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When should I seek fertility help?

It’s not always easy to get pregnant.

“Some people are shocked to find out that for young, healthy couples under age 35, who have no fertility problems, the chance of conceiving every month is only 20 per cent, or one in five,” says Dr. Sony Sierra, a gynecologist at Women’s College Hospital who specializes in Reproductive Endocrinology and Infertility.

“That’s not a lot, so pregnancy may not happen immediately,” she says. But the odds are good that it will happen within a year. “Within 12 months, about 86 per cent of couples will conceive.”

However, studies have shown that beyond 18 months of trying, if a pregnancy hasn’t taken place, then the chance of pregnancy per cycle goes down to about two or three per cent per month. So after 12 months, the likelihood of conceiving declines with the length of time that a couple has been trying.

When to seek help

When to seek fertility help varies with age and other considerations.

“For couples under age 35, who are healthy and have no history of gynecologic problems, I would recommend they see a reproductive endocrinology specialist for a fertility workup after 12 months of trying to conceive,” Dr. Sierra says.

“Because we know that fertility starts to decline around age 35, couples who are older than that may not want to wait that long. In this age group, it’s a good idea to seek fertility help after six months of trying without success.”

Conditions that affect fertility

Some gynecological issues may affect a woman’s fertility. These conditions include:

  • endometriosis
  • irregular menstrual cycles
  • polycystic ovary syndrome (PCOS)
  • fibroids

Young women (under 35) who have these conditions may want to seek fertility help after six months of unsuccessfully trying to get pregnant, instead of waiting a year. But Dr. Sierra suggests that young women with gynecological conditions do try to conceive on their own before seeking fertility help.

“It’s difficult to predict which women with conditions like endometriosis will have fertility issues, and which ones won’t,” she explains. “Young women with gynecologic issues can try to conceive on their own for a few months. If they are in that younger age group, there will be time for assisted treatments later if necessary.”

The exception is women with conditions that are certain to affect their ability to get pregnant, such as blocked fallopian tubes. These women will want to seek fertility help as soon as they are ready to start a family.

Healthy habits

Before getting pregnant, it can be helpful to maintain good health habits that may affect long-term fertility, Dr. Sierra says.

“That includes maintaining a healthy BMI, not smoking, using alcohol and caffeine in moderation, and avoiding potentially harmful substances such as BPAs.”


This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: August 22, 2014

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