Updated by the Progyny Clinical Team — October 2025.
Trying to conceive can be a deep personal journey. For many people and couples, it can also be challenging — about 1 in 6 have trouble conceiving on their own. So, when is the right time to speak with a fertility specialist?
Understanding infertility
Infertility is usually defined as not getting pregnant after 12 months of regular, unprotected sex. This is based on the idea that most heterosexual couples (about 85%) will conceive within a year. But this definition doesn’t fit everyone. For people who don’t have both egg and sperm — like same-sex couples or single parents by choice — infertility can be based on their situation, and help may be needed from the beginning.
To support more people, the American Society for Reproductive Medicine expanded the definition of infertility. This helps those using donor sperm, donor eggs, or a gestational carrier get fertility care sooner.
Your age, health history, and any past surgeries or conditions may also affect when you should get checked. Your provider might recommend that you start testing earlier. A full evaluation can find possible causes of infertility, but sometimes no clear reason is found. This is called unexplained infertility, or subfertility.
Specialists who can help
Reproductive endocrinologists (REIs) are medical doctors who complete specialized training in reproductive medicine after a residency in obstetrics and gynecology (OB-GYN).
Your OB-GYN can help you get started by checking your risk factors, answering your questions, and beginning basic fertility tests. They may also work with an REI for more expert care if needed.
When to see a specialist
Age, medical history, and reproductive symptoms all play a role in when to seek fertility care. You may benefit from seeing an REI even before trying to conceive if you have:
- Irregular or absent periods
- A history of pelvic infection or pelvic inflammatory disease
- Chronic medical conditions
- Pain or difficulty with intercourse
- Past pelvic surgery
- Concerns about a partner’s sperm quality or ejaculation
If you’ve been trying to conceive without success, general guidance suggests:
- Under age 35: Seek care after 12 months of trying.
- Age 35 and over: Seek care after six months of trying.
It’s never too early to ask for support. Having an initial consultation doesn’t mean you have to start treatment. It’s a chance to learn more about your fertility and understand when getting help might be most useful. Your family doctor, OB-GYN, or REI can begin a preconception consultation and order basic fertility testing if needed.
What to expect at your first fertility visit
Most fertility clinics follow a similar process before your first appointment. You may be asked to:
- Complete a detailed medical history form (for you and your partner, if applicable)
- Submit prior test results or records
- Schedule specific lab work or imaging ahead of time
Bring a list of your questions and goals — and ask how your care team communicates (for example, by email, patient portal, or phone). Knowing what to expect can make your experience smoother.
At your first appointment, you’ll review your medical history, discuss any symptoms or risk factors, receive fertility counseling, and make a plan for diagnostic testing. You may also discuss potential treatment options.
Before you leave, make sure you understand which tests are recommended and what your follow-up timeline looks like. Remember: You are choosing the clinic and care team that will guide you through this process. A “high success rate” isn’t the only factor — choose a team that makes you feel heard and supported.
Common causes of infertility
Infertility may stem from egg factors, sperm factors, or a combination of both. Lifestyle and overall health also play an important role.
Common egg factors
- Hormonal issues such as polycystic ovary syndrome can prevent ovulation
- Blocked or damaged fallopian tubes from pelvic infections or prior surgeries
- Adhesions or ovarian cysts caused by endometriosis
- Congenital abnormalities or fibroids
- Endocrine disorders that affect reproductive hormones
- Medications or drugs that interfere with fertility
- Egg quantity and quality decline with age, though the rate varies by individual
Common sperm factors
- Sperm abnormalities, such as issues with count, shape, or movement
- Erectile dysfunction or ejaculation issues
- Past surgeries or vasectomy
- Hormonal or medical conditions such as diabetes
- Genetic conditions, like cystic fibrosis
- Medications, recreational drugs, smoking, or excess alcohol use
- Older paternal age can affect sperm quality and fertility potential
Testing and evaluation
A fertility workup helps identify the underlying causes and guide next steps.
Testing for those with ovaries may include:
- Uterine and tubal evaluation: Hysterosalpingogram, saline sonohysterogram, or hysteroscopy
- Ovarian reserve testing: Anti-Müllerian hormone and antral follicle count
- Ovulation assessment: Menstrual history, basal body temperature, progesterone levels, and luteinizing hormone testing
- Hormone and genetic screening
- Pelvic ultrasound, MRI, or laparoscopy
Testing for those with sperm may include:
- Semen analysis: Sperm count, motility, volume, and morphology
- Advanced testing: DNA fragmentation, leukocyte screening, or anti-sperm antibodies
- Scrotal ultrasound or hormone testing
- Genetic testing or testicular biopsy, when indicated
Your doctor will choose the most relevant tests for your situation.
Treatment options
Each fertility journey is unique. A treatment that works for one person or couple may not be right for another. Trust your care team to personalize your plan based on your results, health, and goals.
Lifestyle and timing
Healthy daily habits can support fertility for anyone trying to conceive. Your provider may recommend:
- Adjusting timing and frequency of intercourse
- Stopping smoking or substance use
- Achieving a healthy body weight
- Incorporating stress-reduction practices such as yoga or mindfulness
Medical and procedural treatments
Treatments typically used when egg or uterine factors are involved:
- Ovulation induction: Medications to stimulate or regulate ovulation
- Intrauterine insemination (IUI)
- Surgical procedures: To treat endometriosis, remove fibroids, or correct blockages
- In vitro fertilization (IVF)
- Intracytoplasmic sperm injection (ICSI) (used with IVF when indicated)
- Donor or gestational carrier options, as recommended by your care team
Treatments for sperm health include:
- Supplements such as zinc, selenium, CoQ10, or antioxidants (if advised by your provider)
- Varicocele repair or sperm retrieval procedures such as:
- Percutaneous sperm aspiration (PESA)
- Microsurgical epididymal sperm aspiration (MESA)
- Testicular sperm extraction (TESE)
- Assisted reproductive techniques like ICSI used in conjunction with IVF
Taking the next step
Fertility testing and treatment can feel overwhelming. Asking questions, understanding your options, and finding a care team you trust can help you move forward with confidence. Whether you’re just starting to try or already exploring treatment, you’re not alone — support and solutions are available.
If you have questions, Progyny is here for you. Please contact your Progyny Care Advocate for support.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.