Fertility challenges are more common than many people realize. According to the Centers for Disease Control and Prevention (CDC), about 1 in 5 heterosexual women aged 15 to 49 with no prior births are unable to get pregnant after one year of trying. While many couples conceive within a year of trying, others may need support sooner, especially for women over the age of 35 or those with known reproductive health concerns.
Austin-based board-certified reproductive endocrinologist Dr. Shahryar Kavoussi explains, “Couples should consider a fertility evaluation if they’ve been trying to conceive for 12 months with no success. But for women 35 or older, we recommend seeking help after 6 months of trying. Early evaluation allows us to identify and address any potential issues sooner rather than later.”
What Is a Preconception Workup, and Should You Get One?
One of the best ways to be proactive is to schedule a preconception workup, which is a comprehensive assessment that evaluates reproductive health for both partners. This can include hormonal testing, ovarian reserve assessment, semen analysis, and lifestyle evaluations. A preconception workup gives couples valuable insights into their reproductive potential, which is especially helpful for couples who are planning to conceive soon but may have risk factors like irregular cycles, previous pelvic infections, or a history of miscarriage.
On the male side of fertility, reproductive urologist Dr. Parviz Kavoussi adds, “Men are often overlooked in the early stages of fertility evaluations, but male factors contribute to infertility in more than half of all cases. A semen analysis can reveal a lot, and we encourage men to take part in a preconception workup if pregnancy doesn’t occur within the expected timeframe.”
Red Flags and Risk Factors
Sometimes, signs of infertility aren’t obvious. But certain red flags may indicate it’s time to seek help:
- Irregular or absent menstrual cycles
- Severe menstrual cramps or pelvic pain
- Prior pelvic surgeries or infections
- A history of miscarriages
- Known medical conditions like endometriosis or PCOS
- Difficulty achieving or maintaining an erection
- A history of undescended testicles or testicular trauma
Other risk factors, such as smoking, excessive alcohol use, obesity, and high stress levels, can also impair fertility in both men and women.
To learn more about early indicators of infertility, read more on recognizing the warning signs of infertility in men and women.
Why Age Matters
Age plays a significant role in fertility. Female fertility naturally begins to decline in the early 30s and more rapidly after age 35, while male fertility typically starts to decline after age 40, although the decline is more gradual.
According to Dr. Shahryar Kavoussi, “If a woman is over 35 and has been trying to conceive for six months without success, we advise seeking help promptly. And for women over 40, an evaluation is recommended right away. Time matters when it comes to egg quality and ovarian reserve.”
Dr. Parviz Kavoussi echoes that urgency for male partners: “Even though men remain fertile later in life, advanced paternal age can impact sperm quality, leading to longer time to pregnancy and increased risks for certain conditions. Earlier testing helps us guide couples more effectively.”
Next Steps: How a Fertility Specialist Can Help
Consulting with a fertility specialist provides answers and helps you form a plan based on your unique needs. In many cases, lifestyle adjustments, timed intercourse, or minor treatments can result in a successful pregnancy without the need for advanced interventions.
Ideally, both partners should be evaluated to gain a comprehensive understanding of the factors affecting fertility and to develop an appropriate treatment plan. A few clinics across the country offer a couples-based approach, with both in-house male and female fertility specialists working together.
Beyond the couples-based approach, it’s also important to consider factors like a clinic’s certifications, staff expertise, laboratory quality, and support services when choosing a fertility center.
