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When should I seek fertility help?

Couple holds hands while a doctor with a clipboard interviews themOne of the biggest myths about getting pregnant is that it is easy.

"Most people are surprised 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.

"In other words, a positive pregnancy test may not happen immediately," she says. But the odds are good that it will happen within a year. "Within 12 months, about 85-90 per cent of couples will conceive without any help."

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 less than five per cent per month. Therefore, after 12 months, the likelihood of conceiving declines with the length of time that a couple has been trying.

When to seek help

"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 10-12 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

Dr. Sierra suggests that young women under 35 with these gynecological conditions try to conceive on their own before seeking fertility help if they are having regular cycles and no history of fallopian tube blockage. However, she recommends they seek fertility help after six months of unsuccessfully trying to get pregnant, instead of waiting a year.

"It’s difficult to predict which women with conditions like endometriosis will have fertility issues, and which ones won’t," Dr. Sierra explains.

Dr. Sierra recommends that women older than 35 seek fertility help as soon as they’re ready to start a family because advancing age further reduces their chance of conceiving. These women might want to initiate therapy options sooner to maximize their chance of getting pregnant in a shorter time frame, especially if they wish to have more than one child.

Healthy habits

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

"This includes maintaining a healthy body weight, not smoking, using alcohol and caffeine in moderation, and avoiding potentially harmful environmental toxins 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: April 22, 2019.

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