we just moved boooo!!!) and I was more knowledgeable than the doc. I know that is a huge leap of an assumption, but when the doc tells me that my cycle IS 28 days long and that I WILL ovulate +/- 14 days into my cycle....yeah...The book is absolutely amazing. EVERY woman, regardless of if you're TTC or not, should read it.

anbenson | January 25 , 2011 7:27 PM

Q&A: When to start worrying about fertility issues?

OK so not sure where I should post this for answers, but I need to figure out my timing and not sure how. I have regular periods, but it's a little strange. For about a week before normal flow starts I have brown/red discharge (happens before every period, not implant bleeding), and then I have about 3-4 days of a normal/heavy flow. I don't know when to start or what all to do. Need help please! I want to conceive ASAP as we all do :)

Tadpol2000 | January 26 , 2011 1:37 PM

Q&A: When to start worrying about fertility issues?

To Tadpol2000 that sounds exactly like my period! I'm not sure what it means though. My hubby and I have been TTC for going on 4 months. I bought an ovulation kit from the store to figure out when I was ovulating and it said the same time 2 months in a row but still no luck. Good luck to you! I'd be interested to hear if that type of period means anything

Suzanne0046 | January 26 , 2011 8:57 PM

Q&A: When to start worrying about fertility issues?

My husband and I have been together for 8 years... we have been TTC for almost 2 and a half years. I've seen a fertility specialist, and he can see no logical reason why we don't have children. I'm almost 25 years old, and my husband is 28. We are both healthy, active indiividuals with no medical concerns or family history of infertility. I chart on a monthly basis, but this month I ordered ovulation tests to help be more accurate. Has anyone else had more luck with ovulation tests than charting on your own?

Jillis20 | April 25 , 2011 6:32 PM

Q&A: When to start worrying about fertility issues?

The advice to "relax and keep at it" if your fertility testing comes back normal is completely wrong. If you're not able to get pregnant on your own after a year, then there is a small chance that you will, without some help. It's called "unexplained infertility". They can't test for everything that may be keeping you from conceiving. Often early treatments include Clomid (and IUIs) which requires monitoring, since it can make you ovulate multiple eggs. After several cycles of failure w/these, we opted for IVF, and after nearly three years of trying, we are now pregnant with twins. You have to take charge of your health, unless you have years to keep trying. We're in our early 30's, so we didn't feel like we had forever to wait.

kthappy76 | June 20 , 2011 10:16 AM

Q&A: When to start worrying about fertility issues?

Impatience does not equal infertility.

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Q&A: When to start worrying about fertility issues?

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