Although there’s no one single approach to fertility and the ability to conceive that’s right for every woman, the American Society for Reproductive Medicine provides some guidelines as to when you might want to start a discussion with your primary care physician or OB/GYN regarding your fertility.

• As a woman, the inability to get pregnant after 12 months of unprotected intercourse at an age younger than 35
• The inability to get pregnant after six months of trying over the age of 35.

Other Reasons to Ask Your Doctor

The American Society for Reproductive Medicine suggests you may also want to consider having a pregnancy conversation with your doctor if you:

• Have a chronic condition such as asthma, cancer, diabetes, thyroid disease or epilepsy, or you take medication for depression. The medication you take may need to be changed or tweaked for safety reasons, and your body may need some time to adjust to the new medication before you become pregnant.
• Are overweight, underweight or smoke. All of these things can contribute to complications for you and baby during or after pregnancy.
• Have a history of multiple miscarriages.
• Have any gynecological concerns, including endometriosis, pelvic inflammatory disease, fibroids, a sexually transmitted infection or polycystic ovary syndrome (PCOS). 
• Experience symptoms like daily pelvic pain, irregular periods or severe acne.
• Had previous pelvic or abdominal surgery. Such surgical procedures can leave scarring that may impede the ovulation or fertility process.
• Have a family history of an inherited disorder such as sickle-cell anemia, thalassemia or cystic fibrosis. 
• Have unexplained infertility.

Having a clear picture of your past and present health and lifestyle may help your doctor ensure you get proper care while you’re trying to conceive.

Next Steps with Your OB/GYN

If you decide to schedule an appointment with your OB/GYN, your visit will most likely consist of a thorough assessment of your medical history to rule out other possible problems such as thyroid disease, hypertension or diabetes — which can play a role in infertility. Your menstrual history may also be evaluated and your doctor may want to get you caught up on Pap smears and screenings for sexually transmitted infections (STIs).

Additionally, a number of tests may be performed to evaluate your fertility levels, such as:

• A pelvic ultrasound may be done to evaluate the pelvic anatomy
• Labs may be ordered for a set cycle day to assess ovarian reserve (an estimate of your supply of remaining eggs)
• Immediately following the end of the menstrual flow, a hysterosalpingogram (HSG) — or dye study — may be done to evaluate the uterine cavity and the patency of the fallopian tubes.
• The cycle-day 21 progesterone level may be assessed to determine if you experience ovulation
• A male semen analysis may be ordered for your partner to evaluate sperm count, motility (movement) or morphology (structure).