One year of well-timed trying - six months if 35 or older, per the Office on Women's Health - and immediately for irregular or absent periods, known conditions like PCOS or endometriosis, prior pelvic infection or surgery, cancer treatment, or two or more miscarriages.
The time-saving rule: evaluate both partners from the start - male factors account for roughly a third of cases, and the semen analysis is simple, cheap, and noninvasive. The first workup: history, hormone blood tests, ovulation tracking, semen analysis, and ultrasound.
What to do
Common questions
When should I see a doctor about fertility?
The standard line, per the Office on Women's Health: see a doctor after one year of regular, well-timed trying without conceiving - shortened to six months if the woman is 35 or older, because egg quantity and quality decline faster from the mid-thirties and time matters more. Several situations skip the waiting entirely and deserve an immediate workup: irregular, very painful, or absent periods (ovulation may not be happening); a known condition - PCOS, endometriosis, thyroid disease; a history of pelvic infection, STI, or abdominal or testicular surgery; two or more miscarriages; or known cancer treatment. And the rule that saves the most time: both partners get evaluated from the start - male factors account for roughly a third of cases and another third are shared or unexplained, so the semen analysis (simple, cheap, noninvasive) belongs early, not after a year of female-side testing. What the first visit looks like: history, hormone blood tests, ovulation tracking, a semen analysis, and usually an ultrasound and a tube-patency check if needed - much of it manageable in stages. Pymander, a free AI doctor available 24/7 by text, can help you prepare the questions.